**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

While navigating her own recovery journey at The Emily Program, Teresa Schmitz discovered a hidden gift in being known as a great listener with a compassionate heart. Being earmarked as an IT Leader who was more into the people on her teams than the technology they were building, she realized her purpose was beyond her title. She connected the dots and soon realized her purpose was to help empower others. She pursued her dreams of becoming a coach and launched her own coaching business, My Best Self Yet.  She now helps women feel empowered to navigate the journey of loving themselves unconditionally. She also empowers others to know and use their character strengths in the In It Together group coaching program. Learn more about Teresa’s story and follow My Best Self Yet on Facebook, Instagram, and her blog.

Grief. We usually associate it with what happens when someone passes away, especially someone near and dear to us. It’s “normal” for people to grieve in that situation. We send cards. We call them up. We tell them how sorry we are to hear about their loss. We expect that they will need time off from work. We expect that they will cry and be sad. It’s a given. It’s grief after all.             

Did you know that grief can also show up when navigating a new health diagnosis during your eating disorder recovery journey?

I didn’t recognize this was the case until a recent appointment with my eating disorder dietitian. I’d been diagnosed with heart disease after a calcium CT scan in early February revealed that I have significant calcium built up in my left ventricle. This ventricle, if blocked with enough calcium build-up, can lead to a fatal heart attack since it’s the main artery. It’s why they call it the “widow maker.”

I did the right thing when I received the diagnosis. I started seeing a dietitian so I could incorporate this new diagnosis into my intuitive eating approach. I didn’t want to slip back into eating disorder symptom use by restricting and avoiding foods I enjoy, only to binge on them in secret because of the restriction. I knew how dangerous that could be, so I wanted to stay on top of that.

I’ve been mostly successful at keeping eating disorder behaviors at bay. What I didn’t realize is that I’d been grieving this new diagnosis this whole time and not allowing that to flow or let it out. I’d been holding it in. I’d been forcing myself to get a grip on the diagnosis as if it’s no big deal. Yet, it’s a huge deal in reality.

You see, my dad suffered his first heart attack at the young age of 42. Six weeks later, he suffered his second heart attack while trying to recover from the first. Five years after that, he suffered another and required quadruple bypass surgery. The last heart attack came fourteen years later. It was fatal. At the young age of 61, my dad was gone. He died instantly when awakening abruptly in the middle of the night suffering cardiac arrest. He rolled down the stairs and breathed his last breath in my mom’s frantic arms. It has weighed heavy on my mind over the years, especially when my own diagnosis came. At first, I wondered if I’d end up with heart disease like my dad. Once that was confirmed, the question shifted: Would I die young of a heart attack too?

Back in February when my doctor delivered the news about my scan, I did what comes natural to me when faced with news I don’t enjoy. I avoided. At all costs. I pretended that it was no big deal. I’ll work with my dietitian. I’ll eat “healthier” once I do that. I’ll be fine. I’m fine. It’s no.big.deal. I buried myself in expanding my coaching practice and keeping “busy,” all the while avoiding the elephant in the room.

The good news is that you can only stuff those feelings and avoid them for so long. Grief has a way of showing up when you least expect it if you don’t process it.

Mine showed up. I started to cry at my appointment when Regina (my super sweet and awesome dietitian) asked the simple question, “Is it actually the vegetable or is it that I don’t want to have heart worries?”

So much pent-up emotion came out of me in the moment. I missed my dad in that moment. I realized that once again I am not in control of my final destiny, even though I’d been trying diligently to control it. I realized my own mortality. I am here on this earth for a short time. I don’t know when my time is coming. “I want to live. Large,” I told Regina through tears. “I want to do it with loving limits,” I continued.

This is when Regina told me I was grieving. She summed it up nicely by saying, “In sessions, I hear so much grief around heart health and the worries and the impact that has added. And it really did rattle your feeling that you were in a recovered state and now need to add some rules here. How the heck does one do that?” True. I don’t want to have heart disease. To me, it brings up so much pain. And if I’m honest, it brings up fear. A lot of fear. Fear of dying young. Fear of regret. Fear of not living. Fear of loss. So much fear.

So now, I must grieve and go through the natural phases of grief – shock/denial, guilt, anger/bargaining, depression, acceptance – just like I did with my eating disorder diagnosis, in order to heal and live my life to the fullest extent. I’m still navigating between the denial and the guilt phases. I know I’ll make progress toward acceptance. It just might take a while. I know it means I need to be honest and give myself a lot of grace. This is a big deal and I’m not going to deny that anymore.

The post How Coping With Another Diagnosis is a Big Deal in Recovery appeared first on The Emily Program.

Whether we want to admit it or not, social media is a big part of our everyday lives. At best, it helps keep us connected and up-to-date on the latest trends. But, as we’re increasingly aware, social media can also pose significant risks. Different trends come with popular social media sites like Instagram and Facebook; one of these trends is “before and after” photos of those in eating disorder recovery. While some may think these photos show progress or success, recovery actually can’t be fully captured in a photograph. 

In this blog, we will explain the problems with “before and after” recovery photos on social media and how we should think beyond appearances when understanding eating disorders and the process of healing from them. 

The Issues with “Before and After” Pictures 

They can trigger body comparison.

People often post life changes or successes on social media, including milestones such as getting a new job, getting engaged, or buying a house. Another popular post in our diet culture is “before-and-after” photos of weight loss. “Transformation” pictures like this often receive enthusiastic compliments and praise.

In online recovery spaces, some people recovering from eating disorders also share their body changes, perhaps to celebrate their healing or show others that recovery is possible and there is hope to recover. However, sharing such a picture may come with unintended consequences, as these “before and after” photos can be incredibly triggering to those in recovery. 

The layout of “before and after” photos suggests that one photo—one body—is more desirable than the other. The photos imply that one body is bad, and one body is good. Whether the photos are showing weight loss or weight gain, the post reinforces the hyperfocus on weight already so present in our culture. These photos can trigger comparison, as people with eating disorders may think they are not “sick enough” if they do not look like the “before” photo. Many seeing this image may think that’s how someone with an eating disorder should look and it may lead them to feel they are not “sick enough” to get treatment. The “before and after” photo may send a message that a specific body size is “sicker” and therefore more worthy of help than another. However, anyone with an eating disorder deserves care and support. 

They reinforce a stereotypical view of eating disorders. 

In our culture, an eating disorder is usually shown as the stereotype of a young white female with anorexia. In reality, eating disorders include a range of diagnoses that can affect everyone and anyone. Restrictive anorexia is just one of many types.

Many of those with an eating disorder won’t have a dramatic “before or after” photo. These photos oversimplify the eating disorder experience and suggest that it can be summed up in a photograph. People of all different body sizes can have an eating disorder, and thinner doesn’t necessarily mean sicker. These photos not only oversimplify the diversity of bodies that experience eating disorders but also promote an incomplete view of recovery. Like illness, health and recovery exist across all body sizes. Again, these “before and after” photos show a very narrow view of what eating disorders and recovery look like.

They don’t show the whole picture. 

Eating disorders are not all about gaining or losing weight. The pictures suggest that this is only a weight disorder, which is not true. Eating disorders are mental disorders, but these “before and after” photos don’t show the mental aspect. They don’t explain the preoccupations, thoughts, feelings, or obsessions that are all experienced with the disorder. These photos give a narrow view of only focusing on physical weight, rather than the person’s mental health. But not everyone with an eating disorder experiences significant weight gain or weight loss in illness or recovery. 

These photos also give the impression that by gaining weight you are recovered. A photo will never show the experience of someone’s recovery. A photo will also never show the complex thoughts and feelings that those in recovery experience.

#BoycottTheBefore

Thanks to mental health advocate Lexie Manion, there is a movement that offers an alternative to the “before and after” photo trend. #BoycottTheBefore is a campaign she started to challenge the “before” photo of eating disorder recovery comparisons. Instead of showing a photo of a visibly sick body in the “before” spot, she included a black graphic with white text saying “I am so much more than a ‘before’ photo.” The photo accompanied a single photo of herself in the “after” spot.

Explaining that “before and after” photos can be triggering and damaging for someone in recovery, Lexie provides insight on how there isn’t a specific “look” to eating disorders or a specific “healthy” size. She explains that the photos only show physical changes and reinforce the stereotype that you must be underweight to have an eating disorder—when actually anybody of any size can have an eating disorder. 

Lexie encourages others to responsibly share their photos and think of those who are still struggling with disordered thoughts and beliefs. In an Instagram post about this movement, she says, “We are strong, resilient warriors, and we will go against the grain and continue to fight to be seen and heard – even if that means not receiving instant validation. Like recovery, change takes time; it is a journey but it is possible.”

Moving Forward 

No matter how it looks, everyone’s individual experience and feelings with their eating disorder are valid. Reminding those that there is hope and recovery is a step in the right direction, but we need to be mindful of how we do it. Our journeys, thoughts, and feelings can’t be summed up in one image. We are all so much more than a photo. 

If you or someone you know is struggling with food or an eating disorder, please reach out to The Emily Program. Call our admissions team at 1-888-364-5977 or complete our online form. 

The post The Problem with “Before and After” Photos appeared first on The Emily Program.

Tell us about yourself!

Hello, I am Melissa (she/her), and I am a Registered Nurse at the Anna Westin House for Adults (AWH) located in St. Paul, Minnesota. I’ve been at AWH for almost three years and currently work straight overnights, which I love. Before nursing, I was a medical assistant and worked in a maternity care center and an OBGYN clinic! I also do some volunteer EMS work for a small town close to where I grew up.

Describe the path that led you to The Emily Program.

I’ve always had a passion for healthcare but not always in the direction of typical medicine; due to some poor personal experiences, I have tended to resonate with a more holistic approach. I knew I wanted to change the patient experience but didn’t know what path or field I wanted because I had interests in several areas of healthcare (emergency medicine, pediatrics, labor, delivery/women’s care, and finally, MENTAL HEALTH!). Part of what I love about nursing is the ability to move around to different specialties and passions. I decided to follow my interest in mental health as there is still such a large stigma and I didn’t personally know many people who wanted to take this on professionally.

What led me to TEP is my interest in substance use disorders (SUDs)/recovery support and the incredible crossover and similarities between SUDs and eating disorders (EDs). I had a friend who was working for TEP, and although I really didn’t know much about EDs, I knew she loved the culture of the company, so I decided to interview and here we are.

What motivates you to show up for work each day? 

Knowing our work does make a difference and being a part of such an amazing team. I love my work family and what each team brings to the table to help our clients.

What do you wish everyone knew about eating disorders?

How common and deadly they are! EDs are not a choice! They don’t have a “look” or a type! All genders, identities, races, backgrounds, ages, shapes, and sizes can suffer from an eating disorder. Also, it’s important for people to know that if you do have questions or concerns about someone around you, approach with curiosity, and know there is support for you as a support person, not just the individual who is suffering. Just like with many other diseases and disorders, there is not a quick fix or one-size-fits-all solution, but there is hope and recovery is possible.

What three words would you use to describe The Emily Program?  

Work in progress—that is meant as the utmost compliment. I see the company and its individuals continuing to grow and learn daily. I think that it is a gift to not sit stagnant in the knowledge we have or things we think we know and always be open to learning and growing to better ourselves, our profession, and the world. I recently attended the 10th Annual Veritas Collaborative Symposium on Eating Disorders with class topics such as “Genes, Environment, and Eating Disorders: What the Clinician Needs to Know,” and it’s amazing what we are continuing to learn, including the genetic crossover between EDs and so many other things that we never even imagined could be related or linked.

What’s something you’re proud of?

Advancing my education and becoming a nurse. I honestly wasn’t the greatest student in elementary, junior high, or high school with topics either being too easy or too hard and my young mind not seeing why I should try so hard. This is partly why I went for medical assisting before nursing, as it seemed less intimidating at the time. I knew nursing school was very competitive and I didn’t think I would make it. When I found my niche in healthcare, I did very well in school and didn’t care how much work it took, as I had an end goal in mind of working in my dream career and hoping to make a difference.

What are three things most people don’t know about you? 

Well, I like to do “Fun Fact Friday” with my residents during vitals, so I know I have shared some of these with residents and coworkers but three things that come to mind are… I am an only child, I grew up in an earth home (this seems to be a popular one because it creates great conversations as most people have no idea what this is), and I had lots of fun pets as a child including a pet goat named Sally The Camel and a ferret named Mr. Mischief. 

The post Staff Spotlight, Melissa Dahl appeared first on The Emily Program.

With 9% of the U.S. population, or 28.8 million Americans, having an eating disorder in their lifetime (ANAD) and a person dying due to complications related to their eating disorder every 52 minutes, it is essential that healthcare professionals screen all their patients for eating disorders. The majority of people with eating disorders do come into contact with healthcare professionals, presenting an opportunity to detect symptoms and intervene early. 

October is National Depression and Mental Health Screening Month, which works to bring awareness to the need for depression and mental health screenings. Screening for eating disorders should be included in all mental health screenings. When it comes to eating disorder detection, knowing the physical symptoms to look out for, the questions to ask, and the people often left out of screenings is essential knowledge to have as a provider. 

Common Health Presentations of Eating Disorders

Eating disorders can cause many health issues that can lead those suffering to seek out help from a provider for those symptoms. Therefore, it is very important to know what symptoms can be an indicator of an eating disorder, as the individual may not explicitly ask for help for their disorder, even if they are willing to seek help for their symptoms. Here are some common health presentations of eating disorders that you might come across:

• Mental health issues
• Menstrual irregularity/amenorrhea
• Gastrointestinal problems
• Injuries caused by over-exercising
• Fainting or dizziness
• Dry skin and nails
• Sore throat
• Cold intolerance
• Leg cramps
• Hair loss

What to Ask Every Patient

The earlier an eating disorder is detected, the better the outcome will be. That is one reason why asking questions about food with your patients is so vital. If you were not taught how to screen for eating disorders in your training, that is unfortunately not rare. Oftentimes, asking someone with an eating disorder about food and exercise can be very triggering, so make sure to use broad, non-leading questions. The SCOFF questionnaire (Morgan, Reid, & Lacey-BMJ, 1999) is a very simple, straightforward questionnaire that addresses people across eating disorder diagnoses. Here are six questions we recommend asking, adapted from the SCOFF questionnaire:

1. Do you feel like you sometimes lose or have lost control over how you eat?
2. Do you ever make yourself sick because you feel uncomfortably full?
3. Do you believe yourself to be fat, even when others say you are too thin?
4. Do food or thoughts about food dominate your life?
5. Do thoughts about changing your body and/or your weight dominate your life?
6. Have others become worried about your weight and/or eating?

If your patient answers “yes” to two or more of these questions, further assessment may be necessary. If there is a concern, the best course of action is a referral for a comprehensive assessment done by an eating disorder specialist.

People Often Left Out of Screening 

In the past, there has been a misconception that eating disorders affect only thin, young, white females. In reality, eating disorders DO NOT discriminate! This misconception has caused healthcare providers to miss eating disorder diagnoses in different groups, including people in larger bodies, people of color, men, and older adults. Below are different things to remember when screening for each of these misrepresented groups:

1. People in larger bodies

Our society is entrenched in diet culture, which pushes the message that thinness equates health, success, beauty, and worthiness. Weight bias fuels the idea that people in larger bodies should take whatever measures necessary to make themselves smaller, no matter how damaging. Weight bias can lead to weight stigma, which can lead to healthcare providers missing the signs of an eating disorder in a person in a larger body. Working on your own implicit and explicit biases is essential to ensuring that all patients get the help they need.

2. People of color

While medical education has improved and the larger culture has started to understand that eating disorders can affect anyone, some of the initial bias has not gone away. The National Eating Disorder Association states that “People of color—especially African Americans—are significantly less likely to receive help for their eating issues.” Despite the fact that people of color are not being diagnosed as often or receiving care as often, they are equally at risk for the development of an eating disorder as their white peers. 

3. Men 

While we think that there are anywhere from four to six million men with eating disorders in America, only one in 10 people getting eating disorder treatment is male. Eating disorders are serious and potentially life-threatening, with some research suggesting that this risk be even higher for men; that is why it is so important to remember that men develop eating disorders as well. Men often express the desire to be more muscular and leaner, rather than weigh less. The idea that all people with eating disorders want to lose weight can be a detriment to diagnosing men with eating disorders. 

4. Older adults

More than 70 percent of people don’t get treatment for their eating disorder because of stigma, access, barriers, and misinformation. Eating disorders do often present themselves in early adulthood, but with such a large percentage of people not getting help, many people continue suffering into their middle-age and beyond. After decades of suffering, people may be more accustomed to their symptoms and fear being a burden to those around them by asking for help. In addition to the people who develop eating disorders at a young age and do not receive help, there are also individuals who do not develop their eating disorder until later in life. 

You Can Make a Difference

It is highly likely that healthcare professionals will come into contact with someone suffering with an eating disorder during their career. These individuals often present with apparently unrelated symptoms and do not generally disclose what’s really going on. It’s important to ask questions about their eating habits in a non-judgmental way in order to create a welcoming environment where they feel comfortable seeking help. It is also important to note that eating disorders come in all sizes, races, ages, genders, and socioeconomic statuses, and not everyone will need the same exact approach. With the proper tools, healthcare providers can help in diagnosing people with eating disorders, resulting in more people recovering and living happier lives. By knowing the symptoms to look for, the questions to ask, and the populations not to overlook, healthcare professionals can make a real difference in the lives of so many people suffering with these mental illnesses. 

If you believe that your patient could be suffering from an eating disorder, you can refer them to The Emily Program for a comprehensive assessment by calling 1-888-364-5977 or by completing an online referral form. 

The post How to Screen for Eating Disorders appeared first on The Emily Program.

Episode description: 

Kelsey is a pediatric registered nurse working on her master’s degree in psychiatric nursing. In this episode of Peace Meal, she shares her eating disorder and recovery story, including the impact of her faith and her college environment on her experiences of illness and recovery. 

Though Kelsey had seen many medical providers growing up, she says her relationship with food long went unquestioned. She had concerns about her eating but struggled in silence for years. She didn’t yet have the language to name her disordered eating, often describing her anxiety and stress more generally instead. She faced barriers getting help in college—a stressful environment already—but only found lasting support after an interaction at church. A person of faith, Kelsey turned to her pastor, who told her that her illness required professional support. Prayers alone would not heal her. After being connected with new resources, she says she became honest with her secrets with her family and made a “no more lying” rule with her parents. Her sister and niece were also strong motivations to help her recover and to model and practice body positivity. Kelsey leaves us with insight and hope for college students, people of faith, or anyone struggling with an eating disorder. 

We cover:

• How warning signs of eating disorders can go unnoticed by professionals
• How faith and religion can play a part in recovery
• The benefits of family support to the recovery process 
• The experience of recovering during the pandemic
• Advice for college students who struggle with body image

In Kelsey’s words:

• On the importance of professional help: “Prayer wasn’t going to do it alone. We needed professionals. We needed a team of people.”
• On the missed opportunities to find support earlier: “Beyond my primary care, there were so many people who disregarded and just didn’t recognize my underlying issues. From doctors to dentists to physical therapists, there are like a hundred instances.”
• On life in recovery: “I think you might expect it to be not messy, but it still is… It’s messy without an eating disorder, [but] it’s better! Life in recovery is beautiful.”

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is a podcast that explores topics related to eating disorders, body image, and how society may influence our thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 61: The Intersection of Faith and Mental Health with Kelsey appeared first on The Emily Program.

Renovation is well underway at The Emily Program – Columbus, the location of two new residential programs opening next year. Currently an outpatient and day treatment site, the Ravines Edge building will soon house adult and adolescent residential programs as well, bringing together a full continuum of care in one convenient spot. In addition to supporting continuity of care for clients transitioning between treatment levels, the location will expand treatment access for the estimated 390,000 Ohioans struggling with these illnesses.

This expansion project comes as we continue to witness the deep impact of the pandemic on people with eating disorders. Triggers exacerbated by social isolation, disrupted routines, and intensified stressors and anxiety have contributed to an ever-growing demand for eating disorder services—a need we’re committed to addressing in our local communities.

 “The past 18 months have only underscored the need for increased access to care,” says The Emily Program’s Chief Strategy Officer Dr. Jillian Lampert. “Eating disorders are highly treatable, but access to effective care at the appropriate level is critical. This renovation will allow us to serve more people with the care that’s right for them.” 

Among the renovations to the older facility are electrical, mechanical, and plumbing work; alterations to increase accessibility; and structural changes to maximize space for outpatient, day, and residential programming. These investments will further transform the building into a safe, supportive, and inclusive place of hope and healing for people with eating disorders. Across all levels of care, clients will be able to focus on recovery in a welcoming environment designed with them in mind.

A behind-the-scenes look at the renovations underway 

Check out the recent progress in Columbus with these behind-the-scenes photos:

The main lobby opening up to the floors above

Residential restrooms and shower rooms

The transformer for expanded electrical service. It’s 1300 lbs and too big for the elevator, so moving it to the lower level was no small task!

An ADA ramp structure and electrical rough-in for lighting to come

A water line installed and backfilled next to the ADA ramp

We appreciate the patience and flexibility of our current Columbus clients and staff during this transition, and we look forward to welcoming everyone to the renovated space once the project is complete and it is safe to do so. 

Learn more about The Emily Program’s residential, day, and outpatient programs online. If you or someone you know is struggling with an eating disorder, please contact us at 1-888-364-5977 or complete our online form.

The post Renovation Underway at The Emily Program – Columbus appeared first on The Emily Program.

A common symptom of many eating disorders is a preoccupation with food and body size, and this symptom can be exacerbated by the toxicity of diet culture. Diet and weight loss have grown to be an over $70 billion industry—yet according to studies, 95% of diets fail. As it has become increasingly common knowledge that diets don’t work, the diet industry has reworked its language to disguise diets as being about “health” and “wellness.” Trying to determine if something is pro-diet culture or not can be tricky. To truly promote health and create a culture that is more supportive of those with eating disorders, we need to learn to identify diet culture and actively resist it. 

What is Diet Culture?

If you’re not familiar with the term “diet culture,” that is not uncommon. Diet culture is so entrenched in our everyday lives that it’s hard to even spot it. Diet culture is the belief that if we want to be more desirable, worthy, and good, then we should make our bodies smaller by dieting. Diet culture is dangerous and harms people of all sizes, including by perpetuating disordered eating and making eating disorder recovery all the more challenging. Even if you are not on a diet, you can still be caught up in the culture of dieting. Some people need to be on diets for medical reasons, such as diagnosed celiac disease or diabetes, but even those who have a reason for dieting other than weight loss can get caught up in a diet culture mindset. Many people don’t even realize that in pursuing “health” and “wellness,” they are living their life according to rules created by diet culture. 

How Diet Culture Has Morphed Over Time

The diet industry has needed to reframe its messaging as more people have learned that diets don’t work. In 2007, researchers from the University of California at Los Angeles published an analysis of more than 30 long-term diet studies. The paper’s lead author, Traci Mann, stated in a news release at the time, “Diets do not lead to sustained weight loss or health benefits for the majority of people.” The booming business that is the diet industry has realized that it must somehow get Millenials on the diet train, and that, along with everyone finding out diets don’t work, has led to “The Wellness Diet.” 

“The Wellness Diet is my term for the sneaky, modern guise of diet culture that’s supposedly about ‘wellness’ but is actually about performing a rarefied, perfectionistic, discriminatory idea of what health is supposed to look like,” says Christy Harrison in her article, “How to Avoid Falling for The Wellness Diet.” In this reshaping of dieting, it’s not solely about weight loss, although thinness is considered an essential aspect of what makes someone healthy in these diets. The Wellness Diet still labels certain foods as “good” and “bad” and intends for you to feel shame if you eat food in the “bad” category. “Clean eating,” detoxes, and cleanses, as well as elimination diets prescribed for the general population, are all part of The Wellness Diet. It’s pertinent to know that detox diets and cleanses are not something that anyone’s body needs, as our liver, kidneys, and lungs do that for us already. 

The False Equation of Thin Equals Healthy

Weight stigma, which refers to negative attitudes, beliefs, or assumptions about others based on body weight or size, is so firmly entrenched in our culture that even healthcare professionals can find themselves misdiagnosing people in larger bodies. More weight-inclusive approaches, such as Health at Every Size (HAES), promote a holistic version of health that is not defined by size, ability, illnesses, or any other trait. HAES is rooted in the belief that regardless of size, everyone is able to reach health and find joy in the process. HAES also encourages people to remember that individuals can be healthy across a wide range of weights and that we should be striving for person-centric care and equalizing access to proper care. If providers can look past an individual’s weight and pay more attention to the signs of an eating disorder, this could help diagnose so many people who need help.

How Diets Affect the Development of Eating Disorders

Diet culture is dangerous for people of all sizes, and particularly dangerous to those predisposed for, currently suffering with, or recovering from eating disorders. According to NEDA, those who engage in moderate dieting are five times more likely to develop an eating disorder and those who engage in extreme dieting are 18 times more likely to develop an eating disorder. The reason for this increased risk is that most diets involve restrictive behaviors. “Engaging in extreme restriction can result in malnutrition and starvation, which, at a neurobiological level, could trigger an eating disorder,” said The Emily Program’s Chief Medical Officer Mark Warren. If you feel that your dieting has gotten out of control, it is important that you reach out for help. The sooner you ask for help, the better the outcome will be. 

If you are struggling with food or body image, The Emily Program is here for you. You can start your road to recovery by calling our admissions team at 1-888-364-5977 or by completing our online form.

The post How “Health” and “Wellness” Have Been Co-opted by the Diet Industry appeared first on The Emily Program.

It can be hard to differentiate between body positivity, body acceptance, and body neutrality, especially if all three of those terms are new to you. One day, you can love your body, and the next day you may struggle with your appearance. Negative body image is a common symptom in most eating disorders, and with eating disorders affecting approximately 30 million Americans and disordered eating affecting 65 percent of American women between the ages of 25 and 45, you could argue that America has a desperate need for movements like body positivity, body acceptance, and body neutrality. Continue reading to learn more about these ideas and how they can help in eating disorder recovery.

Body Positivity

Body positivity is a social movement that promotes equality and acceptance for bodies of all types and sizes. “One of the goals [of body positivity] is to challenge how our society, particularly all forms of media, presents and views the physical human body,” says Kristen Fuller, MD, in her article on Verywell Mind. It is probably the most well-known out of all three concepts. The body positivity movement was started in the 1960s and was created by and for those in marginalized bodies, including larger bodies, Black, queer, and disabled bodies. Body positivity was created in order to advocate for people who experience discrimination based on how they look. 

Negative body image is a common symptom in most eating disorders. Because of this, practicing body positivity can be a great tool in recovery. Body positivity is all about changing how you think about your body instead of changing your body itself. Despite the negative thoughts that your eating disorder may have conditioned you to believe, body positivity is all about telling yourself that your body is worthy. It is important to note that working on body positivity is helpful in recovery, but it cannot replace treatment. 

Body Acceptance 

The difference between body positivity and body acceptance is that with body acceptance, you don’t have to be thrilled with your body every minute, but instead you can figure out how to accept it. This may be especially helpful for those in recovery, as it does not require body love, which can feel like an overwhelming goal. Some think that body positivity does not leave room for insecurities and frustrations, and that loving your body every day is not realistic. Alternatively, acceptance is treating our bodies with respect and care, including all of our deepest insecurities, and knowing that some days will be harder than others. In the end, body acceptance is about reflecting on why you feel negatively toward your body and how you can find peace with your body without needing to change it.

Body Neutrality

Instead of focusing on loving how your body looks no matter what or on accepting your body as it is, body neutrality is a philosophy that believes bodies are neither good nor bad. Body neutrality is also the idea that we can still care for our bodies even if we don’t view them positively. It is a relatively new concept, popularized by bloggers, celebrities, and intuitive eating coaches who have helped to promote the idea that physical appearance does not determisne self-worth. Body neutrality does not require that you love your body all the time, which can be a heavy ask for people who have been taught to hate their bodies for years and even decades. 

Utilizing These Ideas in Eating Disorder Recovery

Remember that body positivity, body acceptance, and body neutrality can co-exist–you do not need to choose only one to aid in your recovery. You may start eating disorder recovery by working on body neutrality; viewing your body in a neutral way may be your gateway into accepting and loving it. Then you may enter a phase of recovery where body acceptance seems possible. It is possible to eventually reach a point in recovery where you have body-positive days and you will feel an outpouring of genuine love for your body. Your recovery journey will not be a straight line, but these tools can help you along the way. It’s okay if you can’t live up to these ideas every day. You are not a failure. Recovery is a process and it takes time. 

It is essential that we never forget that what our bodies look like and what our bodies can do are not the only things that make us valuable; we are complex human beings with amazing qualities that are deserving of love. All three movements have value in shifting our culture and creating a better world for those that are marginalized. Whether you’re working toward body positivity, body acceptance, body neutrality, or all three, we hope that you now understand them a little better. 

If you are struggling with food or body image, The Emily Program is here for you. From providing eating disorder assessments to various levels of eating disorder treatment, The Emily Program walks with you during all stages of healing. To learn more, call 1-888-364-5977 or get started online today.

The post Understanding Body Positivity, Body Acceptance, and Body Neutrality appeared first on The Emily Program.

Episode description:

Dr. Laura Hill is an international eating disorder consultant focusing on brain-based eating disorder treatment approaches. She is an Adjunct Associate Professor of Psychiatry and Behavioral Health at The Ohio State University and Assistant Clinical Professor in the Department of Psychiatry at The University of California, San Diego. She is one of the original founders of the Academy for Eating Disorders and the Director of the organization now known as NEDA from 1990 to 1994. In addition, Dr. Hill is the founder and former President and Chief Executive Officer of The Center for Balanced Living.

In this episode of Peace Meal, Dr. Hill introduces an emerging brain-based treatment called Temperament-Based Therapy with Supports (TBT-S). TBT-S helps people with eating disorders understand their unique temperament so that they can use it as a tool for recovery. Distinguishing between traits and symptoms, Dr. Hill explains that temperament includes traits like impulsivity, introversion, and determination, while symptoms include eating disorder behaviors, thoughts, and emotions. She emphasizes that temperament traits are neither good nor bad; what’s important is how they are applied. TBT-S helps people with eating disorders and their support people use their traits more productively to aid in recovery. Dr. Hill also talks about the importance of support in treatment and recovery. In the end, she addresses how providers can use TBT-S to complement other treatment approaches. 

We cover:

• The basics of Temperament-Based Therapy with Supports (TBT-S) 
• How TBT-S is supported by brain research
• How people with eating disorders can use TBT-S to express their traits more productively and aid in their recovery
• The role of support people in the TBT-S model
• How TBT-S differs from and complements other treatment modalities

In Dr. Hill’s words:

• On the traits we’re all given: “Traits are genetically endowed. You don’t get to choose your trait, you just try to make them better.”
• On the importance of temperament to eating disorder treatment: “What we are finding is that eating disorders have a huge relapse… Our theory is that the relapses are due to us not addressing the traits enough.”
• On the difficulty of imagining life without an eating disorder: “When clients say, ‘I can’t imagine my life without ED,’ they were telling us the truth. I can’t imagine my life without my traits because it’s who I am.”

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is a podcast hosted by The Emily Program and Veritas Collaborative that covers topics related to eating disorders, body image, and how society may influence our thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 60: Temperament-Based Therapy with Supports (TBT-S) with Dr. Laura Hill appeared first on The Emily Program.

The 10th Annual Veritas Collaborative Symposium on Eating Disorders, co-hosted by The Emily Program, will unite healthcare professionals and eating disorder experts around this year’s theme, “Engaging Science, Unifying Voices, and Transforming Access.” In this article, Mae Lynn Reyes-Rodríguez, PhD, FAED, a speaker at this year’s Symposium, discusses the prevalence of eating disorders in the Latino population and underscores the need for culturally competent care.

Eating disorders do not discriminate based on race or ethnicity. Actually, data from different national studies have shown that eating disorders in the Latino population are at similar or higher prevalence when compared with non-Latino Whites (Alegria et al., 2007; Marques et al., 2011; Udo & Grilo, 2018). However, due to the historical emphasis around European White females in the eating disorder field, most of the assessments and treatments have been developed and tested with and for this population. This is problematic because it has contributed to clinician bias and stigma, which are some of the barriers preventing Latinas to seek treatment for eating disorders (Reyes-Rodríguez et al., 2013). Moreover, the research about service utilization among individuals with a history of eating disorders reveals that Latinxs with bulimia nervosa (BN) and binge eating disorder (BED) are less likely to seek treatment when compared with non-Latino Whites (Coffino, Udo, & Grilo, 2019; Marques et al., 2011). This health disparity is concerning because BN and BED are the most prevalent eating disorders in this population (Perez, Ohrt, & Hoek, 2016). Other factors such as lack of health insurance, lack of bilingual services, and lack of information about services can be associated with this underutilization of services (Ali et al., 2017; Reyes-Rodríguez, 2013). The long history of misconception and negligence has negatively affected the early detection, prevention, and treatment for eating disorders in the Latino population.

History does not determine the future but can reshape it

History can be powerful if we choose to learn from it and make changes to construct a better present and future. Fortunately, during the past years, the awareness about how eating disorders are affecting diverse populations has progressively increased. However, much work needs to be done. In the United States, only two main cultural adaptations for evidence-based treatment (EBT) have been conducted in Latinas with binge-eating type eating disorders (Cachelin et al., 2019; Cachelin et al., 2014; Reyes-Rodríguez, Baucom, & Bulik, 2014; Reyes-Rodríguez, Watson, Smith, Baucom, & Bulik, 2021). Using a form of cognitive behavioral therapy (CBT) for binge-eating type eating disorders, these cultural adaptation studies found that CBT was feasible, with good acceptance and effectiveness. Although no major changes were required on the content of the CBT, cultural adaptations in the delivery process are recommended to improve engagement and retention, especially for those less acculturated. The integration of central values in Latino culture such as familism and personalism in addition to bilingual services, treatment at low or no cost, flexibility in order to be responsive to their needs, integrating family or addressing family criticism, and food centrality are some of the cultural adaptations necessary in order to provide a culturally sensitive treatment for Latinas. No cultural adaptations have been published for evidence-based treatment for anorexia nervosa (AN) or for Latino males with any type of eating disorder.

In the direction of continuing to reshape the future, it is essential to focus on early detection, education, and making culturally sensitive treatments more accessible to Latinxs. Considering that Latinxs tend to underutilize specialized treatment, primary care and community settings can be optimal settings for assessment and treatment delivery. Raising awareness and educating primary care physicians about the importance of screening Latinxs for eating disorders on a regular basis ̶ same as it has been established for depression, anxiety, and other mental health disorders ̶ is one of the first steps. Meanwhile, when providers encounter a Latinx patient, the following is recommended:

1. Identify any cultural adaptation (clinical trial, case report) that could inform you about potential modifications to treatment.
2. In the case that a cultural adaptation has not been published, use the current EBT but with an open mind and flexibility to incorporate modifications based on literature review, treatment progress, and feedback from patient and/or relatives.
3. Get well informed about cultural values that are relevant for Latinxs.
4. Recognize your own biases that could interfere with the treatment and determine if a referral is the best course of action.

Recent work about cultural adaptations for diverse populations was published with the intention to provide a practical guide for providers and professionals in the eating disorder field (Reyes-Rodríguez & Franko, 2020). We need to continue making efforts in order to reduce health disparities. If providers and professionals in the field are educated and aware of how to change the misconception that has marked our past, we can begin to make the present and future more fair and equitable.  

To learn more about providing culturally competent care for Latinxs with eating disorders, please register for Dr. Reyes-Rodríguez’s presentation at this year’s Symposium, “Culturally Sensitive Treatment for Latinxs with Eating Disorders: What should I know?” See the full agenda here.

About the Author

Dr. Mae Lynn Reyes-Rodríguez is clinical associate professor at the Psychiatry Department of the University of North Carolina at Chapel Hill. She is fellow of the Academy for Eating Disorders (AED) and Expert of Content for the National Center of Excellence for Eating Disorders (NCEED). As a researcher and clinical psychologist, she has devoted her clinical research career to adapt eating disorders treatments for the Latino population in Puerto Rico during her early career and later with Latinos in the mainland, particularly in Central North Carolina. She has published numerous papers and book chapters on cultural adaptation. She is actively involved in the Latino community as a columnist in one of the main Latino Newspapers in NC, La Noticia, in which she provides psychoeducation on mental health in order to raise the awareness and reduce the health disparities.

References

Alegria, M., Woo, M., Cao, Z., Torres, M., Meng, X. L., & Striegel-Moore, R. (2007). Prevalence and correlates of eating disorders in Latinos in the United States. Int J Eat Disord, 40 Suppl, S15-21. doi:10.1002/eat.20406

Ali, K., Farrer, L., Fassnacht, D. B., Gulliver, A., Bauer, S., & Griffiths, K. M. (2017). Perceived barriers and facilitators towards help-seeking for eating disorders: A systematic review. Int J Eat Disord, 50(1), 9-21. doi:10.1002/eat.22598

Cachelin, F. M., Gil-Rivas, V., Palmer, B., Vela, A., Phimphasone, P., de Hernandez, B. U., & Tapp, H. (2019). Randomized controlled trial of a culturally-adapted program for Latinas with binge eating. Psychol Serv, 16(3), 504-512. doi:10.1037/ser0000182

Cachelin, F. M., Shea, M., Phimphasone, P., Wilson, G. T., Thompson, D. R., & Striegel, R. H. (2014). Culturally adapted cognitive behavioral guided self-help for binge eating: a feasibility study with Mexican Americans. Cultur Divers Ethnic Minor Psychol, 20(3), 449-457. doi:10.1037/a0035345

Coffino, J. A., Udo, T., & Grilo, C. M. (2019). Rates of Help-Seeking in US Adults With Lifetime DSM-5 Eating Disorders: Prevalence Across Diagnoses and Differences by Sex and Ethnicity/Race. Mayo Clin Proc, 94(8), 1415-1426. doi:10.1016/j.mayocp.2019.02.030

Marques, L., Alegria, M., Becker, A. E., Chen, C. N., Fang, A., Chosak, A., & Diniz, J. B. (2011). Comparative prevalence, correlates of impairment, and service utilization for eating disorders across US ethnic groups: Implications for reducing ethnic disparities in health care access for eating disorders. Int J Eat Disord, 44(5), 412-420.

Perez, M., Ohrt, T. K., & Hoek, H. W. (2016). Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States. Curr Opin Psychiatry, 29(6), 378-382. doi:10.1097/YCO.0000000000000277

Reyes-Rodríguez, M., Ramírez, J., Patrice K., Rose, K., Bulik, C.M. . (2013). Exploring barriers and facilitators in the eating disorders treatment in Latinas in the United States. Journal of Latina/o Pychology, 1, 112-131.

Reyes-Rodríguez, M. L., Baucom, D.H., Bulik, C.M. (2014). Culturally sensitive intervention for Latina women with eating disorders: A case report. Mexican Journal of Eating Disorders, 5, 135-146.

Reyes-Rodríguez, M. L., Franko, D. L. (2020). Cultural adaptations of evidence-based treatments for eating disorders. In A. B. G. Christina C. Totolaini, & Daniel Le Grange (Ed.), Adapting evidence-based eating disorder treatments for novel populations and settings: A practical guide (pp. 3-30). New York: Routledge.

Reyes-Rodríguez, M. L., Watson, H. J., Smith, T. W., Baucom, D. H., & Bulik, C. M. (2021). Promoviendo una Alimentacion Saludable (PAS) results: Engaging Latino families in eating disorder treatment. Eat Behav, 42, 101534. doi:10.1016/j.eatbeh.2021.101534

Udo, T., & Grilo, C. M. (2018). Prevalence and Correlates of DSM-5-Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults. Biol Psychiatry, 84(5), 345-354. doi:10.1016/j.biopsych.2018.03.014

The post Eating Disorders in Latinxs: Lessons Learned From History appeared first on The Emily Program.

The 10th Annual Veritas Collaborative Symposium on Eating Disorders, co-hosted by The Emily Program, will unite healthcare professionals and eating disorders experts around this year’s theme, “Engaging Science, Unifying Voices, and Transforming Access.” In this article, Ben Eckstein, a speaker at this year’s Symposium, explores the connection between OCD and eating disorders.

Rigid routines. Experiential avoidance. Feeling out of control. Ruminative thoughts. Are we talking about OCD or eating disorders? Maybe both. Are we talking about OCD or eating disorders? Maybe both. If you’ve spent any time treating eating disorders, chances are good that you’ve come across an individual with comorbid Obsessive-Compulsive Disorder (OCD). While rates vary across different types of eating disorders, studies generally show comorbidity rates ranging from 10–44%. This frequent overlap can create diagnostic confusion even for seasoned clinicians. It’s easy to see why: though there are some clear distinctions, the phenomenological similarities can muddy the water and complicate diagnosis and treatment planning.

What Are the Similarities Between Eating Disorders and OCD?

As the name suggests, OCD involves both obsessions and compulsions. Obsessions are repetitive, unwanted thoughts that are experienced as distressing by the individual, while compulsions are behaviors intended to prevent or reduce that distress. These diagnostic criteria are fundamental to OCD; however, the concepts are not necessarily unique. Obsessions may be a hallmark of OCD, but distressing, repetitive thoughts can be found in many mental health diagnoses (GAD, PTSD, etc.). Similarly, in some eating disorders, a preoccupation with food or body shape might be experienced as repetitive or distressing. Compensatory behaviors such as restriction or over-exercise might serve to prevent or reduce distress, much like a compulsion. When viewed strictly through this functional lens, there can be quite a bit of overlap between these disorders. 

What Are the Differences Between Eating Disorders and OCD?

These disorders share many features, but there are differences – some clear and some a bit less clear. Let’s look at this from a couple of angles: when OCD looks like an ED (food-related OCD) and when an ED looks like OCD (ARFID). And of course, just for good measure, let’s also look at the places where they co-occur; it is here where things get a little murky.

Food-Related OCD

Many people are familiar with obsessions related to contamination (dirt, germs, etc.) or harm (leaving the stove on, house unlocked, etc.), but the content of obsessions can actually be incredibly wide-ranging. There are many obsessions related to food, with compulsions that involve limiting or restricting food intake. Here are a few common examples:

• Fear of choking or vomiting
• Fear of ingesting contaminants through food or drinks
• Fear of allergic reactions to food
• Excessive concern about digestion or defecation
• Religious or moral concerns about food
• “Just right” or magical thinking regarding food intake or exercise

As you’ll notice above, food-related obsessions do not involve fears of gaining weight or of changes in body shape. While over-control and food avoidance may be shared behaviors, the feared outcome driving these behaviors is different. It is also worth noting that obsessions in OCD are typically experienced as ego-dystonic; that is, they are foreign, unwanted, and dissonant from the beliefs of the individual. With eating disorders, cognitions are typically more ego-syntonic; the individual identifies with the thoughts and feels that they are consistent with their beliefs and goals. With food-related OCD, medical complications are possible but atypical; with eating disorders, medical concerns are more commonplace.

ARFID

Avoidant Restrictive Food Intake Disorder (ARFID) throws a wrench in our differential diagnosis toolbox. Unlike classical eating disorders, ARFID does not involve a fear of gaining weight or preoccupation with body shape. In fact, many individuals with ARFID can prefer calorie-dense foods which are typically avoided in other eating disorders, while eschewing what are often considered ”safe” foods, such as fruits or vegetables. There can be fears that mirror food-related OCD (choking, vomiting), though ARFID involves a wider array of experiences driving food avoidance, including fear of trying new foods, sensory sensitivity, disgust, and decreased pleasure and interest in food. These concerns result in avoidance and restriction, though the goal is not to control weight, but to avoid an unwanted experience. 

What About When OCD & Eating Disorders Co-Occur?

We can sometimes gain diagnostic clarity by delving into the fears driving behavior, but we may also find that our examination yields two co-occurring diagnoses. Some examples include:

• A client exercises excessively in an attempt to prevent weight gain. They may simultaneously feel that they need to complete these exercises in a particular way in order to prevent something bad from happening or because a particular order “feels right.”
• A client avoids food with the potential for pesticide use due to a fear of contamination initially, then subsequently determines that they are pleased with their weight loss and continue to widen food restriction.
• A client counts calories throughout their day in order to prevent weight gain; they need their caloric intake at each meal to add up to a “good” number in order to prevent harm to their loved ones.

What Does This Mean for Treatment?

OCD and eating disorders are both fairly specialized fields. Therapists often possess expertise in their client population and treatment modality but can sometimes get stuck when an individual’s presentation deviates from that norm or introduces a complicating comorbidity. Luckily, these disorders share enough in common that there are some strategies to help bridge the gap.

Exposure and Response Prevention (ERP) is a validated treatment for OCD. It involves systematically approaching feared stimuli while removing safety behaviors (compulsions) in order to facilitate new learning (that the feared outcome didn’t happen, the anxiety was tolerable, etc.). Eating disorders provide many opportunities for clients to engage in exposure-based treatment. By approaching meals while removing safety behaviors (restriction, over-control, over-exercise), we can facilitate new learning (distress/fullness are tolerable). Examples might include:

• Constructing meal plans with increasingly challenging foods
• Exposure to avoided situations due to body image concerns
• Eliminating rituals/avoidance related to clothing
• Looking at fashion magazines
• Taking/posting unfiltered pictures
• Eating in front of friends

Sometimes OCD can look like an eating disorder, sometimes eating disorders can look like OCD, and sometimes we encounter both together. Teasing apart these overlapping symptoms can help us to achieve diagnostic clarity and will direct us toward a more effective treatment strategy.

To learn more on how eating disorders and OCD are intertwined, please register for Ben Eckstein and Dr. Steven Tsao’s presentation at this year’s Symposium, “Untangling OCD and Eating Disorders.” See the full agenda here.

About the Author

Ben Eckstein, LCSW, is the founder of Bull City Anxiety in Durham, North Carolina.  He has specialized in the treatment of OCD and anxiety disorders for over a decade, training at the OCD Institute at McLean Hospital prior to opening his practice.  Ben is a board member at OCD North Carolina, serving as secretary and walk committee chair.  In addition to his clinical work, Ben provides training and workshops, dedicated to the dissemination of evidence-based treatment. 

The post Untangling Eating Disorders and OCD appeared first on The Emily Program.

Tell us about yourself!

Hi! I’m Chloé Southcote-Want, Office Manager (OM) at the Seattle Outpatient location of The Emily Program. I’ve been in the OM role for about three years, but I’ve been with The Emily Program for six years this December in various other admin roles, both at Seattle Outpatient and Seattle Residential. Outside of work, I’m a proud dog mom of two very stubborn Plott Hounds.

Describe the career path that led you to The Emily Program.

My background is in public health, with a focus on community health. Prior to coming to TEP, I had worked at a few non-profits doing everything from fundraising for housing and community projects to larger health campaign marketing. After having a lot of experience in more broad public health, I wanted to get more specific experience on the clinical aspects of public health. TEP was the right fit for that, as eating disorders are such an all-encompassing disorder. There are so many factors and things that I learned in my training that I see every day at work, be that social determinants and barriers to treatment, or systems of insurance. Mental health clinics are a really important part of community health systems and the wider public health system.

What motivates you to show up for work each day? 

I really enjoy making the office a comfortable space for our clients to come to every day. I think that is a really important aspect of my job and I take it very seriously. When our clients feel like they are in a warm and welcoming space, they can open up and really dive into treatment. So I try to get up every day and make coming to the office an enjoyable experience for everyone who walks in our door (as much as I can).

What do you like to do when you aren’t working?  

So many things—where to even start! I’m both a baker and a knitter, and I would consider both of those to be my downtime hobbies for when I just want to relax at home. Most of the time while I’m knitting I’ll put one of the several shows I’m working my way through. Currently, I’m watching Upstart Crow, a fantastic British sitcom about Shakespeare. When I’m not doing either of those, I’m most likely to be found at a Seattle Sounders match or watching a cricket match.

What’s one thing most people don’t know about you?  

I have a paper baseball scorebook and I keep score at every baseball game that I attend. I learned how to keep score as a kid from my great-grandfather and it’s a bit of a family tradition. It’s a nice memory to have of each game that I go to, and so far this season I haven’t recorded a single loss in my book—fingers crossed it stays that way. 

The post Staff Spotlight, Chloé Southcote-Want appeared first on The Emily Program.

**Content warning: This article discusses the topic of suicide. Please use your discretion when reading and speak with your support system as needed. If you are experiencing suicidal thoughts, there are resources that can help. Contact the National Suicide Prevention Lifeline at 1-800-273-8255.

Eating disorders impact about 30 million people in the United States. They are associated with high levels of premature mortality, including an increased risk for suicide. Without treatment, up to 20 percent of people with a serious eating disorder will die. Much like eating disorders, suicidal thoughts can affect anyone regardless of age, gender, or any other demographic categorization. 

September is Suicide Prevention Awareness Month – this means that for the month of September, mental health advocates, prevention organizations, survivors, allies, and community members unite to raise awareness on this stigmatized topic and to spread hope and vital information to people affected by suicide. 

As providers, there are certain warning signs of suicidal thinking that you should be looking out for, as well as an appropriate way to approach someone when you spot these warning signs.

The Link Between Eating Disorders and Suicide

A study from JAMA Psychiatry on suicide and eating disorders found that the risk for a suicide attempt is markedly higher among individuals with an eating disorder. The study researchers concluded that loved ones and treatment providers should remain vigilant for signs of suicidal thinking or behavior, regardless of whether the patient has a co-morbid disorder. However,  it is important to note that the presence of co-morbid disorders does elevate the risk of suicide for one with an eating disorder.

Research has shown those with eating disorders often present with a second disorder such as substance use disorder, anxiety, trauma, or depression. That is why it is so important that every disorder a person is experiencing is treated during eating disorder treatment. 

The Important Role of Providers in Suicide Prevention

In the United States, one-half of the people who die by suicide saw a physician in the preceding month, and one third was being treated for a mental illness at the time of their suicide, according to an article in American Family Physician by Jeffrey Stovall, MD and Frank J. Domino, MD. This shows how likely it is that providers will come into contact with someone contemplating suicide and emphasizes the importance of looking for the signs of suicidal ideation. 

7 Warning Signs of Suicidal Thinking 

Certain words or actions can alert you that someone needs help. People with eating disorders who are experiencing suicidal thoughts may:

1. Express thoughts about death or dying or not being around in the future. 
2. Talk about feeling hopeless or having no purpose.
3. Start to create a plan by searching online and elsewhere for ways to end their lives.
4. Display increased anxiety or anger, experience mood swings, or suddenly display a sense of relief or improvement in symptoms.
5. Increase their use of alcohol or drugs, or engage in other reckless behaviors.
6. Begin to withdraw from social activities, isolate themselves from others, or start to give away their possessions. 
7. Say that they feel like they have no reason to live or are a burden to those around them because of their disorder.

Sometimes patients may not verbally express their suicidal thoughts, but it shows in their actions, such as physical signs of substance use or withdrawal, restlessness, or agitation. If your patient is showing signs that indicate a higher risk for suicide, addressing it is of the utmost importance. Comments such as, “I notice you seem sad today,” or “Something else seems to be troubling you today,” may be a good way to start the conversation with someone you are concerned about. Good eye contact, empathetic responses, and a direct invitation such as, “Tell me more,” can be important indicators to the patient that you care about them and want to understand what they are going through. Asking about the patient’s family life, school, work, and relationships may allow the patient the opportunity to reveal suicidal thoughts.

How to Help Someone Experiencing Suicidal Thoughts

Providers may encounter patients with suicidal ideation frequently and knowing how to best approach them can make a huge difference in that patient’s life. If you are concerned about one of your patients, begin with the following steps:

• Have an honest conversation with the patient in private.
• Listen to the patient’s story.
• Avoid minimizing the patient’s problems.
• Assure the patient that you care.
• Ask directly about any suicidal thoughts.
• Encourage the patient to seek treatment and offer referral suggestions.

If the patient does acknowledge their suicidal thoughts, it is important to take them seriously and help them remove any lethal means in their possession. If there is an imminent risk of suicide, for safety reasons you should escort the patient to mental health services or an emergency room.

If you notice the signs of suicidal thoughts or an eating disorder in your practice, it is important that you connect your patient with specialty help.  To refer a patient to The Emily Program, complete our online form or call 1-888-364-5977 today.

The post How to Identify Signs of Suicide in Patients With Eating Disorders appeared first on The Emily Program.

Episode description: 

​​Kathryn is a 31-year-old woman who enjoys cooking, hosting friends, teaching music, and getting lost in nature. Best known for her big heart and passion for life, she lives in a larger body and advocates for people to take up more space. Kathryn joins us in this episode of Peace Meal to share her eating disorder story, including how living in a larger body has impacted her recovery. 

For over 20 years, food was the center of Kathryn’s life. She kept trying to figure out what was happening on her own, blaming herself for her struggles. After talking with the people closest to her, she decided to seek help even though she didn’t have a lot of hope that anything would work. 

As soon as Kathryn reached out for help, however, she says it felt like a “warm hug.” In speaking with an eating disorder specialist, she discovered that she did, in fact, have an illness. It was not her fault. While she experienced many barriers throughout her recovery living in a larger body, she grew to learn that all food is good food and that you should take up as much space as you need. With the support of her treatment team, friends, and family, she learned how to take care of herself, live as the most authentic version of herself, and make sure all her needs are met.

We cover:

• How a decades-long struggle with food led to an eating disorder diagnosis 
• The possible obstacles of the eating disorder recovery process
• How our culture invalidates eating disorders, especially if the person is in a larger body
• What it’s like to be in an eating disorder treatment group as the only person in a larger body
• The importance of taking up the space you need 

In Kathryn’s words:

• On her relationship with food before recovery: “Food was my higher power. It affected my emotions. It controlled everything. Food was always the focus… It was suffocating.”
• On life in recovery: “Freedom is probably the best word. I energetically take up all the space that I need. I make sure that my needs are met… I just get to be me. There are no more lingering clouds of doubt… I just get to live now.”
• On her advice to someone currently struggling with an eating disorder: “Choose healing above anything else…. Living life the way you have been and choosing a path of recovery… Both are hard, but choose healing.”

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is a podcast that explores topics related to eating disorders, body image, and how society may influence our thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 59: Choosing Recovery with Kathryn appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

By Kirsten Kochheiser

I do not know if I remember how to speak. My voice still cracks, I still stutter. I think my heart broke alongside my throat. I miss the ways I could sway people. Now all I hear are disjointed sounds mimicking someone incompetent. I watched as my body grew and my emotions and soul shrunk. It’s hard to breathe now, without a throat to swallow the oxygen to fill parched lungs. Words won’t come out right, but I am learning, re-teaching myself how to speak.

My first ever therapy session went smoothly. She asked questions, I answered them, and that was that. Our second session did not go as well. I was quiet. Not the quiet type who does not speak loudly. No. I was the type of quiet that barely said two words. I was a closed book with a chain wrapped tightly around it, locked with an iron latch. She patiently waited while I learned how to shape my mouth into words. Over time, I began sharing more information but remained mostly silent.  

Our sessions stayed that way for some time. She gave me homework most days, and I would avidly write but would share nothing of what I wrote with her. With her help, I slowly and painfully got back in touch with my emotions. I could not label them at first. Happy, sad, scared-they all conjoined into a tangled ball like yarn, and I had to pick up each thread and painstakingly follow it to the end so I could separate it from the others. 

From her I learned a multitude of coping skills. I learned how to eat again, how to love my body. I learned how to defy the eating disorder, and somewhere along the way, I found bits and pieces of my voice lying around. Some days, I can write. Some days, I remember my voice and let it guide me. These are the days I hold on to. I do not know if I remember how to speak. But I am learning.

The post Breaking the Silence appeared first on The Emily Program.

Genes AND Environment; Nature AND Nurture

It’s Time to Replace those Or’s with And’s and Embrace Complexity in Eating Disorders

The 10th Annual Veritas Collaborative Symposium on Eating Disorders, co-hosted by The Emily Program, will unite healthcare professionals and eating disorders experts around this year’s theme, “Engaging Science, Unifying Voices, and Transforming Access.” In this article, Cynthia Bulik, PhD, FAED, a speaker at this year’s Symposium, explores the complexity of the genetics of eating disorders.

Truth #7: Genes and environment play important roles in the development of eating disorders.
Truth #8: Genes alone do not predict who will develop eating disorders.

— “Nine Truths About Eating Disorders”

As humans, we regularly try to reduce things to their simplest form—for example, what we learned about fractions in grade school math. However, humans are not simple and neither are eating disorders. We all need to eschew all-or-nothing thinking and allow ourselves to inhabit the gray, messy space in between that leaves room for many influences to converge and define an individual’s risk for developing an eating disorder.

No matter who we are and how we identify, we can’t escape the fact that we get 50% of our genetic material from an egg and 50% from a sperm. We also can’t escape the fact that the environment influences us from conception onward (and probably even before conception if we think about environmental influences on eggs and sperm). Just explaining what makes a human is complex, let alone what causes something with complex biology and psychology like an eating disorder. How do we explain this to parents, people with lived experience, and insurance companies in terms that make sense?

One way I like to explain this is with a deck of cards analogy. Let’s say that each suit represents a particular influence—either an influence that increases your risk of developing an eating disorder or buffers (protects) you against developing an eating disorder.

• Diamonds represent genetic protective factors
• Spades represent genetic risk factors
• Clubs represent environmental risk factors
• Hearts represent environmental protective factors

With the meeting of the egg and the sperm, you get dealt your initial hand of diamonds and spades. There is nothing we can do about the diamonds and spades we are dealt or that we pass on to our offspring. We know that there will be hundreds if not thousands of genes involved with eating disorders risk, so let’s just imagine that you inherit a fairly large “dose” of spades (genetic risk factors). Those have to be counterbalanced with the diamonds that you might have inherited from your other parent (genetic protective factors). At this time, we know much less about genetic protective factors than genetic risk factors. But from the point of conception, you have your spades and diamonds.

Then we start accumulating clubs and hearts along the way. Clubs can be challenges in utero, prematurity, adverse socioeconomic experiences, loss, trauma, teasing, and other environmental events that increase the risk of developing an eating disorder or other mental health problem. But those are buffered by the hearts you accumulate like a loving family, a comfortable childhood, community, faith, and people in your life who support and encourage you.

Your ultimate risk for developing an eating disorder depends on your hand and the balance (or lack of) between risk and protective genetic and environmental factors. Now, this is oversimplified because there are many forces at work. For example, occasionally, someone will get dealt a joker—that might be a rare gene or too many copies of a gene that disrupts the whole system. Although there have been very few rare variants discovered in eating disorders, that does not mean they do not exist. There is more work to do.

Of course, there are always more factors that can influence risk and protection but conceptualizing risk in terms of these four suits can help parents and people with lived experience begin to embrace the complexity of eating disorders. It also helps to understand that there is nothing that we can do about the spades and the diamonds, but all of the work we do in treatment focuses on the critical importance of the clubs (minimizing their impact and processing their effects) and hearts (recognizing them, bringing more into your life, and realizing that you deserve them).

I will be speaking about this model in greater detail at the conference and will illustrate how the Eating Disorders Genetics Initiative (EDGI) will be embracing the complexity of eating disorders by studying both genetic and environmental factors in eating disorders across individuals from a diverse array of backgrounds. This is to ensure that our work adequately represents the way that eating disorders occur in the world so that any novel treatments that emerge from this science will be inclusive and not contribute to health disparities that have plagued our field for far too long.

We invite everyone to visit edgi.org to learn more about how to participate in the EDGI study. If participating in research is something that you are not familiar with or if you have any questions, feel free to give us a call at (984) 974-3798 or send us an email at edgi@unc.edu. Our team can answer any questions you may have in English or Spanish.

To learn more on how nurture and nature play a role in the development of eating disorders, please register for Dr. Bulik’s presentation at this year’s Symposium, “Genes, Environment, and Eating Disorders: What the Clinician Needs to Know.” See the full agenda here. 

About the Author

Clinical psychologist Cynthia M. Bulik, Ph.D., FAED is the Founding Director of the University of North Carolina Center of Excellence for Eating Disorders, Distinguished Professor of Eating Disorders at the University of North Carolina at Chapel Hill, and Professor of Nutrition in the Gillings School of Global Public Health. She is also Professor of Medical Epidemiology and Biostatistics and Director of the Centre for Eating Disorders Innovation at Karolinska Institutet in Stockholm, Sweden.

Dr. Bulik received her BA from the University of Notre Dame and her MA and PhD from the University of California, Berkeley. She completed internships and post-doctoral fellowships at the Western Psychiatric Institute and Clinic in Pittsburgh, PA. Dr. Bulik has developed eating disorders programs in New Zealand, the United States, and Sweden and has active collaborations all over the world. She has published more than 600 papers and 50 chapters on eating disorders. She is the author of seven books including Crave: Why You Binge Eat and How to Stop, The Woman in the Mirror, Midlife Eating Disorders: Your Journey to Recovery, and Binge Control: A Compact Recovery Guide.

Dr. Bulik has been the recipient of numerous awards including the Eating Disorders Coalition Research Award, the Academy for Eating Disorders Leadership Awards for Research and Advocacy, the Price Family National Eating Disorders Association Research Award, and the Don and Melissa Nielsen Lifetime Achievement Award from the National Eating Disorders Association.

Dr. Bulik is past president of the Academy for Eating Disorders, past Vice-President of the Eating Disorders Coalition, and past Associate Editor of the International Journal of Eating Disorders. She serves on advisory boards of several advocacy organizations and is the founder and co-chair of the Eating Disorders Working Group of the Psychiatric Genomics Consortium.

She is passionate about advancing the science of eating disorders and translating science for the public. Read more at http://cynthiabulik.com.

The post Genes and Environment: Embracing Complexity in Eating Disorders appeared first on The Emily Program.

Eating disorders are biologically based illnesses that have both psychological and physical manifestations. This is why The Emily Program employs a multidisciplinary team of eating disorder specialists to deliver the best comprehensive care to every client. We know that no two people have the same eating disorder, so we also personalize our treatment to best fit each client’s unique situation.

Our team is able to look at eating disorders from every angle and plan treatment accordingly. In addition, we know how important it is for all of our team members to collaborate to ensure that everyone is on the same page with the client’s care. Every role is essential to the treatment and recovery of our clients. Read on to learn more about the diverse roles that make up our incredible team of professionals.

Medical Providers

Medical professionals at The Emily Program evaluate, diagnose, treat, and monitor physical ailments related to an eating disorder. Our medical team includes physician assistants, nurse practitioners, nurses, medical assistants, and more. Their main objective is to manage the medical complications that persist with eating disorders. These complications can include bacterial infections, type 2 diabetes, and osteoporosis. Depending on the setting of the care they provide, they may be involved in groups, outings, mealtimes, and therapeutic interventions. As with other members of the team, The Emily Program’s medical providers provide holistic and compassionate care for clients.

Therapists

Therapists collaborate in a multidisciplinary setting with other Emily Program clinicians to deliver comprehensive treatment to each client and their family. Therapists help clients learn how to address their symptoms and feelings in connection to eating and food. Therapy aids in coping and self-growth as well. They also serve as the main contact for their families. There are several different kinds of therapeutic treatment that are used by therapists at The Emily Program, including CBT, CBT-E, DBT, and FBT. Therapists also lead assigned group counseling sessions, use therapeutic communication skills to build strong client relationships, complete assigned studies and audits, and much more.

Psychiatry Providers

A psychiatrist is a medical doctor who can diagnose and prescribe medication to treat mental health disorders. Psychiatry providers at The Emily Program meet individually with clients, lead goals and psychoeducation groups, and attend supportive meals. They are responsible for communicating their treatment direction to staff. Psychiatrists are involved in all of our intensive programs and residential care.

Dietitians

Dietitians help clients choose food options that lead to a healthier lifestyle and nutritional balance. At The Emily Program, our dietitians go beyond the typical role of a dietitian, offering clients nutritional evaluation, counseling, education, and meal-planning services to promote mindful, nourishing eating patterns. Our dietitians also run support groups, venture into the kitchen for hands-on learning, and join clients for therapeutic meals.

Eating Disorder Technicians

Eating disorder technicians play an integral role in the function of the client’s day-to-day experience. Their responsibilities include supporting and monitoring clients during and outside of programming, leading activities designed to help clients adjust to living in a community setting, and assisting clients in gaining the skills needed to manage their eating disorder. Our eating disorder technicians draw from their experience and education in mental health, psychology, social work, and related health fields.

Yoga Instructors

At The Emily Program, the yoga instructor is a member of a multidisciplinary team that uses their training and knowledge in yoga to plan and lead yoga groups for clients receiving eating disorder treatment. Being a yoga teacher at TEP takes certain skills and experience that being a standard yoga teacher does not. Additional training in trauma-sensitive or trauma-informed yoga is preferred.

Eating disorder centers like The Emily Program are able to offer a level of specialty care that other healthcare providers are often unable to offer. One reason for this is the wide range of professionals at our centers. Another reason is that the staff at The Emily Program undergo ongoing eating disorder training, ensuring that they stay up-to-date on the latest research and treatment options. Each of the roles on our team is crucial for the recovery process and has the opportunity to make a positive impact on clients, their families, and the overall mission of the organization. The environment at The Emily Program supports wellness, for both clients and employees. Everyone here is deeply passionate about the integrity of the work, providing excellence in the delivery of care, and advocating for eating disorder awareness, recovery, and increased access to treatment. 

If you are interested in what The Emily Program has to offer, you can visit us online or call 1-888-364-5977. Learn about the levels of care we offer, here. If you are interested in becoming a part of The Emily Program team, visit our Careers page.

The post The Role of the Multidisciplinary Team in Eating Disorder Treatment appeared first on The Emily Program.

As a parent, you just want the best for your child. You would do anything for them. And when they are struggling or in pain, it is likely that what you want to do most is to simply make the problem go away.

While parents and families cannot “fix” an eating disorder any more than they can fix another illness, they can take an active role in a child’s recovery. In fact, support from loved ones is integral to the healing process. As your family transitions back to school this year, there are several things you, as a parent, can do to support your child’s recovery. In this blog, we’ll cover some challenges commonly experienced by students with eating disorders and provide strategies for parents supporting them in recovery.

Challenges of school for students with eating disorders 

As your family prepares for the return to school, it is important to consider the anxiety that often comes with the transition. It can be a tough and trying time for students of all ages. The change in routine often comes with changes in everyday activities, pressures, and mealtimes, changes that are likely only compounded this year as more students return to in-person learning. After significant time spent in virtual environments, the drastic shift may bring an overwhelming mix of emotions. In addition to these stressors, students healing from an eating disorder face the added challenge of balancing school with recovery.

Academic pressures

The pressures surrounding exams, homework, grades, report cards, social cliques, and future plans may trigger or exacerbate disordered eating in students. Many students with eating disorders also struggle with perfectionism, a trait that is often reinforced or celebrated in school settings.

Bullying

Bullying is an unfortunate experience in elementary through high school and can be a precursor to eating disorders. When students are made to feel bad about themselves or their bodies, the resulting stress may spark or worsen eating disorder thoughts and behaviors. The bullying may reinforce the eating disorder “voice” often experienced by those with eating disorders by echoing its cruel scrutiny and criticism.

Being labeled as too large or too thin will, unfortunately, have many negative repercussions on how someone will view or carry themselves throughout their life. While bullying can take many forms, it is clear that weight-shaming needs to be part of anti-bullying discussions. Bullying is never okay, and it can have a significant impact on the development of eating disorders. 

Sports

While sports are a popular and valuable activity for many students, some come with an increased risk for those susceptible to developing eating disorders. Sports like track and field, wrestling, cheerleading, and dance, to name a few, place an extreme emphasis on body size, weight, or shape.

It is important to discuss why restrictive eating, fasting, and overexercise for sports are dangerous for your child and can be damaging to their recovery process. When complimenting your child for their sport, be sure you don’t comment on or compare their body to that of other students in their sport. 

Social comparison

Eating disorders are particularly prevalent among adolescents and young adults, an age group that experiences acute body anxieties and tremendous social comparison. Cultures that idolize and put emphasis on appearance can have a large impact on how your children view themselves.

Online, social media platforms like Instagram and Tiktok play a huge role in how students see themselves and others. Young adults are being bombarded by social media ads about weight loss, dieting, the “perfect” body, and other various body shaming messages every day. 

Discuss how heavily Photoshopped images are not realistic and recommend body positive accounts to your child. It is important to know what your child is watching, who they are following, and what their online social media presence is. 

Lunchtime

Given that eating is often the highest-anxiety situation for people with eating disorders, it is important to plan for the triggers that commonly appear during school lunches and snacks. Individuals with eating disorders or in recovery may experience stress and anxiety about eating in public, for example. In an attempt to manage these feelings, students may restrict food or eat in secret.

Packing lunch with your child can help them plan for lunchtime activities and help them gain confidence. If it is helpful for your child, having a conversation before the day’s meals may also alleviate the pressure of food. Keep to the meal plan set out for your child and encourage that meal plan. This is a very important step in the recovery process.

Balancing school and recovery

Recovery is a long process and will take time. So often, society thinks that mental disorders are a choice and can easily be dealt with by “getting over it.” We know this is not the case. Take time to help your child recover. It will never be an overnight recovery. 

Your child’s recovery cannot wait–their health must come first. This doesn’t necessarily mean that their education has to completely stop. The Emily Program has locations, such as the Anna Westin House for Adolescents, that allow students to continue their education while going to treatment. 

How to support your child in eating disorder recovery

While the return to school may be particularly challenging for those with eating disorders, the transition can be made smoother with appropriate planning and support. Here are some tips for parents to keep in mind:

Set a good example. If you are constantly talking about weight or dieting, or comparing yourself to others, your child will see that. Make body positive remarks, don’t put anyone down, and make an effort to model body positivity or body neutrality for everyone. 

Stay non-confrontational, non-judgmental, and supportive. Use “I” statements when you talk to your child about any eating disorder-related concerns. Allow for a private space for them to talk openly about their eating disorders. Applaud their victories, no matter the size.

Enjoy family activities that do not revolve around food. Find ways to connect with your child that are not food-centric. A game night, gentle walks, or evening at a local park, for example, are ways to connect in a more comfortable setting for a person with an eating disorder.

Know the signs of an eating disorder. Signs that a student may be struggling with an eating disorder include poor performance on coursework, unrealistically high expectations, procrastination, difficulty concentrating, or withdrawal from social or favorite activities.

Some other common signs of eating disorders include:

• Rapid weight loss or gain
• Abdominal pain
• Dieting, skipping meals, or following strict food rules
• Excessive exercise
• Frequent comments about food or eating
• Constant self-criticism
• Body image concerns
• Sadness or other mood changes
• Perfectionistic attitude
• Using food to manage emotions or “numb out”
• Isolation and mood changes

Involve professional support. Eating disorders require multidisciplinary care from a team knowledgeable about the complexity and severity of these illnesses. Dietitians, therapists, psychiatrists, and nutritionists, all play a role in helping treat an eating disorder. 

Don’t be afraid to ask for help from healthcare professionals specializing in eating disorders. Parents are very important to their child’s recovery and giving support to your child will be very beneficial to their recovery. Encourage your child to go at their own pace and ask for help when it’s needed. Eating disorders are not and will never be a choice. No one needs to go through an eating disorder alone. 

If your child is returning to school with an eating disorder and looking for support, reach out to us at 1-888-364-5977. Here are some tips on how to show positivity and good body image for your child.

The post How to Support Your Child Returning to School With An Eating Disorder appeared first on The Emily Program.

Episode description:

Shikha Advani is an incoming master’s student and dietetic intern at Boston University who is passionate about eating disorders awareness, as well as diversity, equity, and inclusion in the nutrition and eating disorder fields. As a teenager, Shikha battled anorexia and orthorexia. She hopes her story can help others with eating disorders, no matter where they are in their recovery process.

In this episode of Peace Meal, Shikha discusses what her relationship with food and her body was growing up, how professionals and her loved ones responded to her eating disorder, and how she believes nutrition and eating disorders curricula in universities could be improved. She talks about the weight bias and racism she experienced as a South Asian woman living in a larger body, including the praise she received from doctors for weight loss. Shikha also emphasizes the importance of therapy in addition to any other kind of treatment for eating disorders. In addition, she dives into what her dietetics curriculum at her university was lacking, including topics like social justice, fat positivity, and more, and what it was like to push back against outdated ideas. Finally, she discusses her hopes for the future of the dietetics and eating disorder fields.

We cover:

• How weight bias can prolong an eating disorder diagnosis
• Why recovery from anorexia is more than just weight restoration
• How eating disorders can take away the joy of food
• How Shikha pushed back against the weight-centric curriculum of her university
• What Shikha’s hopes are for the dietetics and eating disorder fields going forward

In Shikha’s words:

• On the true meaning of food: “[I’ve] learned that food is more than what you should put in your body… food is joy, food is something that represents culture, food is so much more.”
• On the future of the dietetics and eating disorder fields: “I’m really hoping to see a lot more diversity, equity, and inclusion in the field. I’m seeing a lot of people talk about why diversity is important, but a lot of people tend to forget about the equity and inclusion part of it.”
• On inherent worthiness: “Diet culture is rampant and there’s constantly people around you that will tell you, you are not worthy because of the size of your body, the color of your skin, but you’re strong and you’re worthy.”

Follow Shikha Advani on Instagram @nutrition_by_sa

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is a podcast that explores topics related to eating disorders, body image, and how society may influence our thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 58: Advancing Eating Disorders Education with Shikha Advani appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

While navigating her own recovery journey at The Emily Program, Teresa Schmitz discovered a hidden gift in being known as a great listener with a compassionate heart. Being earmarked as an IT Leader who was more into the people on her teams than the technology they were building, she realized her purpose was beyond her title. She connected the dots and soon realized her purpose was to help empower others. She pursued her dreams of becoming a coach and launched her own coaching business, My Best Self Yet. She now helps women feel empowered to navigate the journey of loving themselves unconditionally. She also empowers others to know and use their character strengths in the In It Together group coaching program. Learn more about Teresa’s story and follow My Best Self Yet on Facebook, Instagram, and her blog.

A tradition of mine was started on August 13, 2017. That was about a week shy of when my daughter was heading off to college for the first time and moving away from home. It was also a little more than two months shy of my official eating disorder diagnosis.

At that time in my life, I was struggling with not only my eating disorder (unbeknownst to me at the time), but also underlying depression and anxiety. It was a time when I tried hard to find small bits of hope in the everyday of life yet would come up short many days due to the depression and loud eating disorder. That summer, I had been painfully counting down the days until my daughter would leave (as if my life would stop when she did), rather than counting up the hours I had with her in the present moment. I was finding all the things “wrong” rather than all the blessings I had. To say it was a tough time in my life is an understatement.

Yet that day, four years ago, was the day I decided to write myself a letter. I had never written myself a letter before. On that particular August day, I decided that I wanted to spend the next year, while my daughter was away at college, becoming more resilient because I felt aimless and unsure of where I was headed. I had no idea that it would then become an annual tradition.

That first year I wrote, I told my future self that fear was currently the thing holding me back. I vowed that I was “going after what I want, which is a soul-fed life full of love, joy, and happiness.”

The ironic thing about that first letter is that much of what I wrote I wanted to accomplish came true in that first year. It was ironic because it was almost as if my soul knew I had an eating disorder and needed help and this letter was forecasting what was needed. As I closed out my letter, I said, “When you read this on August 13, 2018, you are going to smile and just enjoy what you see and feel in your life. Here’s what I envision:

1. Meditation will be a daily habit
2. Yoga will be a weekly habit
3. Living in the present moment will be a little easier than today
4. Your resilience muscle will be stronger
5. You’ll feel happy
6. You’ll be closer to your career that’s soul-fed
7. You’ll have completed a retreat somewhere
8. You’ll offer love to yourself on good days and bad days.”

I finalized that letter with “You’re going to be proud of who you are in a year! I can’t wait to read this letter in a year and celebrate!”

The following year, on August 13, 2018, the opening line of my letter, after addressing it My Dearest Teresa, was “You have so much to be proud of!” Last year, in 2020, I recognized how much my eating disorder diagnosis was truly a gift. It was a gift because I got to heal myself, make new dear friends, and learn how to love myself and my body as if my life depended on it, because it does.

Writing a letter to my future self has become an annual tradition—something I look forward to year over year. I’m always fascinated by how much of what I write in the letter actually comes true. It’s fascinating to me because I don’t read the letters in between the year and I don’t write down what I say anywhere else. It’s almost like my soul knows what to write and then also what to incorporate and make happen.  

What will you write to your future self today?

The post Traditions appeared first on The Emily Program.

The 10th Annual Veritas Collaborative Symposium on Eating Disorders, co-hosted by The Emily Program, will unite healthcare professionals and eating disorders experts around the theme of “Engaging Science, Unifying Voices, and Transforming Access.” In this article, Roberto Olivardia, PhD, a speaker at this year’s Symposium, examines the complex relationship between ADHD and eating disorders.

Alex*, 35, feels that the only thing that gives him relief from the chaos caused by his ADHD is food. He makes several stops on his way home from work. Along the way and later at home, he might order and eat four hamburgers, four large French fries, a pizza, two bags of potato chips, two gallons of ice cream, and a dozen cupcakes. His numbness after such a binge turns into frustration and disgust. Then he vomits. He swears he will never binge and purge again, something he has told himself for 10 years.

Although eating disorders have been recognized for many years, their association with ADHD is relatively new. ADHD is poorly understood. In a nutshell, it is characterized by attention dysregulation (versus a lack of attention), impulsivity (addictive behaviors, emotional dysregulation, risky actions), and poor executive functioning (disorganization, poor time management, low working memory, impulsive decision making). Some people with ADHD are also hyperactive. ADHD impacts every life domain. 

Research has demonstrated that individuals with ADHD have a greater risk for developing binge eating disorder or bulimia nervosa than their peers without ADHD. A 2007 study conducted at Harvard Medical School found that girls with ADHD were almost four times more likely to have an eating disorder than those without ADHD.

Many people with ADHD have poor impulse control and find it hard to regulate their emotions. This combination can set the stage for binge eating. Haley, 28, compares it to a drug problem. “Food is my heroin,” she says. “It sounds dramatic, but it is true. As hard as I try to prevent a binge, it is like driving over the same pothole that blows out your tires every day.”

For people struggling with bulimia, food is self-medication for anxiety, stress, anger, and boredom. Eating is stimulating, so when sufferers feel “empty” emotionally, food fills the gap. People with ADHD who can feel inadequate and incompetent turn to food as a source of comfort. Eating is used as an unhealthy outlet to take control of their lives. Both people experiencing binge eating and people with ADHD have trouble heeding their internal cues of satiety and hunger.

Fernando, 44, who has struggled with bulimia since he was 15, says, “Controlling my weight is my only success. I was constantly procrastinating, being overwhelmed, and getting nothing done. Back then, there was no support or recognition of ADHD. Everyone thought I was either not trying hard enough or was stupid. After hearing that for so long, I started believing it myself.”

There are biological, neurochemical, behavioral, and psychological reasons why people with ADHD are predisposed to develop eating disorders. When a sufferer also has ADHD, seeing treatment through an ADHD lens is essential. Knowing how the eating disorder is affected by ADHD symptoms, and how it, in turn, affects ADHD symptoms, must be central to treatment. Not managing the ADHD usually leads to treatment failure. The presence of unmanaged ADHD will undermine any treatment of a comorbid condition, like an eating disorder. If the eating disorder therapist is not an ADHD expert, it would be helpful to add an ADHD therapist to the team to consult or collaborate in the treatment.

In addition to typical treatments for eating disorders, patients with both ADHD and eating disorders can benefit from psychoeducation about ADHD and executive function training, as well as discussion around adopting a nonjudgmental, non-shaming view of their ADHD. This includes also connecting to the strengths that come along with an ADHD brain.  Stimulants are a first-line treatment for ADHD symptoms, but there is hesitation among prescribers to provide stimulants to patients with eating disorders. Research has shown, however, that using stimulants for patients with ADHD and bulimia promotes impulse control that can prevent binge eating, as well as boost executive functions that, in turn, make people’s lives easier. Stimulants also help the patient execute the treatment plan. In fact, Vyvanse, a stimulant and ADHD medication, is the first FDA-approved drug for the treatment of Binge Eating Disorder.

Treating an eating disorder is a process that requires investment, hard work, and the proper resources and support. Having undiagnosed and untreated ADHD can make that process so much harder. However, identified and treated ADHD can significantly help in eating disorder treatment, giving patients the much-needed hope and proper tools to forge a path to recovery.

To explore the relationship between ADHD and eating disorders in greater depth, please attend Dr. Olivardia’s presentation at this year’s Symposium, “The Interesting Relationship Between ADHD, Eating Disorders, and Body Image.”

*Names changed to respect patient confidentiality

About the Author

Dr. Roberto Olivardia is a Clinical Psychologist, Lecturer in Psychology in the Department of Psychiatry at Harvard Medical School, and Clinical Associate at McLean Hospital. He maintains a private psychotherapy practice in Lexington, Massachusetts, where he specializes in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), Obsessive-Compulsive Disorder (OCD), and Body Dysmorphic Disorder (BDD), as well as issues that face students with learning disabilities. He is a nationally recognized expert and specialist in eating disorders and body image problems in boys and men.

He is co-author of The Adonis Complex, the first book of its kind detailing male body image issues. He has appeared in publications such as TIME, GQ, and Rolling Stone, and has been featured on Good Morning America, CNN, and VH1. He has spoken on numerous webinars and presents at many talks and conferences across the country. He currently serves on the Professional Advisory Boards for Children and Adults with ADHD (CHADD), The Attention Deficit Disorder Association (ADDA), and ADDitude, as well as a Featured Expert on Understood.org.

The post The Interesting Relationship Between ADHD and Eating Disorders appeared first on The Emily Program.

Episode description:

Dr. Dana Harron is a practicing psychologist, the founder and director of Monarch Wellness & Psychotherapy, and the author of Loving Someone with an Eating Disorder: Understanding, Supporting and Connecting with Your Partner. She joins us in this episode of Peace Meal to discuss how partners of people with eating disorders can support their loved one through illness and recovery.

Dana discusses the common mistakes that partners of people with eating disorders can make and how to avoid those mistakes. She also provides practical tips for approaching a partner when you notice unhealthy behaviors and how to respond when a partner shares that they are struggling with food or their body. In addition, Dana covers useful strategies for supporting a partner during eating disorder recovery, emphasizing the importance of self-care to this process.

We cover:

• The impact of eating disorders on close relationships
• Mistakes commonly made by partners of those with eating disorders
• How to approach a loved one when they display warning signs of an eating disorder
• What to say when a loved one shares they are struggling with food or their body
• Strategies for self-care and for caring for your partner with an eating disorder

In Dana’s words:

• On the confusing nature of eating disorders: “Eating disorders are particularly tricky for loved ones because it seems choiceful. I think it’s really important to keep in mind that it is not. Nobody would decide, ‘I don’t want to be properly nourished.’”
• On communicating with a partner who has an eating disorder: “You don’t have to say the perfect thing. In fact, the pressure to say the perfect thing, I think, is part of what makes people say all kinds of things that are very far from perfect. Just shoot for good enough.”
• On respecting our different struggles: “We all have a different cognitive set. So for one person, food is difficult; for another person, sleep is difficult. I often say, telling someone with an eating disorder to ‘just eat differently’ is like telling an insomniac to ‘just go to sleep.’ It’s not that easy.”

Learn more about Dr. Dana Harron on her website. Find a copy of Dana’s book, Loving Someone with an Eating Disorder: Understanding, Supporting and Connecting with Your Partner, on Amazon, Barnes & Noble, or IndieBound. 

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is a podcast that explores topics related to eating disorders, body image, and how society may influence our thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 57: Supporting a Partner with an Eating Disorder with Dana Harron appeared first on The Emily Program.

In this article, we explore the trait of perfectionism, including common signs, thought patterns, and health risks. Learn the difference between perfectionism and healthy striving, as well as ways to challenge perfectionism to protect against the negative toll it can take on a person’s life.

What is perfectionism?

Perfectionism is a temperamental trait commonly defined as the tendency to hold unrealistically standards—to strive for perfect at all costs. Despite popular thought, it is not the same as healthy striving. “Perfectionism is not striving for excellence,” as researcher Brené Brown explains. “It’s not about healthy achievement and growth.” Instead, it is a self-destructive and unattainable goal.

Often, those who identify with the trait of perfectionism feel pressure to meet extremely high standards to avoid feelings of shame and judgment. If they are perfect, the faulty thinking goes, then they can avoid or minimize these painful feelings. Paradoxically, impossible standards will inevitably only set up feelings of failure and self-defeat, because they are just that—impossible. Rather than recognizing them as such, people who struggle with perfectionism will often blame themselves for not meeting the unattainable expectations, only to continue a debilitating cycle of even more judgment and blame.

The signs of perfectionism

Perfectionism can impact people at any age. Some common signs include:

• Unrealistic expectations
• Constant comparison
• All-or-nothing thinking (perfect vs. failure, good vs. bad)
• Thinking in “musts” and “shoulds” (“I must be perfect,” “I shouldn’t make any mistakes”)
• Procrastination or avoidance of tasks
• Indecisiveness
• People pleasing
• Giving up quickly
• Highly critical
• Fear of rejection or disapproval from others
• Fear of failure
• Defensiveness, especially in response to perceived criticism
• Low self-esteem

Perfectionistic thinking may sound like:

• “I must do things right the first time.”
• “I must do everything well, not just the things I know I’m good at.”
• “If I can’t do something perfectly, then there is no point even trying.”
• “Nothing good comes from making mistakes.”
• “I don’t deserve credit for the things I do well because there’s always something more I could do.”

Where does perfectionism show up?

While sometimes perfectionism affects only one area of a person’s life, it can cut across multiple domains. Some environments where perfectionism may manifest are: 

• School or work: Taking much longer than others to complete tasks; procrastinating due to a lack of confidence; believing that a less-than-perfect score or feedback is a sign of failure
• Personal relationships: Demanding perfection from loved ones; expecting oneself to be a “perfect” partner, daughter, etc.
• Physical activity: Dwelling on mistakes, experiencing little enjoyment from the sport or physical activity; athletic burnout
• Hygiene and health: Needing to eat a “perfect” diet; rigid exercise routines
• Personal environment or possessions: Needing one’s home, car, office, or other environment to be immaculate; excessive money and time spent perfecting one’s environment
• Physical appearance: Excessive worrying about personal style or appearance; spending excessive time getting ready before going out

The health risks of perfectionism

Perfectionism poses significant health risks and has been linked to several mental health conditions, including eating disorders. Research shows that people with anorexia or bulimia have higher levels of perfectionism than those who don’t. Perfectionism has also been identified in patients with binge eating disorder, though less research is available for that diagnosis.

In addition to eating disorders, perfectionism can cause or exacerbate depression, anxiety, symptoms of OCD, insomnia, and social isolation, among other conditions.

How to manage perfectionism

Like all temperamental traits, the traits associated with perfectionism can be used in both productive and destructive ways. The persistence (even in the face of frustration and little success) common in those affected by perfectionism, for example, can help a person overcome adversity and hardship.

Key is identifying how to channel such traits in productive ways. To challenge perfectionism in your own life or to support someone who is doing the same, consider the following strategies:

• Recognize perfectionistic tendencies.
• Identify behaviors that are unhelpful and how they could be helpful if standards were changed
• Recognize any roadblocks to change – what are the fears or concerns about modifying excessively high standards?
• Notice and challenge perfectionistic self-talk.
• Make a thoughtful action plan to target behaviors.
• Lean on support.

In the end, remember that perfection is unachievable, and perfectionism has the potential to lead to eating disorders and other health concerns. Let’s recognize the beauty that comes in imperfection in ourselves and others. 

References 

Bulik, C. M., Tozzi, F., Anderson, C., Mazzeo, S. E., Aggen, S., Sullivan, P.F. (2003). The relation between eating disorders and components of perfectionism. American Journal of Psychiatry, 160(2), 366-368.

Beattie, K. (2019, January 7). Destructive traits of perfectionism, from Dr. Brené Brown.  https://www.thegrowthfaculty.com/blog/4destructivetraitsofperfectionismfromDrBrenBrown

Benson, E. (2003, November). The many faces of perfectionism. Monitor on Psychology, 34(10). http://www.apa.org/monitor/nov03/manyfaces

Hasse, A. M., Prapavessis, H., & Owens, R. G. (2013, June 24). Domain-specificity in perfectionism: Variations across domains of life. Personality and Individual Differences, 55(2013), 711-715.

Scott, E. (2020, February). 10 signs you may be a perfectionist. https://www.verywellmind.com/signs-you-may-be-a-perfectionist-3145233

The post The Dangers of Striving for Perfection appeared first on The Emily Program.

Tell us about yourself!

Hello! I’m Annie Root, the Site Director at The Emily Program’s Cleveland outpatient location. I started with TEP in 2018 as a program coordinator for the adult DBT program. Additionally, I’ve worked as an outpatient DBT therapist, intake clinician, and clinical manager before becoming the site director in April 2021.

Describe the path that led you to The Emily Program.

In 2013, I graduated with an MA in Clinical Mental Health Counseling from John Carroll University. Following graduation, I spent the summer at Penn State as an academic advisor, and then as an individual and family therapist at a teen crisis shelter for a few years. Seeking a new challenge, I came to work for The Emily Program in the adult DBT program in 2018!

What have our clients and your colleagues taught you?

Both have taught me that the learning never ends. We can gain expertise with time and education, but there are always new clients, new presentations, and new treatment strategies. Knowing this feels both hopeful and humbling, but most of all, it challenges me as a clinician and leader to seek out new perspectives.

What three words would you use to describe The Emily Program?

Since starting with TEP, I’ve always felt the company culture to be collaborative, inclusive, and supportive.

What are you most enjoying about the summer?

Being outside, seeing family, and recently taking a trip to Chicago for my sister’s COVID-delayed wedding.

Strangest job you’ve ever had?

I was a tour guide on my college campus, and part of the training was learning to walk backwards and talk at the same time. This was a skill I never quite mastered!

The post Staff Spotlight, Annie Root appeared first on The Emily Program.

Amanda Winstead is a writer from the Portland area with a background in communications and a passion for telling stories. Along with writing, she enjoys traveling, reading, working out, and going to concerts. If you want to follow her writing journey, or even just say hi, you can find her on Twitter.

We live in a world where almost everyone understands how popular social media is. But not everyone takes the time to think about how powerful it is. With billions of active users on some type of social media platform across the globe, it’s one of the most influential factors in our society today.

In some cases, that can be a good thing. In others, it’s not.

Social media influences everything from fashion and music to viral trends and marketing techniques. It also can greatly influence your health. Again, that can be a good thing or a bad thing, depending on what you choose to follow and believe.

Understanding the overall impact of social media can help you make better choices when it comes to your health. That’s especially important if you’re dealing with or have recently overcome an eating disorder. Taking control of your own life and choices will make a big difference.

So, how does social media influence your health? Should you stay on your current platforms, or is it time to take a step back?

How Social Media Can Influence Your Health

Social media can influence people’s health and wellbeing the same way it influences anything else. Things quickly become “trends” for a reason. The more people who become interested in something, the more it will get shared online. Sometimes that can be inspiring, sometimes it can be damaging. We’ll touch more on that later.

It’s important to know how spending time on apps like Facebook, Twitter, and Instagram can really influence you. For starters, scrolling mindlessly for hours on end not only can contribute to a lack of motivation or boredom, but it can cause eye strain, headaches, and a lack of focus.

The mental health aspects of social media have been widely studied as well. Some of the biggest drawbacks to spending too much time on social media include:

• Comparing yourself to others
• Experiencing FOMO (Fear of Missing Out)
• Developing body image issues
• Feeling isolated
• Experiencing cyberbullying

On the other hand, social media can be inspirational. It’s inspired many people to try new things, travel to new places, and accomplish goals.

It’s impossible to deny the impact social media can have on your health, in general. How far does that impact go if you’re trying to deal with an eating disorder?

What Are the Positives?

It’s estimated that eating disorders impact 9% of the U.S. population. That’s 28.8 million Americans who will experience some type of eating disorder in their lifetime. When you consider how many people use social media daily, it’s impossible for the two not to intersect. But, are there any positives to that?

We’ve already touched on the fact that social media can be motivating and inspiring. That is, perhaps, one of the biggest positives for someone dealing with an ED. You can use it to connect with others who might be going through some of the same struggles. If you look in the right places, you can become a part of support groups, watch videos that can help, and even connect with experts who can help you find a balance.

Another positive to social media is being able to witness recovery stories. When you can see people who have been through what you’re dealing with now come out on the other side, it’s a great way to inspire hope and know that you’re strong enough to get through this.

What Are the Negatives?

One of the biggest “cons” of social media for someone with an ED is comparison. Connecting with people is wonderful, but when you start comparing yourself with how others look, it can become a dangerous and harmful experience.

Comparison is natural in everyday life. But social media takes it to a new level by allowing people to show the “highlight reels” of their lives. You might know that a picture or video has been edited or filtered. It’s still hard to stop comparing. You can break free from the comparison cycle by:

• Limiting your time on social media apps
• Unfollowing accounts that make you feel bad
• Taking a break
• Being real on your accounts

When you’re trying to overcome an eating disorder, social media can be a positive resource or a way to make your recovery harder. Ultimately, it’s about balancing your time on social media with other positive things in your life, including surrounding yourself with in-person support. While you don’t need to stay off these platforms completely, if you start to notice that they’re doing more harm than good for your health and wellbeing, consider taking a step back. You might be surprised at how much better you feel when you do.

The post Social Media’s Influence on Health and Eating Disorders appeared first on The Emily Program.

Episode description:

Lisa Whalen, PhD, is the author of Stable Weight: A Memoir of Horses, Hunger, and Hope. Her writing has also appeared in An Introvert in an Extrovert World, The Simpsons’ Beloved Springfield, Introvert, Dear, and Adanna, among other publications. Lisa teaches writing and literature at North Hennepin Community College and is an equestrian and volunteer for the Animal Humane Society.

In this episode of Peace Meal, Lisa describes two key components of her eating disorder recovery: writing and horseback riding. Underscoring the multifaceted nature of the healing process, she reflects on how writing and riding each offered unique lessons for her mind and body. Writing, she explains, supported and extended her therapy lessons, while riding provided a space to put the lessons into practice. Lisa introduces us to a few of the horses that served as mentors throughout her recovery, highlighting the lessons they could teach us all about staying present, taking up space, and being imperfect. She then translates how these and other recovery “nuggets”—the wisdom learned from horses, writing, and therapy—continue to serve her life and career.

We cover:

• The mental health benefits of writing, even if we never share our writing with others
• What horses can teach us about taking up space and owning our imperfections
• The power of body language in both animals and people
• How traits like perfectionism, high sensitivity, and introversion can be harnessed for good
• Why recovery—like all growth and learning—is best taken one step at a time

In Lisa’s words:

• On the therapeutic role of horses: “For me, riding horses felt like a therapy practicum… I learned all this stuff while I was in therapy, and the horses were forcing me to practice it over and over.”
• On embracing imperfection: “There’s no end to the learning. There’s no perfect. You’re always working toward it, but it’s never a standard because the horses aren’t perfect—and they don’t care if they’re perfect or not.”
• On the support of therapy: “It started off for me as a safe space. It was this place I could go and I could talk about all the worst stuff about myself and there was no judgment. She was only rooting for me. She only wanted me to succeed and to be happy and healthy, and she had the tools and the skills to help me do it.”

Learn more about Lisa on her website and follow her on social media @LisaIrishWhalen. Find her book, Stable Weight: A Memoir of Horses, Hunger, and Hope, at Hopewell Publications and on Amazon.

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 56: The Healing Power of Horses with Lisa Whalen appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

While navigating her own recovery journey at The Emily Program, Teresa Schmitz discovered a hidden gift in being known as a great listener with a compassionate heart. Being earmarked as an IT Leader who was more into the people on her teams than the technology they were building, she realized her purpose was beyond her title. She connected the dots and soon realized her purpose was to help empower others. She pursued her dreams of becoming a coach and launched her own coaching business, My Best Self Yet.  She now helps women feel empowered to navigate the journey of loving themselves unconditionally. She also empowers others to know and use their character strengths in the In It Together group coaching program. Learn more about Teresa’s story and follow My Best Self Yet on Facebook, Instagram, and her blog.

Self-love journeys are not easy. They cause you to reflect on your beliefs and challenge what society has taught you about your worth and your body.

About three months into my own self-love journey, I spent a few hours doing something that challenged some deeply rooted beliefs. As homework in between my weekly sessions, my therapist suggested that I part with clothes that no longer fit me. She told me it would set me free. I didn’t realize how emotional this would be when I decided to do it one Saturday afternoon.

I went through my closet and gathered up clothes that I’d been shaming myself with. These clothes had fit me only months before when I was on an appetite suppressant that resulted in weight loss. But they no longer fit me now. Former diet plans taught me to keep these clothes as a reminder of what I once could fit into and should aim to return to. Shaming was an everyday approach to getting into those clothes again (along with the next best diet). I thought it was what you did to love yourself. You kept the smaller clothes as a reminder, and you quickly got rid of ones that became too big. I spent hundreds of dollars on clothes in a short period of time. How could I part with the clothes I bought at a “normal”-size women’s clothing store? I thought.

The clothes sat piled on my bed. I tried on each piece to determine if it fit (even though I knew full well that none would). One by one, I moved the clothes from one pile to another: from “not tried on” to “tried on and doesn’t fit.” I sat in my pile of clothes that no longer fit, sobbing. The eating disorder voice got louder and louder. I had attached so much meaning to these clothes, and it was becoming pretty clear to me at this moment. Wearing a certain clothing size meant I was “normal” and “healthy” is the meaning I was attaching.

Through tears, I gathered the clothes into three piles: ones that I would sell to a second-hand consignment store, ones that I would donate, and ones that I would toss. I knew I needed to get rid of these clothes as soon as possible if I was to “succeed” at this homework. With them hanging in my home, more shaming could happen.

Throughout this experience, my eating disorder wanted power, so shaming me was how he could weasel his way in as I made progress in other areas. I would journal those thoughts shortly after this experience. At the time, I thought these were my words. Yet now, well into my self-love journey, I know that much of what I journaled was the voice of my eating disorder:

“I’m in tears. I’ve just spent 45 minutes going through my closet and have had to pull most of the clothes out because they don’t fit. This is the hardest thing I’ve had to do. I’ve let myself go. I’ve gained X pounds in the last year. I let myself go. I feel so ashamed. I cannot look at myself in the mirror. I see fat. I see burden. I see pain. I see hurt. I see fat. This is the hardest thing in my life at the moment to do. So many clothes. So much money. And I’ve let myself go. I didn’t think I had gained that much weight back. I thought I’d get back to about X and stabilize there. But the scale said X on the day Abbie [my dietitian at The Emily Program] weighed me. My lowest was X. I feel so fat. So unlovable. I’ve got to stop. The only way to heal is to love myself. This is who I am now. I am still the same person inside. Well, maybe mentally I’ve changed for the better, yet I’m still Teresa Joan Schmitz.”

This was the hardest thing I had to do at the time on my journey toward freedom, as you can see how much my eating disorder voice came out to attack me at that moment. I was trying on clothes before deciding to get rid of them. That was Ed making me feel ashamed. It felt hard because it felt like my identity was out the window. Hard because there was a lot of money that went into those clothes. I had already gotten rid of “big” clothes before, and now I was doing the same, only a different size. Up and down like a yo-yo dieter. It highlighted the pain of never being happy with myself, including my body.

Loving your body is not easy. You see so many flaws, yet you know it is the only body you have and that it needs love and compassion to survive. You can’t live a full life if you continue to bash your body, and in turn, your soul. Your soul longs for love and acceptance. Once you learn to accept your body as it is, your soul will be free. You can love yourself for all your imperfections. I will stay awake and fight for my own health and my own needs so that my body no longer has to endure the pain and the abuse. I may never lose a pound again, and yet my body is worthy of love. Every ounce I can smother it with. There is no better love than this. To offer myself the same unconditional love my puppy offers me will set me free.

This experience forced me to challenge old beliefs. And that’s the deal. If you hold on to those old beliefs, you won’t come close to freely loving yourself.

The post Outgrowing Ed’s Clothes appeared first on The Emily Program.

Tell us about yourself!

Hi! I’m Jenna Schuder and I am a dietitian at The Emily Program’s St. Louis Park location in Minnesota. I am the program RD for the adult intensive outpatient program (IOP), I see clients in outpatient (OP), and I recently became Clinical Manager. I was first a dietetic intern through the University of MN-TEP internship and have now been employed at TEP for five years.

Describe the path that led you to The Emily Program. 

The path leading me to The Emily Program has been an adventurous one! My undergraduate degree is in social work and housing studies. After college, I joined AmeriCorps for two years before deciding to go back to school for nutrition and public health. I pursued an undergraduate degree in nutrition and a graduate degree in public health. It was during my dietetic internship that my passion for eating disorders was sparked. I’ve always been drawn to relationship building and helping professions, so when I did a rotation at TEP it felt like I had finally found the career that encompassed all my passions.

What motivates you to show up for work each day?  

I am consistently inspired by the resiliency of my clients. I enjoy celebrating their victories and find purpose in supporting them during challenges, too. Additionally, I am encouraged by the support of my co-workers and could not do my job without them.

What one thing do you wish everyone knew about eating disorders? 

I wish everyone knew that you cannot tell if a person is struggling with an eating disorder just by looking at them. Additionally, making comments on other people’s appearance is not helpful. I wish more people complimented personality traits over physical appearance.

What do you like to do when you aren’t working?   

I am guilty of getting a COVID puppy! Nellie is a Mini Aussiedoodle. She is smart and high-energy and has kept me entertained and on my toes during the pandemic. I’ve been spending a lot of time training her with the ultimate goal of getting her to be a certified therapy dog.

The post Staff Spotlight, Jenna Schuder appeared first on The Emily Program.

Swimsuit season. Beach body. Bikini ready.

The terms are thrown around casually every summer. In regular conversation, on social media, and via media and advertising, we’re hit with messages that suggest we must prepare and perfect our bodies before changing into warm-weather clothing. “Get ready” for the summer, the messages say, by getting your body “ready.” “Follow this workout, stick to that diet plan, and you’ll look and feel your best!” The noise is hard to escape.

This summer, we’re confronted by messages not only about “beach bodies,” but about “post-pandemic bodies” as well. We hear and see chatter about getting our “pre-pandemic bodies” back. Diet and exercise routines are sold as a way to “fix” any COVID-related body changes or to make up for the pandemic time we “should’” have spent fixing our bodies. Amid this noise, we may also feel anxiety about others seeing us in person again, fearing body judgment or commentary. 

Combine the “summer body” pressure with the “post-pandemic body” pressure, and it’s no wonder that this summer is a challenging time for those experiencing body image concerns, disordered eating, and eating disorders. But while Summer 2021 is a unique time to reenter and reconnect with the world and our loved ones, we actually don’t need to change our bodies at all to do it.

In this article, Dr. Jillian Lampert, Chief Strategy Officer of The Emily Program and Veritas Collaborative, helps us explore how we can all practice self-compassion this “swimsuit season” and help our loved ones do the same.

Summer body image concerns

Summer is a common trigger for people struggling with eating disorders and body image concerns. With its warmer temperatures and more revealing clothing, the season can exacerbate body dissatisfaction and anxiety about appearance. Dr. Lampert says these concerns are often magnified when others discuss their own body issues, make appearance-related comments, or promote diet culture’s “beach body” concept. 

“When we say those things around people who are really uncomfortable in their bodies, their discomfort is heightened even more,” she explains. “And when we compare ourselves to others, oftentimes, we wind up feeling less than.”

The summer—and especially this summer—also brings additional opportunities for social events and get-togethers, which can also be high-anxiety situations for people with body image concerns. As Dr. Lampert says, “Maybe we haven’t left the house very often in non-athletic or leisure attire, and are expressing concerns like ‘I forgot what it’s like to wear jeans.’” Add to this discomfort the triggers related to food and eating around others, and social events can be incredibly challenging occasions.

Social media and the “ideal summer body”

Instagram, TikTok, and other social media are among the influences that reflect and reinforce the pressure of the ideal summer body. But, Dr. Lampert reminds us, the “summer body” we see idealized is a myth. It doesn’t exist; it cannot actually be achieved in real life. “We’re not highly edited, staged photos with strategic angles 24/7 when we’re walking around in the world—we’re real people,” she says.   

While social media does offer some benefits, the good comes with risks. Algorithms can set you down rabbit holes and engulf you in images and messages promoting diet culture ideas. It often takes a deliberate effort to find the positives and leave the rest. To do so, Dr. Lampert recommends actively curating your social media feeds to incorporate accounts and influencers who are body-positive or body-neutral.

“Social media is one of the areas we focus on in eating disorder treatment,” she explains. “We know that social media is highly reinforcing—that your brain can experience a dopamine spike when you look at something rewarding and makes you want to look more.”

She suggests that people in eating disorder recovery could also consider taking a social media break or putting limits on their consumption. Then, with support, they can work to better understand why, how, and when they want to consume and engage with content online.

Ways to practice self-compassion this summer 

Coming into this season of reconnection isn’t really about our bodies, Dr. Lampert says. It’s about our relationships. If you find yourself overly focused on how you look this summer, she recommends a language shift toward compassion and gratitude. Instead of thinking of all the things we “have” to do in the next couple of months, consider adopting the word “get.” “You get to do things that you haven’t been able to do for so long,” she says for example. “You get to see these people that you haven’t been able to see for so long.” 

Dr. Lampert also says that it’s important to acknowledge the many emotions you may be feeling about reconnecting with others this summer. Maybe you feel excited. Or maybe you feel anxious, scared, nervous, or sad. Often, how we feel about our bodies is influenced by our emotional state, and tending to our emotional needs is good self-care during the summer and beyond. 

How to help a loved one navigate summer body image concerns 

If you’d like to support a loved one navigating body image concerns this summer, a great place to start is with yourself. Reflect on how you feel about your own body and what you say and model. Dr. Lampert says, “We can really influence and support somebody in their recovery by being positive, or at least neutral, and appreciative of ourselves. What are you saying about your body? Are you talking about the way your clothes fit? Are you engaging in diet talk?”

Comments about food or bodies—both our own and others’—aren’t helpful to anyone, and this diet talk is especially not helpful to others struggling with body image. As we reconnect with others, use this opportunity to explore topics unrelated to food, body, or eating. “Instead, focus on reconnecting, experiencing the present, and be aware of what you’re broadcasting, because those are all things that your loved one will pick up on,” says Dr. Lampert.

In eating disorder treatment, the focus is shifted away from changing the body to changing the way we feel about the body. We celebrate what the body does for us and how we can be gentle with it, instead of disparaging it or being disappointed by it.

People may still feel uncomfortable in their bodies during treatment, but Dr. Lampert says that’s often part of the process. “We think the part of the brain that is involved in body image and body perception is one of the last to change and reconfigure to the current reality,” she explains. If people with eating disorders focus on nurturing themselves and their bodies, body perception can catch up.

And that’s where the focus should be for all of us. While we cannot completely eliminate diet culture messages this summer, we can put our effort toward self-compassion and body trust. Our bodies—exactly as they are—carried us through what was an incredibly difficult year. Treating them with kindness is a way to thank and honor them.

The post Navigating the Pressures of Swimsuit Season appeared first on The Emily Program.

Episode description:

Emily Layden is a writer and former high school English teacher from upstate New York. A graduate of Stanford University, her writing has appeared in The New York Times, Marie Claire, The Billfold, and Runner’s World. She joins us in this episode of Peace Meal to discuss her debut novel All Girls. We explore the depiction of disordered eating and anxiety in the book and society more generally, using Emily’s experience with the co-occurring concerns as context along the way. 

We center our conversation on one of the characters of All Girls, Macy, who struggles with clinical anxiety and an eating disorder resembling ARFID. Emily tells us about her decision to write Macy as she did, eschewing graphic descriptions of behaviors to highlight Macy’s anxious thoughts instead. She describes what she hopes All Girls adds to the larger conversation about eating disorders and the adolescent females among whom eating disorders are particularly prevalent. Emphasizing the importance of taking both eating disorders and young women more seriously, we explore how society tends to think similarly of both.

We cover:

• The relationship between anxiety, obsessive thoughts, and disordered eating/eating disorders 
• How exercising compassion with her students became a way for Emily to exercise compassion for herself
• How our culture routinely dismisses or trivializes eating disorder stories and other experiences prevalent among young women
• How one character in All Girls, Macy, can widen our cultural understanding of eating disorders
• What the reader response to Macy says about changing attitudes toward eating disorders and mental illness

In Emily’s words:

• On the connection between anxiety and disordered eating: “Macy is anxious, you see in her chapter, about so many things entirely unrelated to her body or to food. But she copes with that anxiety through avoidant and restrictive behaviors.”  
• On typical eating disorder depictions: “So often when we have a depiction of an eating disorder on TV or in literature, it tends to be this very narrow reflection of the experience.”
• On the parallel between society’s understanding of young women and of eating disorders: “I think that there’s this whole culture that says that girls are not really whole people and thinks that they are trivial or overly emotional… and I think we see a lot of that same flattening with our cultural thinking about eating disorders.”

Find Emily on Instagram @emilylayden and at emilylayden.com. Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 55: Eating Disorders in Fiction with Emily Layden appeared first on The Emily Program.

What is ARFID?

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by food avoidance or restriction that results in nutritional deficiencies and interferes with daily functioning. As in anorexia, ARFID can lead to significant weight loss or a failure to gain weight. It does not include concerns about body weight and shape, however. Instead, ARFID primarily manifests as avoidance related to the sensory properties of food and fear about eating.

Previously known as selective eating disorder (SED), ARFID was introduced in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The following criteria must be met for an individual to be diagnosed with this eating disorder:

1. An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
   • Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
   • Significant nutritional deficiency
   • Dependence on enteral feeding or oral nutritional supplements
   • Marked interference with psychosocial functioning
2. The eating disturbance is not attributable to a concurrent medical condition or is not better explained by another mental disorder.
3. The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
4. The disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.

It is important to note that an individual may still have a serious eating disorder that warrants care even if some of these criteria are not met.

Warning Signs and Symptoms

Warning signs of ARFID may include:

• Notable weight loss
• Failure to meet nutritional needs
• Stunted growth
• Stomach problems without apparent reason
• Eating an extremely limited variety of foods
• Restriction of certain foods due to taste, smell, or texture
• Lack of interest in food
• Fear of swallowing, choking, or vomiting
• No body dysmorphia or drive for thinness

Physical Effects of ARFID

The physical consequences of ARFID are similar to those of anorexia, as both disorders lead to significant nutritional deficiencies. When the body is denied essential nutrients, it is forced to slow down its processes to conserve energy. The impact can be far-reaching, touching virtually every body system. Left untreated, these effects can be devastating—even fatal. But when ARFID is recognized and addressed early, the physical consequences can be treated, and, in some cases, fully reversed.

Dermatological Effects

When in a malnourished state, the body uses its limited energy to preserve its most vital organs, leaving the skin, hair, and fingernails in poor condition. Dermatological consequences of ARFID include dull, dry, and pale skin; thinning hair; and weak, brittle fingernails. A soft, downy layer of hair may also appear on the face and body. Known as lanugo, this hair grows as the body’s way to protect itself against heat loss and an intolerance to cold associated with malnutrition.

Gastrointestinal Effects

Those with ARFID may suffer from a variety of gastrointestinal complications, including gastroparesis, constipation, and bloating. Gastroparesis refers to delayed stomach emptying—the stomach emptying slower than normal—which often presents as excessive fullness, nausea, bloating, and early satiety. The condition further complicates an individual’s ability to consume adequate nutrition.

Constipation is also common when the body has insufficient food and fluid to process and create waste. It is difficult for the intestines to move material through the body’s systems and produce regular bowel movements. Cramps and feelings of fullness often result, leaving affected people in intense discomfort or pain.

Endocrine System Effects

Nutritional deficiencies alter the body’s hormone states, which may result in low blood sugar levels, reduced sex drive, amenorrhea, and even infertility. Hypoglycemia, or very low levels of blood sugar, can cause headaches, fainting, mood changes, and difficulty thinking. Fluctuations in the production and secretion of sex hormones like estrogen and testosterone are linked to sexual dysfunction and a low sex drive. Menstruating people with ARFID may experience abnormal cycles or missed periods, which may impact fertility.

Nervous System Effects

A highly active organ with significant energy demands, the brain also suffers as a result of AFRID-related malnutrition. This is especially concerning in adolescents, as brain development lasts well into early adulthood. At all ages, people with ARFID may experience poor concentration and decision making, as well as slowness in thought or processing. Memory may be impacted as well, interfering with an individual’s ability to recall information or experiences.

Skeletal System Effects

People with ARFID are at risk for low bone material density and strength as another result of nutritional deficiencies. Bone loss can lead to osteoporosis and a higher susceptibility to fractures and breaks. Because bones are sensitive to changes in hormones as well, low estrogen levels and missed menstrual periods in females can make bones even weaker.

Cardiovascular Effects

Complications involving the cardiovascular system include hypotension, bradycardia, arrhythmia, and electrolyte abnormalities. The function, strength, and rhythm of the heart are impacted by malnutrition and dehydration, which places individuals at higher risk for heart failure or cardiac arrest that can be fatal.

Recovery is Possible

Eating disorders are serious but treatable illnesses. Given the potential severity of physical complications associated with ARFID, people affected by the eating disorder should seek help as soon as possible. The sooner an individual begins treatment, the sooner the adverse health effects of ARFID can be treated and the quicker recovery usually is.

With professional treatment, recovering from ARFID is possible. If you think that you, a loved one, or your patient could have ARFID, reach out to The Emily Program today at 1-888-364-5977 for assessment and care.

The post Physical Effects of ARFID appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

This blog was submitted anonymously by a woman in eating disorder recovery.

For most of my life, I thought of food as the enemy. I actually used to say that it was my biggest weakness. It was like a drug I was supposed to avoid instead of something my body needed to live. If I ate only a certain amount or type of food, I was being good, but if I ate more than that limit or a “bad” food, I was being bad. The food made me bad (or so I thought), and therefore it was something I needed to fear or fight. Just like an enemy.

About two years ago, a therapist told me something that helped me finally move away from that thinking. I was working on challenging the idea of “good” foods vs. “bad” foods, and week after week, this therapist kept telling me that food is neutral. It still wasn’t clicking. I still couldn’t get away from the categories. And then she encouraged me to reframe it: to think less of the particular food—and whether it is “good” or “bad”—and to think about my relationship to it instead. Instead of thinking, “x food is bad,” she recommended that I say, “My relationship to x food could be improved.” Rewording it in this way helped me see that it was not the food that was the problem, but it was my relationship with the food that was.

This experience was like a lightbulb moment that helped me understand a couple of things. First, it showed me what people mean when they say “peaceful relationship with food” and how my relationship with food was not peaceful in any shape or form. Secondly, it helped me picture what I was actually working on in recovery. Before this moment with my therapist, I was operating as if going through the motions of recovery (following a meal plan, maintaining weight) would automatically make food less of an enemy. While those things were important, I also needed to look at the thoughts and judgments that I was directing toward food. If you want to have a peaceful relationship with a person, you can’t always be thinking judgy things about them, and the same is true for food. You have to look at the things that go into making the relationship work. While food isn’t inherently good or bad, there are some barriers that make it seem that way and you have to work on overcoming those so that you can view food from a more neutral and accurate place.

I am grateful to that therapist and I would give the same advice to others struggling with food or judgments about particular kinds of food. Food is just food, and once you remove the “good” and “bad” labels from it, there is much more room for you to finally have a better and more peaceful relationship with it.

The post Redefining My Relationship with Food appeared first on The Emily Program.

The average number of products in a grocery store tops 28,000, according to the Food Marketing Institute. It’s enough to overwhelm any shopper. For those with eating disorders, the tremendous selection can further heighten difficulties with food and make grocery shopping an errand that is anything but enjoyable.

Food is a common preoccupation and trigger in eating disorders of all types, including anorexia, bulimia, binge eating disorder, and OSFED. Thoughts of food often consume the day, as do rules of what, when, and how much should be eaten. The abundance of food at the grocery store can exacerbate these thoughts, sparking significant anxiety, fear, and distress upon entry. Factor in the store aisles awash with food labels and fellow shoppers commenting on food, and it’s no surprise that the grocery store is a highly stressful environment for those with eating disorders.

In this article, we provide several strategies for grocery shopping in eating disorder recovery. Learn how to navigate the shelves in person or virtually, and ensure you check out with items that serve your recovery.

1. Shop at a smaller store.

Big-box grocery stores are defined by their larger selections. And more options—more aisles, more brands, more items—can mean more eating disorder-related challenges. For example, you may feel compelled to compare food products and nutrition labels. It’s a common eating disorder behavior aimed at distinguishing so-called “good” foods from “bad” ones. The pressure to pick the “best” option can make choosing even a single item an all-consuming and stressful task, so much so that you might leave the store empty-handed. Alternatively, shelves upon shelves of highly desirable foods may lead to a large purchase that could trigger an episode of binge eating.

If you are overwhelmed by the sheer number of food items at your store, try opting for a smaller store where there are simply fewer options. The limited selection can help you more easily find what you’re looking for, expose you to fewer food messages and products, and relieve the pressure to evaluate countless brands before placing an item in your cart.

2. Shop at quieter times.

Large groups of people, especially in food-related situations, can also trigger eating disorder symptoms. At the grocery store, you may overhear comments from other shoppers (e.g., “We’re not getting that. That’s so bad for you.”) or cashiers (e.g., “Looks like a junk food run!”), which are likely to reinforce eating disorder thoughts and beliefs. You may also receive or perceive food judgment from those looking in your cart or at your items on the checkout belt.

Though we cannot eliminate all potential triggers of our diet-obsessed culture, there is nothing wrong with adjusting your schedule to the benefit of your recovery. If shopping around others is challenging for you, consider choosing a less popular time to visit the store, such as weekdays and mornings. Fewer people may mean fewer diet culture comments to process, which reserves your energy for the task at hand.

3. Shop online.

Online ordering eliminates the need to roam store aisles, a benefit appreciated during the pandemic that will extend beyond it. Grocery delivery or pickup services may be particularly useful to those affected by eating disorders, as they can lessen the triggers associated with crowds and packed shelves.

When shopping online in recovery, make use of simple strategies and tools available to manage your triggers. You can, for example, consciously choose not to click through the image carousel on each product—a tactic that may deter or stall the compulsive act of checking and comparing labels. For a firmer boundary, use the quick “Add to cart” option to avoid seeing that information at all.

4. Make a list.

A plan increases the likelihood of success at the grocery store. When planning your meals at home or alongside a dietitian, keep a list of the items required. Be sure to bring your list to the store, and if it’s helpful, remind yourself that these items don’t require additional thought or second-guessing. The decision has already been made: they are necessary for the snacks and meals ahead. These foods fit under an all-foods-fit philosophy, and you can trust that your body will know what to do with them.

5. Get support.

You don’t have to handle grocery shopping alone. Involve a friend or family member by asking them to join you at the store, or, perhaps on difficult days, ask them to make the grocery run for you. At the store, a support person can hold you accountable to your list, as well as help to interrupt the urge to obsessively compare labels or fill your cart with more than what you need. They can also help you stick to an appropriate time for shopping.

Professional support is another key asset in helping you navigate grocery shopping and other food-related activities. For guidance around your unique shopping challenges or dietary needs, reach out to a provider who specializes in eating disorders.  

At The Emily Program, we treat people with all types of eating disorders using a multidisciplinary team and integrative interventions. Along with psychotherapy and education, we provide nutrition and food-related experiences and skills that promote a more mindful and peaceful relationship with food. If you or your loved one is struggling with food, schedule an eating disorder assessment or contact us at 1-888-364-5977 today.

The post Strategies for Grocery Shopping in Eating Disorder Recovery appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. This story includes mention of self-harm. Please use your discretion when reading and speak with your support system as needed.

Melanie Stephen is a wife and mother to two beautiful girls. She obtained her graduate degree in social work in 2020 and began pursuing a fulfilling career in the field of eating disorders. She has volunteered her time as a mentor and support group leader, while also working as an Inpatient Clinician for those struggling with eating disorders and co-occurring illnesses. She is pursuing a life that is full of adventures, opportunities, and possibilities that allows for self-growth, passion, authenticity, and genuineness.

Through her recovery, she has learned to be true to herself, scars and all, and to allow the world to see that it’s realistic to be perfectly imperfect. She has earned her certification as a Certified Eating Disorder Recovery Coach and Certified Eating Disorder Peer Mentor, as well as certification in Expressive Therapy. She also plans to continue advocating for the Eating Disorders Coalition and become a Certified Intuitive Eating Counselor. It is her deepest hope that with her personal and professional experiences, she will be able to help others in their journey to recovery and be free from disordered eating.  

Recovery Conversations is a question-and-answer series that features voices and stories of eating disorder recovery. Melanie Stephen joins us today to reflect on the “roller coaster ride” of her recovery and the lessons it has for others currently struggling.

How did you decide to seek help for your eating disorder?  

This is a hard question to answer because I decided to seek help for recovery many times. There were a few half-hearted attempts in my early adulthood, but my insurance company didn’t believe that I was “sick enough” to qualify for those levels of care. The second time was in 2007, after a bad self-harm incident for which I was brought to the hospital. I had already been in contact with two different residential programs and this episode fast-forwarded that process for me. I flew with my husband to Tennessee shortly afterward and checked myself into a treatment program, one I would have liked to attend off and on again for many years if it weren’t for the out-of-pocket expenses. While this treatment provided me with a lot of knowledge of my eating disorder and self-harm and its impacts on not only my own life but those of my loved ones, it was simply too short-lived. I needed more time.

I can remember the day after returning home from treatment and finding out that I was pregnant, an unplanned blessing after having experienced a miscarriage only six months prior. I was terrified about how my body would change and the impact all of it would have on my recovery. I used the opportunity to submit an article, “The MOM in Me,” to the You Are Not Alone recovery newsletter. It was a reminder of why I was working so hard and who it was for. After my daughter was born, life was beautiful and exciting, but due to a variety of circumstances, my husband, daughter, and I moved abroad to Singapore. During our time there, I genuinely enjoyed being a mother and spending time together as a family exploring new things, but my eating disorder was still very much a part of my life. I sought help but was conflicted with many of the practitioners because of Eastern/Western medicine philosophies, especially in relation to mental illness. After two more miscarriages and two episodes of self-harm, the decision was made to return home so that I could receive more treatment in America. My health was fading, my mental health was fading even faster, and I just wanted to focus on getting healthy, being a good mom, and providing a good life for our family.

It’s an awfully long story, but I will keep it as short as possible. I became pregnant with my second daughter and began seeing a therapist. This professional may be the greatest influence in all my treatment endeavors because he taught me about conditioned habits, the addictive personality, and how to differentiate myself from my eating disorder. He helped me learn how to identify who I am separate from my eating disorder and begin practicing days free of behaviors, and he had no problem loading on the in-between session homework, which I needed. This therapy carried me through a high-risk pregnancy that ended on a very scary note. My baby was healthy and fine, but I was rushed out to the operating room for hemorrhaging and couldn’t hold my little girl until many hours later. This was my motivation to continue seeing my therapist and explore additional ways I could be actively working in recovery.

Over the years, my reasons to seek recovery and help have changed depending on where I am in my life. The most recent one was when I graduated with my graduate degree in social work and couldn’t wait to work in service to others. To be strong for the individuals that I serve, I need to practice my own strength and draw on my own journey. I am reminded often of how important this work is and how rewarding it can be when a patient simply says, “Thank you for your help.”  

How did you stay motivated in recovery?

For me, the motivation always came down to one simple thing: to give myself the opportunity for a better, more rewarding, more adventurous life in which I can be authentic, compassionate, loving, and accepting. When I struggle, I am reminded of the fact that I am raising two daughters in a society that is bombarded by images and thoughts of what people should look like, how they should act, and what they should say. Staying motivated allows me to step back and see what they are going through not only from the perspective of a parent, but also that of a social worker. It’s also motivating that after so many years of working to this point in my career, I finally can engage in the world of recovery more, support others in their journeys, and hopefully impact a few along the way with my own story. 

If you could go back to the beginning of your recovery, what would you tell yourself?  

I must start by saying that I fully believe in the butterfly effect and that if I went back and changed one thing about my path, it would inevitably change the entire course of my life. However, with that said, I can remember pivotal moments throughout the journey that I would play the “would have/could have/should have” game with. The most important one was when I attended a residential treatment program in 2007. Not only had my bulimia taken over my life, but so had my self-harm, and my husband and I discussed the need for more extensive treatment that cost a lot of money, out-of-pocket. I attended the program for 21 days, leaving early from my 28-day plan, and returned home with a stronger foundation for recovery but without the commitment that I needed. If I could go back, I would stay in that program for at least 2–3 months and I believe it would have impacted the rest of my life.

However, knowing that it would also impact my having had two children, living abroad, my journey to find a passionate career, etc., I would simply change the thought that I left treatment with. I would go back and tell myself to be compassionate, patient, and respectful of myself. I would tell myself to take a deep breath because the journey will be long and taxing, but I believed in myself. I would give myself a hug and provide the reassurance that while this is challenging, everything passes in time. 

Favorite recovery quote?  

When I think about answers to this question, dozens come to mind. I adore quotes, and often in my work as a mentor, I utilize them for those that I am working with. They can be inspiring, thought provoking, and for me, powerful. Out of all the quotes that I can think of related to recovery, it’s one simple one: “Recovery isn’t linear, but it is possible.”

There is no straight path to recovery. It’s full of ups and downs, twists and turns, successes and failures. I learned a lot about myself throughout the recovery process, and at times, it wasn’t always something I wanted to learn. There were times when I would take a step forward, only to take two backward, and beat myself up for what I perceived to be a lack of progress—a failure. Other times, I wasn’t actively engaging in recovery, but it happened organically.

The roller coaster ride of recovery is painful, challenging, tormenting, depressing, and overwhelming. However, despite all the relapses, dark moments, rock bottoms, losses, and anguish, the journey is one of self-discovery, growth, acceptance, compassion, and triumph. I cried a lot, I often crawled away into a dark hole to hide from the world, I screamed, I experienced torturing self-hatred, I self-harmed, and I failed. But through the nonlinear recovery journey, I also discovered parts of myself I never knew existed, have been inspired, practiced gratefulness, and aimed to be more optimistic and accepting of the roller coaster of life. Recovery looks different for everyone, but the most important thing is to be authentic, embrace the journey, and know that IT IS possible. 

What words of encouragement would you share with those who are struggling?  

Don’t give up.

I wanted to give up so many times, to turn in the towel and just accept that this was how I was going to live. Everyone has their rock bottoms, and I can honestly say that I had dozens, which threatened my relationships, my family, my education, my career, my opportunities for travel and adventures, but I tirelessly forged on in recovery. I kept listening to the therapists, professionals, peers in recovery, authors, blog writers, etc. to keep my passion for recovery ignited. Even though I had moments of despair, a lot of them, I knew that life beyond my eating disorder was possible. I knew that with ongoing hard work and commitment, I would be able to grow from my experiences and learn who I was without my eating disorder. It was a matter of telling myself that I was worth it, and that even with the scars, internal and external, I was whole and capable of great things. Those struggling need to be reminded that recovery takes time, but the rewards are utterly amazing. Beyond the eating disorder is a life that is fulfilling, filled with opportunities and adventures, and that provides the chance to help others going through the same or similar experiences. Recovery is one of the hardest things that a person can do and it tests every part of your being, but don’t give up!

The post Recovery Conversations: A Q&A with Melanie Stephen  appeared first on The Emily Program.

Episode description:

Holly Toronto is a Certified Master Level Coach who specializes in body image. She has five years of experience helping people stop prioritizing other people’s expectations of beauty, belief, or behavior so that they can live their life from a place of wholeness, fully aligned with the truth of who they are. Holly joins us in this episode of Peace Meal to explore factors that impact our relationship with our bodies, as well as some strategies to improve it. 

Holly first unpacks how purity culture shaped the way she learned to relate to her own body. Messages about sexuality contributed to body distrust and triggered negative body image at a young age. Her body shame increased as she grew into early adulthood and experienced acne. She adopted a “pure food” diet meant to clear her skin, but lost weight and received validation for that instead.

Though it seemed normal and even “healthy,” in reality, the highly restrictive diet was taking a serious toll on Holly’s mental and physical wellbeing. And then came a turning point. Holly shares how finding intuitive eating impacted her life and career by challenging misguided ideas of health and set her on a path toward food freedom and body trust. She dispels common myths about intuitive eating and describes how she walks alongside her clients who adopt it. Emphasizing the importance of body trust and partnership, she offers tips for anyone seeking to heal their relationships with their bodies.

We cover:

• The parallels between sexual purity and “pure” or clean eating
• Myths and realities of intuitive eating
• The far-reaching impact of body image healing
• How to relate to your body as a partner instead of an object
• How to honor and trust our body signals

In Holly’s words:

• On the gifts of intuitive eating: “What intuitive eating gave me was a sense of trust in my body—that I don’t have to manipulate her for her to be healthy. For her to be strong. For her to be exactly what she needs to be. I needed to disconnect the weight from the worth and the weight from the health.”
• On the importance of body trust: “This body that we live in was our original life partner. And like any partnership, trust is the foundational element.”
• On connecting to ourselves: “Body image healing can be a gateway back to ourselves—to a sense of deeper homecoming, connection to ourselves, and what we want to be putting out into the world.”

Find Holly on Instagram @holly.toronto. Learn more about The Emily Program online or by calling 1-888-364-5977.

—

About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 54: Building Body Trust with Holly Toronto appeared first on The Emily Program.

June is Pride Month, a time to celebrate the LGBTQ+ community and sexual and gender diversity. Members of the community and allies unite in pride and solidarity to recognize, honor, and uplift the voices of lesbian, gay, bisexual, transgender, and queer and/or questioning people.

As we honor the LGBTQ+ community this month and beyond, we must also commit to better understanding and addressing the issues it faces. One such issue is eating disorders, which affect LGBTQ+ people at disproportionately high rates.

In this article, we explore eating disorders in the LGBTQ+ community and offer ways to support affected community members during Pride and throughout the year.

Eating disorders in the LGBTQ+ community

Eating disorders aren’t unique to straight, cisgender women. They cut across all social categories and intersections, including sexual orientation and gender identity. While the majority of the field’s research has focused historically on straight females, the studies involving LGBTQ+ people show high prevalence rates of eating disorders.

In fact, research suggests that some LGBTQ+ community members experience eating disorders at even higher rates than their straight and cisgender counterparts.

• In one study, 54% of LGBTQ+ adolescents and young adults surveyed indicated that they had a diagnosed eating disorder, and an additional 21% suspected that they had an eating disorder (NEDA).
• Men who identify as gay are thought to represent 5 percent of the total male population, but among males who have eating disorders, 42 percent identify as gay (NEDA).
• People who identify as gay, lesbian, bisexual, or “mostly heterosexual” experience elevated rates of binge eating and purging as compared to their heterosexual peers (Bryn et al., 2009).

Like eating disorders in other populations, eating disorders in the LGBTQ+ community are complex and multifactorial. Sexual or gender identity alone does not predict who will develop one, as other biological, psychological, and social factors also play a part. Experiences related to sexual orientation and gender identity can, however, contribute to the development or maintenance of an eating disorder.

Factors that may increase the likelihood of an eating disorder in a susceptible LGBTQ+ person include:

• Discrimination, harassment, and bullying related to sexual orientation or gender identity
• Anxiety and fear of rejection about coming out
• Internalized homophobia, transphobia, or misogyny
• Gender dysphoria experienced by trans and/or non-binary individuals
• Appearance ideals within certain segments of the LGBTQ+ community (especially gay men)

How to support LGBTQ+ individuals with eating disorders

Support is key to recovery for people of all gender and sexual identities. And true support means caring for the whole person instead of just their illness. When supporting LGBTQ+ people with eating disorders, it is vital to affirm their gender and sexual identities and to recognize how these identities intersect with the experience of illness and recovery.

Here are some strategies to provide support that is safe, inclusive, and affirming for LGBTQ+ community members with eating disorders.

1. Center LGBTQ+ voices and experiences.

Start by simply listening to LGBTQ+ people about their relationship with food and their bodies. Remember that each person is the expert of their experience, and any support offered should respect their individuality and guidance on what is and is not helpful.  

Some practical tips for actively listening and learning include:

• Create a safe space for people to share what they need, making it known that you will listen with confidentiality and without judgment.
• Ask how you can help using questions like: What can I do? Would you like to research LGBTQ+-friendly treatment options together? Would it be helpful to share a meal? What isn’t helpful?
• Read and listen to the experiences of people in the LGBTQ+ community, understanding that there is no singular story. This blog and this podcast will get you started.

2. Affirm each person’s identity through inclusive language.

Adopt language that affirms all gender and sexual identities.

• Introduce yourself with your name and pronouns and ask others for theirs.
• Practice using gender-neutral terms (e.g., “everyone”) in place of gendered ones (“men and women”).
• Create intake forms that don’t assume sexual or gender identity.

3. Acknowledge the intersection of eating disorders and LGBTQ+ identities. 

Eating disorders can affect the LGBTQ+ community in unique ways. Recognize that special factors may play a role in the development and maintenance of these illnesses in this population, including:

• Eating disorders being overlooked or dismissed across the LGBTQ+ community because they do not fit the stereotype
• Discordance between body and gender identity among trans and/or non-binary people that can trigger disordered behaviors as a means to improve body dissatisfaction or distress
• An elevated drive for muscularity among gay men that can introduce or exacerbate eating disorder symptoms

Learn more about eating disorders among lesbian, gay, and bisexual individuals here, and about eating disorders in transgender individuals here.

4. Appreciate that recovery is not one size fits all.

Eating disorder recovery looks different for everyone, and several mainstream recovery messages may be particularly out of touch with the experiences and needs of LGBTQ+ people.

When providing messages of support, be wary of:

• Messages championing total body positivity (e.g., “Your body is perfect the way it is!” “Love the skin you’re in!”), which can be invalidating for those experiencing gender dysphoria
• Messages celebrating the return of menses, which can be dysphoric for trans and non-binary individuals
• Heteronormative and patriarchal messages meant as motivation in recovery (e.g., “Guys like women with curves.”)

5. Support efforts toward greater inclusion and diversity.

LGBTQ+ individuals face unique barriers to eating disorder treatment, and ensuring that the community has access to care is ongoing work.

Support efforts toward greater inclusion and diversity in the field, including:

• Striving to make all eating disorder programs safe and affirming spaces
• Continuing education on the unique needs and experiences of LGBTQ+ people with eating disorders
• Ensuring LGBTQ+ people are included in research that informs social and healthcare policies

Much like recovery itself, supporting LGBTQ+ people with eating disorders is an active process that requires compassion and sensitivity. To be helpful is to be inclusive, non-judgmental, and culturally competent. Care must be tailored to the needs of each person, reflecting an understanding of and respect for each person’s identity and unique life experiences.

At The Emily Program, we welcome people of all sexual orientations and gender identities with all types of eating disorders. If you are a member of the LGBTQ+ community struggling in your relationship with food, give us a call today at 1-888-364-5977.

The post How To Support LGBTQ+ Individuals With Eating Disorders appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

While navigating her own recovery journey at The Emily Program, Teresa Schmitz discovered a hidden gift in being known as a great listener with a compassionate heart. Being earmarked as an IT Leader who was more into the people on her teams than the technology they were building, she realized her purpose was beyond her title. She connected the dots and soon realized her purpose was to help empower others. She pursued her dreams of becoming a coach and launched her own coaching business, My Best Self Yet.  She now helps women feel empowered to navigate the journey of loving themselves unconditionally. She also empowers others to know and use their character strengths in the In It Together group coaching program. Learn more about Teresa’s story and follow My Best Self Yet on Facebook, Instagram, and her blog.

Before treatment, I’d been searching for a lost soul.

I looked for her in everything I did and in everyone around me. I chased after my career as if I’d find her there—as if my soul and my work were one and the same. I chased after other people’s lifestyles because I thought their lives were better than mine, especially if their bodies were smaller than mine.

I could not find peace within myself because my eating disorder had convinced me I wasn’t worthy enough. If you keep chasing, you’ll eventually find her is what my eating disorder convinced me. We can’t find our souls in a job or another human being (I know this now), and I was exhausted from years of trying. By the time I entered treatment, I was exhausted mentally, physically, and emotionally.

It took months of treatment to peel back all these layers and to realize (and believe) I was worthy. On a summer night in June, seven months into treatment, I felt a sense of peace wash over me and words poured out of my soul as if I’d discovered the pot of gold at the end of the rainbow. I took time to write a poem to myself. It went like this:

Your Soul Is Beautiful

You walk into a room
And my eyes light up.
It’s like I just want to zoom
All my attention to you. I want to be you.
I can’t help but notice
All your beautiful features –
Your caring heart, your soothing voice,
Your gentle touch, your ever-flowing kindness.
I look into the mirror expecting to find
Someone else and yet I look deep
Into your eyes and realize it’s you.
You who looks like a beautiful human being.
You who’s been here all along. It’s you.
Yes you, Teresa Joan Schmitz!
It’s you I’ve wanted to be for years.
It’s you I’ve been trying to find for years.
It’s you. You’re here. Right before my eyes.
Yes, it’s really you.

Journaling and drawing became an avenue for me during my journey. Sometimes words just flowed out of me. Other times, I was stuck. But I kept showing up for myself in those words, even when I was stuck. I wanted to feel worthy standing next to anyone. And now, I’m so proud to say that I do feel worthy no matter what my job title is or who I’m standing next to.

I no longer search for my soul in my career or in other people. I’ve found her within. 

The post Written from the Heart appeared first on The Emily Program.

Each June, members of the eating disorder community unite to recognize World Eating Disorders Action Day (WEDAD). People experiencing eating disorders firsthand, along with the friends, families, providers, researchers, and policymakers who support them, rally across the globe around a common goal of understanding, connection, and healing.

We invite you to join us this year. Here are five actions you can take today to support eating disorder awareness, education, and recovery.

1. Learn about eating disorders.

Eating disorders are complex, confusing illnesses. Many myths and stereotypes surround them, including the common misconception that they are a choice and only affect thin, young, white cisgender women.

In reality, eating disorders are brain-based illnesses that affect people across all social groups. Over 70 million people worldwide are estimated to be affected, including roughly 30 million in the United States. 

To learn more eating disorder facts, check out this “ED 101: Understanding Eating Disorders, Treatment, and Recovery” presentation or podcast episode. Each resource provides a general overview of eating disorder causes, types, warning signs, and treatment options.   

To dive deeper into the topic of eating disorders, consider information in support of this year’s WEDAD theme, #Equity4EatingDisorders. The following resources explore eating disorder experiences that differ from the stereotypical narrative:

• People of color with eating disorders: “Episode 14: Eating Disorders Aren’t Just a Thin White Woman’s Disease” (Peace Meal episode) and “Beyond ‘Eating Disorders Don’t Discriminate’”
• Transgender individuals with eating disorders: “Eating Disorders in the Transgender Community”
• Lesbian, gay, and bisexual individuals with eating disorders: “Eating Disorders in the Lesbian, Gay, and Bisexual Community”
• Men with eating disorders: “How Do Eating Disorders Present in Males?”

2. Talk about eating disorders.

One of the most powerful tools we have in the collective fight against eating disorders is talking about them. These illnesses are often shrouded in secrecy, shame, and stigma, and open conversation allows us to bring them to light and understanding.

Here are some ways to bring eating disorders into conversation:

• Join the WEDAD dialogue on social media using the hashtags #WorldEatingDisordersDay and #Equity4EatingDisorders
• Raise awareness of stigmatizing or inaccurate depictions of eating disorders by providing feedback to press, brands, and other content creators
• Share one of the recovery stories featured on The Emily Program’s blog or podcast, or—if you feel comfortable—reach out to share your own

If you suspect someone you love may be experiencing an eating disorder, now is the time to talk about that as well. To approach the conversation, ask your loved one whether it is ok to discuss their eating habits (“I’m concerned about your eating. May we discuss how you typically eat and your relationship with food?”). Then ask the following six questions:

1. Do you feel like you sometimes lose or have lost control over how you eat?
2. Do you ever make yourself sick because you feel uncomfortably full?
3. Do you believe yourself to be fat, even when others say you are too thin?
4. Do food or thoughts about food dominate your life?
5. Do thoughts about changing your body or weight dominate your life?
6. Have others become worried about your weight and/or eating?

In this informal survey, two or more “yes” answers strongly indicate the presence of disordered eating. Encourage your loved one to reach out for a professional assessment. The Emily Program is available seven days a week at 1-888-364-5977.

3. Advocate for eating disorders policy change. 

Legislative advocacy is an action that can bring change at both a local and federal level. Make your stance known on eating disorder issues by joining with an organization like The Eating Disorders Coalition for Research, Policy & Action (EDC), which advances the recognition of eating disorders as a public health priority throughout the United States. 

Current policy efforts at the national level include:

• The Nutrition CARE Act, which would provide coverage for medical nutrition therapy through Medicare.
• The SERVE Act, which would substantially increase access to eating disorders care for servicemembers and their families covered under TRICARE.

To support and stay aware of eating disorders policy initiatives, sign up for the EDC’s text message action alerts. You’ll be notified about easy opportunities to contact your Members of Congress as they arise throughout the year.

4. Support an eating disorder organization.

There are numerous organizations dedicated to eating disorder prevention, education, and recovery. Consider lending your time as a volunteer or contributing financially to one that benefits those affected by these illnesses. 

Among the organizations The Emily Program supports are: 

• WithAll, whose mission is to prevent eating disorders and support recovery with simple, accessible tools. One of its activities is providing living-expense grants to people receiving eating disorder treatment. 
• The Center for Balanced Living, which aims to raise eating disorder awareness, advocacy, support, and scholarship.

Find additional eating disorder-related organizations here.

5. Make a step toward eating disorder recovery.

If you are in the process of recovering from an eating disorder, the most important action to take this WEDAD is a step in the direction of your own healing. It doesn’t have to be grand and it doesn’t have to be perfect; even a small, imperfect step is progress.  

Some powerful steps toward recovery include:

• Unfollowing a social media account that triggers you 
• Asking a friend or family member to support you in choosing a new snack food
• Stepping on the scale one fewer time this week
• Turning off the TV or setting aside your phone to more mindfully eat your next meal
• Telling yourself one body-positive or body-neutral affirmation the next time you look in the mirror

Much like the steps taken in recovery, the actions taken this WEDAD and beyond add up. Each time one of us learns more or speaks out about eating disorders, our collective effort is stronger and our voice is louder. 

Eating disorders are fierce illnesses, but together we are fiercer.

The post Participate in World Eating Disorders Action Day appeared first on The Emily Program.

Episode description:

Maddy Walters is a psychology student passionate about eating disorder research and advocacy. She brings her passion and personal experience to this episode of Peace Meal to help us examine the intersection of social media and eating disorder recovery. We explore what it’s like to share your recovery online and to engage with others sharing theirs.

Maddy reflects on what she’s learned by creating a recovery Instagram account and how her recovery has evolved in the time since she did. Highlighting the key benefits and challenges of participating in an online recovery community, she offers insight into both the rewarding and tricky parts. She emphasizes the importance of protecting and prioritizing recovery—online and off—and leaves us with practical strategies for others trying to heal in a social media world.

We cover:

• Why and when Maddy decided to create a recovery Instagram page
• Finding solidarity, support, and encouragement in people who are also recovering
• The impact of triggering content online, including that which is intended as recovery inspiration
• Strategies for engaging with social media in recovery
• Resources to practice and protect your recovery both online and in real life

In Maddy’s words:

• On encountering triggering content on social media: “If I see something that’s really good about a page, but there’s still so much that’s making me feel bad… I block, I restrict, I unfollow. Because there are a lot that don’t do that.”
• On what’s good about eating disorder recovery: “What’s not good?! I really just cherish every single day since I can actually enjoy it and understand what’s good about it instead of just focusing on myself.”
• On protecting your recovery when using social media: “It’s so important to guard your space.”

Find Maddy on Instagram at @maddyjwalters. Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, and tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 53: Social Media and Recovery with Maddy Walters appeared first on The Emily Program.

Tell us about yourself!

Hello! My name is Caitlyn Starcher, but everyone calls me Cait. I have been at The Emily Program’s Columbus location for almost three years and have been involved in pretty much every one of our programs at one point. My current position is half outpatient therapist and half intake clinician. Since our location is growing, my position will be changing soon and I will become half outpatient therapist and half outpatient FBT (family-based treatment) therapist. I received my Master of Social Work from The Ohio State University.

Describe the career path that led you to The Emily Program.

Prior to working at The Emily Program, I worked in general mental health and did outpatient therapy for a wide variety of populations. I mostly worked with teens and adults and did some minor substance use therapy as well. Before that, I interned and worked at a private practice near The Ohio State University’s campus, where I saw a lot of college students and a lot of our work was focusing on adjustment to college. I chose to work at TEP because I was interested in eating disorders and excited to become an “expert” in a field in comparison to the generalist roles I had before.

What’s something you’re really proud of?

My husband and I bought a house last summer! It was very exciting to accomplish that during quarantine and because the market in Columbus is extremely competitive. We have been enjoying decorating and making some updates throughout the year. I love to entertain, so I am really excited that some of the COVID restrictions are finally being lifted.

What’s a fun fact about yourself?

I know I’m biased, obviously, but I believe I have the cutest cat in the world. He’s an adorable grey and white domestic shorthair, but what’s fun about him is that he has a white mustache.

How do you spend your time off work?

The quarantine has forced me to pick up some indoor hobbies. I crochet, I’ve gotten into indoor gardening with herbs and house plants, I love interior decorating, and I’m learning guitar. When it’s nice outside, I do enjoy going for walks, going to concerts, and just spending time with friends.

The post Staff Spotlight, Caitlyn Starcher appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Recovery Conversations is a question-and-answer series that features voices and stories of eating disorder recovery. In this edition, Rachel reflects on what she has learned about the process of healing and shares her favorite recovery song, strategies, and advice for others affected by eating disorders. 

What one word would you use to describe life with an eating disorder? What one word describes recovery?

Life with an eating disorder is small and life in recovery is big. There is so much life beyond the limited world of an eating disorder that you really can’t see until you have some distance from it.

What do you wish you knew earlier in your recovery?

I wish I knew that recovery isn’t a final destination or place you arrive at all of a sudden. It’s an ongoing process of getting better. I used to see it in black-and-white terms (either a serious eating disorder or full recovery), but the in-between is actually where recovery happens.

Favorite recovery song?

I like “Rise Up” by Andra Day whenever I need extra motivation to keep fighting against the critical eating disorder voice. I listen to it whenever I’m feeling hard on myself and want to give up or relapse. It always gives me at least a bit of hope and encouragement.

What strategies help you protect your recovery today?

Taking care of myself is the most important thing I do today. That means that I obviously need to eat, but I also need to get enough sleep and rest. Being overly busy is a big trigger for me so I have to be deliberate about protecting the time I need to rest and make sure I’m taking care of myself. It’s also important to remember that I need to be the one to make sure I’m eating and resting well; no one else is going to do that for me.

If you could give one message to someone currently experiencing an eating disorder, what would it be?

First and foremost, you are not alone. An eating disorder can make you feel like you are or that this is a problem you caused yourself, but that is so untrue. I was blown away by all the people who were willing to support me when I reached out for help, so I’d encourage you to take a chance and open up to someone who cares about you. I know it’s hard, but I promise you that no one is expecting you to fix an eating disorder all by yourself.

The post Recovery Conversations: A Q&A with Rachel appeared first on The Emily Program.

Mental health is health. Like the physical health we tend to associate with the word, it is a core component of well-being. It is not secondary to physical health—not an afterthought or bonus quality—but instead equally important to our overall health.

While mental health encompasses more than the presence or absence of illness, mental illness does indeed pose a significant threat to it. In this post, we lay out five basic facts about mental illness in general and eating disorders in particular.

1. Mental illness is real.

Mental health conditions are not imagined or made up. They are not choices or attention-seeking behaviors, not something that can be “snapped out of” or simply willed away. They are profoundly real illnesses based in the body’s most complex organ, the brain. 

As brain-based illnesses, mental health concerns like eating disorders are just as physiological as illnesses like cancer or diabetes. They come with their own share of physical health consequences as well. Anorexia, bulimia, and ARFID, for example, can result in heart failure, early-onset osteoporosis, amenorrhea, kidney failure, pancreatitis, and more. Binge eating disorder and compulsive overeating can lead to Type 2 diabetes, heart disease, and high blood pressure, among other conditions.

2. It is common for mental illnesses to co-exist.

People with eating disorders also commonly suffer from co-occurring mental health issues, including depression, anxiety, obsessive-compulsive disorder (OCD), and substance use.

Research shows the following:

• More than 50% of adolescents (ages 13–⁠18) with an eating disorder met the criteria for another mental health diagnosis (Swanson et al., 2011).
• More than 70% of adults with an eating disorder had co-existing mental health concerns (Ulfvebrand et al., 2015).
• About 66% of people with anorexia or bulimia have one or more lifetime anxiety disorder as well (Kaye et al., 2004).
• Nearly 75% of people with binge eating disorder have at least one lifetime mental illness in addition to their eating disorder, and 43% have at least one current co-existing illness (Grilo et al., 2009).
• Nearly 75% of children with ARFID have an anxiety disorder (Nicely et al., 2014).
• Approximately 25% of people with an eating disorder have symptoms of post-traumatic stress disorder (PTSD) (Tagay et al., 2014).

3. Mental illness isn’t always obvious.

While mental illness is every bit as legitimate as physical illness, the symptoms aren’t always as visible. In the case of eating disorders, people often go to great lengths to hide their behaviors and thoughts. Doing so is actually part of the illness.

Compounding the secrecy often inherent to eating disorders is a high degree of stigma and shame. Cultural ideas that associate eating disorders with willpower or vanity, for example, perpetuate the false belief that eating disorders are choices or character defects and can keep people from opening up about their private struggle.

4. But there are some key warning signs.

Though mental illness may not be immediately obvious, it can have a broad and deep impact on a person’s life. Signs that indicate that you or someone you love is struggling with an eating disorder include:

• Dramatic weight gain or loss
• Rapid or persistent decline or increase in food intake
• Frequently talking about food, weight, and shape
• Eating in secret, hiding food, disrupting meals, feeling out of control with food
• Excessive or compulsive exercise patterns
• Purging, restricting, binge eating, or compulsive eating
• Abuse of diet pills, laxatives, diuretics, or emetics
• Denial of food and eating problems, despite the concerns of others
• Medical complications, such as menstrual irregularity, dizziness, fainting, bruising, dry skin, leg cramps, hair loss, brittle hair, osteoporosis, diarrhea, constipation, dental problems, diabetes, chest pain, heart disease, heartburn, shortness of breath, organ failure, and other serious symptoms

5. Recovery is possible. 

Mental illnesses, much like their physical counterparts, are diagnosable and treatable conditions. In the same way you’d see a physician for an infection or broken bone, we recommend speaking with a trained professional about your mental health concerns. They can assess your condition and connect you with appropriate support.

The Emily Program offers residential, day, and outpatient programming for adolescents and adults with eating disorders and related mental health issues. If you or someone you know is struggling, please call 1-888-364-5977 or complete our online form to get help now.

The post 5 Facts Everyone Should Know About Mental Illness appeared first on The Emily Program.

Episode description:

Katie Price is a registered nurse and yoga teacher whose understanding of what it means to care for bodies—both hers and others’—has been shaped by her recovery from anorexia. She cares deeply about walking alongside others struggling with eating disorders and hopes that by sharing her story, she can offer hope and support.

In this episode of Peace Meal, Katie offers exactly that. She shares the many gifts within her story of illness and healing, revealing the light, growth, and support that can be found in moments of darkness and challenge.

Katie begins with an honest account of life with anorexia, an illness her parents recognized early on. A meal plan, weight checks, and outpatient appointments were established quickly, but the eating disorder fought to maintain its hold. Katie found herself caught in a “tenuous dance” between it and recovery.

The eating disorder led Katie to what seemed like the lowest point possible. “It felt like the darkest, rockiest bottom I could have ever imagined,” she reflects about the moment she entered a higher level of care. But there, at the hospital, is not only where she started to crawl out of the pit of anorexia, but also where she began to realize the gifts of connection, support, and hope she’d continue to find along her journey.

Describing her life now, Katie paints a picture rich with feeling and meaning. It is not free from challenges—far from it, especially as a nurse during the pandemic—but still, she notes, it beats the days spent in illness.

Even when it’s hard, she says, “I’m present to it, and it’s the fullness of life that I fought so hard for. And it’s so much better than my eating disorder—even when it’s a lot to handle—so I’m endlessly grateful for that.”

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 52: The Gifts of Recovery with Katie Price appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

By Abby Anderson

My body had an eating disorder long before my brain knew I did. That’s the thing about this kind of disease—it’s not always caught before the damage begins. What’s more, there’s no medicine to make it go away. My perspective in the beginning was centered on extreme perfectionism. What once centered in school and extracurricular activities was now morphing into eating rituals and weigh-ins. I became a physical representation of control.

The day I admitted I had a problem was one filled with relief and fear. I was opening myself up for what felt like the first time in my life. Asking for help was always foreign to me and this was the ultimate reach. It felt freeing to no longer bear the burden on my own, but I was terrified. I was desperate to change my thoughts while maintaining a tight grasp on the physical body I had “earned” through manipulation and scarcity. My perspective was a combination of exhaustion and complacency. I was ready to listen.

Immersed in treatment, I’d say my attitude and interest were positive. It felt good to take the back seat, to have people who were meant to help me and to educate myself on the ways in which my behaviors were anything but healthy. It was such a contrast to my previous life. My physical and emotional muscles were worn out, relaxing into the hands of professionals with meal plans and endless therapy sessions. I was at peace here. Home in a place that I never expected to be. It was the first time in my life I stopped trying to help everyone else and instead started helping myself.

When the inevitable release came, I felt exposed to a world that didn’t stop while I was away. The warm offices and balanced dinners had nourished my body and soul, but it seemed the external environment was just waiting for me to come back. It still grasped at me, with pretty lies and promises, for a mind that was wired for perfection. Each day I lived in this world my new mindset got a little more clouded and a little harder to maintain. The optimistic perspective turned regretful and I questioned my needed weight gain. I had done so much work, but society was saturated with its pretty pictures and weight-loss bars.

It wasn’t long before I returned to intensive outpatient programming, hoping to strengthen some of the beliefs so easily thwarted in a diet-obsessed world. I felt at home there. Safe, guided, and in unison with people who understood the voice inside my head. When I left this time, it was to a new country, and with it came a new opportunity to be the person I knew I could be.

In Europe, things changed for the better. I had momentum following additional treatment and the population was more forgiving than ours concerning matters of food, exercise, and expectations. Priorities were different. I was different. I felt like I had permission to explore food instead of being afraid of it, to be excited about it again, and to honor a body that was hungry, both physically and mentally, for a different way. I nourished everything about myself there. I fell in love. I found the way of life that fits me. It wasn’t always easy, but life never is.

A few weeks before returning to the U.S., that voice came back in full swing. I felt like going home meant going back to my old routines. Restriction and disordered exercise didn’t feel like an option, but a non-negotiable. I had to stay conscious of my eating disorder as I went back to the place that encouraged its existence.

It’s been almost two years now since I spent that time abroad and I am still working every day to overpower the part of me that isn’t so kind. Recovery is anything but a straight line. The more you learn about yourself and the disorder, the more you have to unpack. It’s a journey—a bumpy one. Since coming home I’ve experienced the all-too-common “nonlinear” aspects of recovery. If you’ve been in any sort of eating disorder environment, this claim is not unfamiliar to you. “Nonlinear” is a nice way of saying that there is no easy way out. Which is true. I have days where I have to fight harder just to eat normally or take a rest day, but I also have moments where I answer my cravings or prioritize friendships and feel deeply free.

During my many phases of recovery, I have learned so much more than I ever imagined about my own eating disorder and its general nature. I had to accept that there would not be one day where everything snapped into place. I had to sit with truly uncomfortable feelings and question why I had so many impossible standards set up around my body. The hardest part was proving them wrong when I was so used to believing them.

I know how hard it is to counteract that voice every day. I know that sometimes the answer does feel like giving in, but I promise it’s not. With an eating disorder by your side, you will never win.

The post Recovery Is Anything But a Straight Line appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

While navigating her own recovery journey at The Emily Program, Teresa Schmitz discovered a hidden gift in being known as a great listener with a compassionate heart. Being earmarked as an IT Leader who was more into the people on her teams than the technology they were building, she realized her purpose was beyond her title. She connected the dots and soon realized her purpose was to help empower others. She pursued her dreams of becoming a coach and launched her own coaching business, My Best Self Yet.  She now helps women feel empowered to navigate the journey of loving themselves unconditionally. She also empowers others to know and use their character strengths in the In It Together group coaching program. Learn more about Teresa’s story and follow My Best Self Yet on Facebook, Instagram, and her blog.

Choosing to say yes to the eating disorder treatment that is offered after your diagnosis can be scary. Most likely, you’ve been living with your eating disorder for some time, and it has been your go-to coping skill when life got hard. Yet, I am living proof that while it is scary at the beginning, it is very rewarding at the same time. There is so much you gain from seeking a recovery journey.

I remember when I was first diagnosed with my eating disorder, three weeks shy of my 46th birthday. I thought I was “too old” to have an eating disorder. I’d been uneducated about eating disorders up until that point in my life and bought into the stereotype that they were only for teenagers or young adult women. At the time, I also bought into the stereotype that overweight people had no self-control, and they chose to be overweight.

I felt alone and ashamed before entering treatment—feelings an eating disorder loves to capitalize on. I thought the problem was that I didn’t know how to lose weight or was “addicted” to high-calorie foods (the “no self-control” stereotype). My weight and body size were the problem, my eating disorder convinced me, so I spent years trying to fix it. It was as if my body was a project that needed constant fixing.

Then, one Monday evening, I showed up for intensive outpatient treatment at The Emily Program. Much to my surprise, the other women in programming that night were about my same age or a little older. I learned so much about eating disorders in treatment. I learned that it really wasn’t me who was the problem. It wasn’t that I was “doing” anything wrong. Quite the opposite. I learned that an eating disorder is a mental health diagnosis and had nothing to do with the number on the scale.

It would take a lot of convincing me that I was not the problem. You don’t just start believing everything you hear that first night after having danced with an eating disorder for years (for me, I’d first heard “you have an unhealthy relationship with food” from my primary doctor in 2011 and yet was not formally diagnosed with an eating disorder until October 2017). I thought the eating disorder was just an excuse to be overweight—that somehow, I had “chosen” to be overweight. I’d been successful in my career and just couldn’t get my eating “right,” I thought, because my eating disorder had fed me this lie for years.

Once I could cut through all the preconceived notions that I was the problem, I was able to see that I was not the problem and that I was so worthy. Underneath the need for control was a woman who deserved to be loved and happy and joyful. Not because of my size or shape. Simply because I was a human being. I kept showing up to outpatient treatment, my weekly dietitian and therapy appointments, and eventually DBT class and body image yoga. Night after night, I committed to something so important to me. It was as if my life depended on this once-in-a-lifetime chance, because it did. The nights seemed long at the time, yet looking back, the first months went so fast.

Fast forward well over three years and I can’t believe how far I am on my recovery journey. Life feels so carefree now. I don’t view my body as a project that needs fixing anymore. I no longer have deep-rooted stereotypes or beliefs about eating disorders or my own worth. That is by far the best thing about recovery. I feel and believe I am worthy. I said yes to recovery, and I know you can too!

The post Choosing to Say Yes to Treatment appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Julia Tannenbaum is the author of The Changing Ways trilogy, which she started writing when she was seventeen, and the co-creator of Nourish, an online cookbook and eating disorder recovery blog. She’s an advocate for mental health awareness and often incorporates her personal struggles into her written work. Tannenbaum is currently pursuing a Creative Writing and English B.A. at Southern New Hampshire University. She lives in West Hartford, Connecticut with her family.

I still find it surreal sometimes that it’s already been five years since I was in my last treatment program. Five years since I’d wake up in the morning and dread the moment I’d have to eat. Five years since I was convinced that my identity was dependent upon my disorder. Five years since I tried to hurt myself. Five years since that fateful moment, at the tender age of fifteen, when I realized I deserved more than the half-life I was living and finally committed to recovery.

I distinctly remember that moment as if it happened only yesterday. I was in the process of being admitted to my second residential treatment center (my ninth inpatient program overall), having just come straight from an ED ward where, for the first time, I’d been exposed to adults with eating disorders. Seeing women in their thirties, forties, even fifties and sixties, walking around evoked a revelation: I didn’t want to be here in a couple of decades. I didn’t want to be chained to my disorder forever. I wanted to get better.

Upon learning I’d be at the residential treatment center for six to ten weeks—a timespan I initially objected to—I was forced to decide whether I’d put in the hard work and see if I could make it stick or take the easy road and half-ass my way through another program. After spending the last two years in and out of treatment, I was becoming fed up with the substandard quality of my life. I didn’t want to waste another opportunity to reclaim the freedom that had been stripped from me since I was thirteen. So, I picked up my chin—and my fork—and got to work. When I discharged from the center nine weeks later, I was determined to make it my last treatment program. Five years later, I’ve never had to go back.

Navigating recovery outside of inpatient care has been immensely challenging. The thing about recovery is that it’s not linear. Recovery is like a roller coaster ride; full of twists and turns, of ups and downs, of lows and highs, and one moment, you could be on the top of the world only to come completely crashing down in the next. This was very much the case with my recovery. But just because something isn’t easy doesn’t mean it’s impossible. With support from my parents and outpatient treatment team, a meal plan called the Exchange System that taught me how to feed myself adequately, hobbies that gave me hope for the future and an identity outside of my disorder, and a whole lot of internal strength and drive, I was able to navigate those initial ups and downs to reach a better, healthier, and happier place in my life.

Over the past couple of years, my health and happiness have continued to grow as I’ve had new and exciting experiences, become more comfortable with myself and my body, and ultimately built a life I’m proud of and can live on my own terms—not the terms of my disorder. This past February, I celebrated five years out of treatment. That, in itself, was a milestone I once never imagined I’d reach. But now that I have, now that I know what life beyond anorexia feels like, I never want to go back.

Recovery truly is the gift that keeps on giving. Since committing to recovery, I’ve published a young adult trilogy, The Changing Ways series, that tells the story of a high schooler’s journey to overcome mental illness and is largely based on my personal experiences. I currently run a food and recovery blog with my mom called Nourish and am working on turning our delicious recipes, many of which helped me when I was refeeding, into a physical cookbook that can help others who are battling the same demons I was not too long ago. I’ve gotten involved in mental health activism and have partnered with NAMI and NEDA, among other incredible organizations, to share my story of surviving anorexia and finding hope amid darkness. More recently, I’ve begun advocating for other topical issues I feel passionately about—animal rights, LGBTQ rights, and gender equality, to name a few—and look forward to doing more when the world reopens.

All that I’ve been able to accomplish in the few years I’ve been free from my disorder has led me to believe that I have a lifetime of greatness ahead of me and a future well worth living. I don’t consider myself “cured” (although I hope to be one day), but for me, that’s not what recovery is about. For me, recovery means I’m in control of my life. It means I have hopes and ambitions that are unrelated to food, calories, and weight loss. It means I recognize the importance of prioritizing my mental health and always make an effort to put it first, knowing from past experiences what will happen if I don’t. Most of all, recovery means I’m finally free.

Everyone’s journey with mental health is different; likewise, so is everyone’s recovery. Mine just so happened to be a topsy-turvy mess that’s taken ample time, patience, and grit to straighten out. It was a challenge like none other; however, now that I’m here, now that I’m in recovery, I’m confident that it was completely worth it.

The post Celebrating Five Years of Anorexia Recovery appeared first on The Emily Program.

Alex Rudin is a multimedia artist based in New York City. Her artwork is narratively focused on the complexities of the human experience through stylized portraiture and anecdotal commentary. Her intent lies in uncovering and expressing the truths of what it is like to be a woman in modern America. Alex is currently creating work surrounding feminist issues, including eating disorders and sexual abuse. In addition, Alex regularly uses her work to speak about political and social justice issues. She has partnered with organizations such as Women for the Win, Article 3, and The Sam & Devorah Foundation, among other female-led orgs. Alex’s writing and artwork have been featured in USA Today Mag, Grit Daily, Yahoo.com, and The Female Lead. She has shown in both solo and group exhibitions in New York, Delaware, and Philadelphia.

In this Q&A, we ask Alex about her artwork and the impact of art on those creating it, those consuming it, and on society at large. She explains how art has benefited her recovery from an eating disorder and body dysmorphic disorder and shares samples from her portfolio.

Tell us about your art and how your experiences with an eating disorder and body dysmorphia have informed it.

I have always been an extremely creative person. I am also a very emotional person. The synthesis of these two facets of my life was imminent. For much of my life, I have struggled with dysmorphia and disordered eating. Having an eating disorder (ED) is excruciatingly lonely and isolating. In an effort to deal with these feelings I turned to my artwork for self-expression. Yet, I knew all too well that these two aspects of myself were either going to destroy each other, or come together to heal one another. Was my eating disorder going to “consume” my creative spirit, or would my art work to heal the cutting and critical voices in my head?

In an attempt to translate my thoughts and feelings to the canvas, I found that making the invisible visible was an invaluable tool to help better comprehend my disorder. Being able to do this for myself was not only a learning tool but also a connection to others with similar issues. The ineffable qualities of consuming art are transcendent. Art allows the viewer to sit in introspection and to question oneself, no matter the discomfort level. I believe the same to be true in overcoming an eating disorder. We must confront to overcome, and we must reflect to progress. Art allows us to tap into the recesses of our minds to expose the complexes at the core of our psyches.

Making work about my own struggles with dysmorphia and disordered eating has enabled me to more deeply understand my personal struggles with perception and reality testing. It has also given me confidence in ways I never thought possible. Recovering from a severe eating disorder has been the longest and most difficult process of my life to date. Those who have walked down this road know that recovery is not linear. Eating disorders have no size, no shape, no color, no religion, and no gender. They do not discriminate. This is a battle I fight constantly. The voice inside my head tells me that I will never be good enough in this body of mine. It tells me that no matter what I achieve, if I’m still this weight, it won’t matter. It makes me paranoid. It makes me fearful of socializing. It makes me feel ashamed. Yet, my work says something different. Art has taught me more than any book or article. It has taught me the most valuable lesson of all—my value has nothing to do with my body.

Could you share some of your art with us?

I Wore A Shirt Into The Pool That Day
20 x 30 in, Acrylic, ink, pastel, watercolor, gouache on paper

I Have Scars That Remind Me
16 x 20 in, Acrylic, ink, pastel, watercolor, gouache on paper

Reality is Non-Reality
18 x 24 in, Acrylic, ink, pastel, watercolor, gouache on Canva Paper

How has sharing your art served your recovery?

Being able to share my work around my recovery has been fruitful in numerous ways. Connecting with others who have struggled with similar issues has made me feel less alone. While I have loving personal and professional support systems, having an ED is the ultimate experience of isolation. No matter who loves me or tries to help there is always a constant negative dialogue in my head. Now, as a result of sharing my work and story, I know that I am, in fact, not alone at all. Reaching others who have suffered from disordered eating in a positive and productive manner has been key in my attempt to relinquish the solitude of my disorder.

In addition, sharing my story and dysmorphic artwork is the definition of exposure therapy, a recovery method I am all too familiar with. While exposure invariably brings about anxiety and fear, the subsequent relief that it brings is unparalleled. Talking openly about my journey has led me to take yet another serious look in the mirror. This is not the end of my journey, and there is still plenty of work to be done. However, I can safely say that by sharing my artistic expression of dysmorphia I am one step closer to healing that part of myself.

How can art change the ways bodies are viewed in our society?

Living in the age of technology has quite literally and figuratively warped our minds into thinking our natural state is glitch, something to be fixed or remedied in order to be accepted. My series Dysmorphic II highlights the very real threat that our current society poses. We live in a world where physical perfection is the silver bullet for happiness. Rampant increases in body dysmorphic disorder (BDD) and eating disorders are the result. By exploring the correlation between psychological states and expression of the human form, my work attempts to peer into the moment where societal pressure and psychology meet, where expectation and acceptance clash, and where reality and fiction diverge.

As citizens of the modern era, we are constantly barraged with images of perfected, altered, unachievable bodies. The societal impact of such imagery is pervasive. We use terms such as “bikini body” and “summer body” to emphasize the importance of looking a certain way in order to garner acceptance. These overtones only shame those with non-conforming bodies and make them feel unworthy of praise, acceptance, and self-confidence. This is what needs to change. Representation matters. Words matter. Seeing common, everyday women in campaigns and fashion shows allows society to embrace differences and consider them valuable and beautiful…and normal. While advertising and imagery play a key role in our perception of ourselves, art can take it all a step further. The purpose of art is to challenge the viewer and question accepted notions of truth. In doing so, artists can offer a conduit to understanding in addition to equitable representations of the body.

What do you hope your art says to other people affected by eating disorders?

I hope that my artwork inspires others to use creativity as a vehicle to help further one’s own recovery. To me, it is all about agency. What choices will you make to silence the voices of your eating disorder? Personally, I leveraged my artistic voice, and trusted that it would lead me down the road of recovery. Whether it be writing, music, or visual arts, using some form of creative expression will open your mind and enable you to access the invisible. Once you make the un-seeable seeable, it loses its power. They say “seeing is believing,” but in this case “seeing” allowed me to lose belief in the power of my eating disorder. It allowed me to take possession of my own narrative and put my ED in the back seat. While I know we will most likely be driving together forever, I am now in the driver’s seat, and that is what I call control.

For more of Alex’s work, please follow her on Instagram @_alexrudin. To view Alex’s portfolio, please visit alexrudin.com. To shop Rudin Studios, please visit rudinstudios.com.

The post Making the Invisible Visible: A Q&A with Artist Alex Rudin appeared first on The Emily Program.

For many, summertime means vacations, long, warm days, and a much-appreciated break from school or work. It is a season of sunshine and recreation. For the millions of people with an eating disorder, however, summer often means something much more difficult than carefree leisure and freedom.

As the school year ends and summer approaches, now is the time to plan for and address the common challenges facing people with eating disorders during the summer. In this article, we discuss some key factors that make this season difficult for those affected by these illnesses and describe how providers and loved ones can help to connect them with support.

Summer challenges for those with eating disorders

While no time of the year is easy for those with eating disorders, the summer season presents unique difficulties that can trigger and worsen symptoms if left unchecked. Changes in routine and environment, as well as additional food-related activities and body image concerns, are among the particular factors that can make the summer especially difficult.

Changes in routine

The change of the seasons often brings a change in routines, a key trigger for those with eating disorders. School breaks and more flexible work schedules may impact eating patterns, as may summer calendars full of activities or simply additional free time. Like any disruption to regular eating, these changes create an opportunity for eating disorder symptoms to take hold or worsen in those susceptible.

Changes in routine that can trigger or exacerbate an eating disorder include:

• Waking later in the mornings and then skipping or skimping on breakfast
• Working irregular shifts at a summer job, disrupting regular meal and snack times
• Increasing activity levels in warm weather but neglecting to adjust food intake accordingly
• Feeling bored by extra free time or overwhelmed by a busy summer schedule, both feelings that can trigger urges to engage in disordered behaviors

Changes in environment

Much like changes in routine, changes in physical environment can pose challenges for those with eating disorders. People often spend more time at home or on vacation during the summer months, and with this change in scenery often come changes in food availability and options. Interaction with support systems may also change, introducing stress to those who benefit from the presence of particular friends, family, or professionals during the rest of the year. 

Examples of environment-related challenges include:

• Feeling out of control around food in the house when spending more time at home
• Food insecurity in situations where someone no longer receives the meals or snacks at school or work received during non-summer months
• Exposure to more fear foods and less access to familiar foods when eating on the go and at restaurants when traveling
• Exposure to stressors of the home environment when moving home from college for the summer

More activities involving food

The season of barbeques, picnics, and backyard parties often brings an additional focus on food, a stressful situation for those with eating disorders already preoccupied with it. Triggers associated with food-centric social gatherings range from a change in structure around meals to the presence of fear foods to the pressures of eating around others.

Potentially triggering food-related activities include:

• Social gatherings that include an overwhelming amount of highly palatable food
• Summer events, such as festivals and fairs, at which all food is prepared by other people
• Parties where food is eaten while standing instead of served at a table
• Socializing with alcohol, a substance many people with eating disorders struggle with

Heightened body image concerns

As temperatures rise in the summer, feelings of body dissatisfaction often do as well. Wardrobes change to include clothing that exposes more of the body, often exacerbating body insecurity, body checking, and comparison behaviors in people whose eating disorders include a body image component. Diet culture amplifies these concerns further in the form of messaging that promotes diet and exercise as means to make ourselves “beach body” or “bikini body” ready—that is, to try to force our bodies into resembling the bikini-clad ones seen in the media.

Situations that can trigger body image concerns include:

• Trying on clothes from last season that no longer fit
• Seeing more diet-related messaging on social media
• Feeling exposed when wearing season-appropriate clothing
• Hearing comments from others about their own bodies, diets, or food

Signs that someone might be struggling

The warning signs that someone may be struggling with an eating disorder during the summer are similar to those present during the rest of the year. Look for:

• Dramatic weight gain or loss
• Rapid or persistent decline or increase in food intake
• Verbal preoccupation with food, weight, and shape
• Restricting, purging, binge eating, or compulsive exercising
• Denial of food and eating problems, despite concerns of others
• Eating in secret, hiding food, disrupting family meals, or feeling out of control with food
• Medical complications, such as amenorrhea, bradycardia, osteopenia or osteoporosis, electrolyte abnormalities, low body temperature, and orthostatic hypotension

I think my patient or loved one has an eating disorder. Now what?

If you notice signs of an eating disorder in a patient you treat or someone you love, acknowledge it. Don’t ignore the feeling you have that something might be wrong or justify disordered behaviors with an alternative explanation. Early detection and intervention are critical to a person’s recovery.

1. Ask the person about the signs you notice.

Open the conversation with your patient or loved one by expressing concern about the signs you see.

• Providers: Ask if your patient is willing to discuss their eating habits with you: “I’m concerned about your eating (or weight, body image, etc.). May we discuss how you typically eat and your relationship with food?” Then ask the following six questions, adapted from the SCOFF questionnaire (Morgan, Reid, and Lacey, 1999):

1. 1. Do you feel like you sometimes lose or have lost control over how you eat?
   2. Do you ever make yourself sick because you feel uncomfortably full?
   3. Do you believe yourself to be fat, even when others say you are too thin?
   4. Do food or thoughts about food dominate your life?
   5. Do thoughts about changing your body and/or your weight dominate your life?
   6. Have others become worried about your weight and/or eating?

• Loved ones: Share your concerns, providing examples of eating habits or disordered behaviors you’ve noticed. Approach the conversation with gentle compassion and care, understanding that eating disorders are illnesses shrouded in shame.

2. Connect the person to eating disorder treatment.

If you suspect an eating disorder, connect your patient or loved one with a specialty treatment center such as The Emily Program. Eating disorders are assessed and treated most effectively by specialists who provide multidisciplinary and evidence-based support.

• Providers: To refer your patient to The Emily Program, call us at 1-888-364-5977, use our online referral form, or direct your patient to our website to request an eating disorder assessment.
• Loved ones: To find care for your child, call us at 1-888-364-5977 or complete our online form. For adult friends and family members, pass along our number or show them our website to help them get started with care.

3. Stay connected and informed.

• Providers: To stay informed of your patient’s progress throughout their eating disorder treatment, ask them to complete a Release of Information form so that we have permission to share health information with you. Learn more about eating disorders by attending one of our education or networking events.
• Loved ones: Getting support and education around your loved one’s illness can help you in understanding and supporting them. Check out our resources and support options for families and friends to learn more about eating disorders and connect with others in a similar situation.

While summer may present additional challenges for those with eating disorders, it can also be the season your patient or loved one finds help. Professional support is key to understanding and caring for these complex illnesses so that people can fully enjoy health in recovery, no matter the season.

The post Eating Disorders Don’t Take A Summer Vacation appeared first on The Emily Program.

Episode description:

Abby Anderson is a business school graduate who works a corporate job and is passionate about mental health, yoga, and personal development. Diagnosed with anorexia in the summer of 2018, she has experienced a series of ups and downs worth noting to anyone with an eating disorder or disordered eating.

In this episode of Peace Meal, Abby tells us about the process of her eating disorder recovery, including the shifts in motivation she has experienced during it. She begins with the rock-bottom moment she first sought help. Exhausted and physically depleted, she recalls being highly motivated to make a change then.

But, as is typical in recovery, her motivation ebbed and flowed as time went on, and she learned why healing is often described as a nonlinear process. “Your body catches up a lot before your mind does,” she says.

In the process of recovering both physically and psychologically, disordered behaviors crept back into Abby’s life. Her “unhealthy voice” got louder the more she engaged in these behaviors, and the pressures of the college environment didn’t help.

Returning to treatment allowed Abby to recommit to and strengthen her recovery, a process that continues today. She has insight into the common barriers to healing, as well as tools to maintain motivation.

Abby shares several strategies that have been helpful to her healing, emphasizing the power of supportive environments and people. Reflecting on her own experience, she concludes with words of advice for those currently feeling unmotivated or ambivalent about recovery: “The best thing I ever did—and the hardest thing I ever did—was take my hands off the steering wheel and give it to someone else. . . give it to a professional.”

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 51: Staying Motivated in Recovery with Abby Anderson appeared first on The Emily Program.

By Alex Ellen

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. This post includes references to domestic violence and abuse. Please use your discretion when reading and speak with your support system as needed.

When I was 13, I had to quit gymnastics due to an injury. This, combined with hitting puberty, resulted in a little, very normal weight gain. I wanted to get “fit” again, so I began eating what seemed like a very healthy, balanced diet, and exercising more. It seemed like simple maths: less in, more out. 

As I started to lose weight, one of my friends said to me, “Don’t go all anorexic on us though.” I never had heard the word “anorexic”… so I asked what it was, and she explained, “Some girls stop eating to lose weight.” And I remember in that exact moment, the feeling of the “penny dropping.” It had never even occurred to me to stop eating, but I thought, Well that would be quicker and easier. And, just like that, I stopped eating.

Very shortly after my mum explained the harm this would do to my body—and I, being a classic people-pleaser, didn’t want her to be upset—I simply went back to eating what I considered healthy. But… the seed had been sown… I knew I could give up food if I wanted to. 

A few years went by, along with an increase in the turbulence in my home life, and suddenly at 16 I found myself desperately overwhelmed. I had started my A-levels, my parents’ relationship was deteriorating into full-blown domestic violence and abuse, and I was struggling with my sexuality. I felt lost and acutely self-conscious. I wanted to be perfect… to achieve, but to never be a “problem” or contribute to the issues at home. These feelings were very burdensome and I felt a need to press pause. To simply STOP.

Food, and specifically avoiding it, gave me this opportunity. Because the world started and stopped with calories. Nothing else mattered, and anorexia convinced me that I was very, very good at denying myself even basic sustenance. I prided myself on my “strength of will” and quite literally looked down on everyone who ate (so EVERYBODY). And so began the painful isolation. It was just me and the voice. 

This continued for many years. I maintained a very low body weight, got good grades, and held down a job. But underneath the perfectionism I was cracking and so was my family. Everything was amplified. When you are literally starving, even the slightest disturbance feels like sheer panic. Your body is in starvation mode and you cannot function properly; instead, you are trying to survive, on high alert whilst also shutting down. It’s intense and terrifying. 

Then I met a therapist, Karen. She saved my life. Without a doubt. She didn’t treat me like a patient. Instead, she appealed to my intellect and naturally scientific mind. She explained the neuroscience behind anorexia. Behind my lack of logical and sound decision-making. She also removed the responsibility of the illness. Instead, she gave me the responsibility of recovery. Anorexia was not my fault, was not me. But choosing to get better, and continuing to choose that every day, that was me. I suddenly felt the power of choice. 

This was key for me. Anorexia removes all choice. You don’t have a choice of whether you eat or not, of whether you exercise or not, of whether you lie or not. Anorexia has all the control. So to then be offered, very sincerely, the choice of recovery? I found this so empowering. Because that was mine to make. That doesn’t mean it was easy, but it was mine.

It was a long and very painful journey. I had buried myself under so much self-doubt. I really had no idea who I was without anorexia. But I wanted to find out. I used to tell myself, “Find out who I am without this, because worst case, if I don’t like me, I can starve again.” It gave me a feeling of nothing to lose, so why not just give it a go…

I’ve now been recovered for nearly eight years. And I can absolutely promise that life is better with food in it. It’s harder, because I feel everything. I’m no longer numb to the pain that life brings. But I’m also able to feel the joys that life brings. I’m fit and strong and very self-aware. I’m able to care for myself in such intuitive ways. I view these skills as gifts from anorexia. Anorexia allowed me a place in which to hide and survive when my world felt unbearable. But recovery and food gave me passion and exuberance, in even the smallest of ways. Life literally tastes good. 

Recovery is possible. Don’t believe the lies your eating disorder has told you. Because you’re surviving. You’re strong. And you absolutely do have the power in you to thrive. Recovery is waiting, patiently, and when you’re ready, that choice, that powerful part of your wonderful brain, is going to pull you from the depths of despair and you will remember that you—who you are—is not this. You, whoever you are, are ready to flourish. Allow yourself the kindness of choice. Allow yourself the freedom to choose recovery. Know that you are worth saving and you will save yourself. 

The post Recovery is Possible appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

By Isabella Gómez Girón

“Okay, okay, just another more, my tongue needs it—my tongue? Not my tongue. Something needs it. I need to keep filling. But not my stomach, not my throat, those are clogged. It’s the heart, it’s the soul, not the body” (This is Me Eating Hugs). 

Have you ever felt like what you’re trying to fill while anxiously eating is more than your stomach? And you want more and more, even though you are not even hungry?

Well, I have been there too, and still am sometimes. My name is Isabella Gómez Girón, and I am a Colombian artist based in NYC. I hold a BFA in Acting and a Minor in Psychology from NYU. I participated in Et Alia Theatre’s online series called This Is Me Eating. . . , an experimental online series where each participant filled in the blank to describe what they were metaphorically eating as a way to explore the relationship between food, our body, and our image. I wrote This Is Me Eating Hugs toward the beginning of the pandemic when one of my fears was that I—being completely alone in NYC—would fall back into bad habits with food, as it would become my only comfort in that period of isolation. I was afraid my desire for overeating and my negative thoughts about my body image would start to control me. Writing this short experimental film helped me to channel those feelings out of my brain, allowing me to trust that I loved myself enough to not overeat all the time as a way to solve all my emotional turmoil.

I have always been a food lover, but I have also been obsessed with having “less extra skin.” I grew up dancing ballet, and as someone with a big bottom and hips, I felt like I would never be able to dance as beautifully as the extremely skinny ballerinas. Looking graceful while dancing, I thought, meant nothing would move when I jumped. After hours of practice, I would get home exhausted, but I would not allow myself a full dinner.

Years passed and I moved to NYC to pursue acting, and my relationship with food became even more intricate. I officially started a relationship with emotional eating. The change of language, culture, friends, and household was extremely tough, and brownies, waffles, and cheese were my way of feeling loved, my way of feeling hugged. But sometimes I would feel so isolated or just anxious and stressed that I would eat more than my stomach could handle—to the point where it would hurt to breathe. I would be in pain and I would still keep grabbing more and more food. 

“It’s like my hand stops being controlled by me and it just moves from the bag to my lips, from the bag to my lips. . . My tongue ignores the signals from my aching stomach.” 

Even at parties, what kept me calm was the snack table. For many years in the past, I hadn’t really gone crazy eating lots of Oreos in one night for many days in a row—plus, at these parties and reunions they were free—and I overindulged. I gained a lot of weight that first semester, and when I got back home to see my high school friends, I felt ashamed of my body just because I didn’t fit society’s idea of a “hot” and pretty body.

Emotional eating to the point of pain continued to be part of my life, but not as constant, and I also learned how to exercise in a healthier way. Since then, food has always been this beautiful blessing, but sometimes I feel that all of a sudden it betrays me, or I guess I betray myself and lose control, to the point that I cause myself mental and physical pain. When I saw Et Alia Theatre’s initiative, it inspired me to finally put into words what I hadn’t really shared with anyone before. My head still goes into this back-and-forth pattern: 

“Love the curve, the lingering skin. Despise the curve, the lingering skin. It’s like the weather, some days I am shining and other days I am locked under the rain in my bathroom calculating the difference between yesterday and today, between the day before yesterday and yesterday, between…” 

No matter how many loved ones say, “‘It’s beautiful, it’s human,’ I want to go ‘Tell me again.’ ‘It’s beautiful, it’s human.’ ‘Again?’ ‘It’s…’”

We have to love ourselves first, and that sounds simple—perhaps as “just a saying”—but it is true! It takes courage and work to do so, and it doesn’t happen all in one day. And the days where one feels loved by one’s own self prove that embarking on that journey is worth it and priceless.

“There will always be new blocks in the way, but now I know smiles, hugs, and kisses can live in arepas, patacon, and maracuyas in a healthy way as well. And there are more days where that lingering skin is not so much of an issue. Some days. I am working on it [wink].”

I want my love relationship with food to have respect, not manipulation—not a love where we need each other, where we fill voids, but a love that brings joy, that celebrates, that teaches me, that travels with me, and accompanies me, and that sometimes I get too much of but never to the point where we become a threat for each other. It’s okay to be comforted by food, but it’s also important to learn how to hug yourself as well.

Our relationship with food and our body are relationships like others in our life; we have to take care of them, we have to work them out, and we can have arguments, but we also have to seek forgiveness and compassion. I know sometimes one negative comment from someone you care about can feel like you are months back on your path toward a healthier relationship with your image, but no, it’s just a weird road bump. You are still walking forward. If you watch my short and read this, I aspire to make you feel less alone in your journey, to realize that more people than you think struggle with this, but also to remind you that your own journey is unique. You are the one who can speak for yourself, and no one can tell you how it feels to live in your body. Your feelings and experiences are valid, valuable, and real, and at the same time, you are not alone.

To watch the short film This Is Me Eating Hugs, click here. For upcoming projects, or if you would like to collaborate, I invite you to follow me on social media! Find me on Instagram at @isabellagomezg and on Facebook at @GomezGironIsabella.

The post This Is Me Eating Hugs appeared first on The Emily Program.

Episode description:

Kenzie Osborne is a mental health blogger, chef, recipe developer, and former NCAA athlete. After battling intensely with anorexia, she was able to find peace with food through cooking, traveling, and learning about the many benefits food has on the mind, spirit, and body.

Kenzie shares her story with us in this episode of Peace Meal. We begin by discussing a label long attached to her—“the healthy and fit one”—and its impact on her identity. A daughter of doctors and sister to high-performing athletes, she felt immense pressure as part of a family defined by health and athletics.

“That’s who [others] knew my family was. That’s who they expected me to be,” she reflects. “And I felt like when I lived up to those expectations, I was accepted and I was praised, and I would get really positive feedback.” 

As Kenzie’s “healthy” eating and exercise were validated, her eating disorder grew stronger, and its impact was far-reaching. Terrified and unable to be present around food, she missed out on social events. She faced health complications. Her wellbeing, her athletic performance—her life—suffered. Still, as it often is in a culture that normalizes disordered eating, it was hard to recognize that she had a serious illness.

After a gym teacher expressed concern, Kenzie told her parents she needed help. Immediately, her family lent generous support in ways both traditional and creative. They joined Kenzie at meals—both virtually and in person, for however long they took—and started playing games inspired by shows like Chopped and Guy’s Grocery Games.

“It was so cool because it got my mind away from the nutrition for a second and it put it on the creativity,” she says of her family’s Food Network-inspired nights.

Kenzie took her new interest in food to culinary school, which both challenged and strengthened her eating disorder recovery. Gradually surrendering long-held control in food preparation, she began to see food as more than a nutrition label. She discovered what normal eating looks like—and what it tastes like. She opened her eyes to food’s various cultural, social, and creative elements.

Culinary school, along with traveling, helped Kenzie appreciate food as integral to a full life. In addition to cooking and developing recipes, she celebrates food now by photographing and writing about the life-affirming moments we can share around a meal.

Kenzie’s blog is currently under construction. For now, find her on Instagram at @chefkenzieosborne.

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 50: Food is More Than a Nutrition Label with Kenzie Osborne appeared first on The Emily Program.

For many people, college is a time of tremendous transition and change. It provides new freedom and responsibility and offers lessons in life far beyond the classroom.

It is a milestone time—and one far too often hijacked by eating disorders.

All types of eating disorders can develop, return, or worsen in young people during their college years. Though these illnesses occur across the lifespan, they are particularly prevalent between the ages of 18 and 21. Research has found that the median age of onset is 18 for anorexia and bulimia and 21 for binge eating disorder, both findings within the age range of the traditional college student.

This article examines eating disorders in college students, including potential risk factors, warning signs, and tools for screening and intervention. Learn what makes college students particularly vulnerable to these complex mental illnesses as well as ways to identify and support those affected by them during college and beyond.

Eating disorders in college students

A 2013 NEDA survey estimated that between 10% to 20% of women and 4% to 10% of men in college suffer from an eating disorder. Four of ten students have either experienced an eating disorder themselves or know someone who has. Another study of college students identified that 13.5% of women and 3.6% of men showed eating disorder symptoms.

Research also indicates rising rates of eating disorders on campus. According to NEDA, the rate of male respondents with eating disorders has risen dramatically in recent decades, as has the rate of female respondents, albeit less dramatically.

Gender minority (GM) students and college student-athletes experience particularly high rates of eating disorders.

Gender minority (GM) students

According to a 2019 study, gender minority (GM) students exhibit a significantly higher prevalence of eating disorder symptoms than do their cisgender peers. GM students had a 2–4 times higher prevalence of anxiety, depression, eating disorders, and non-suicidal self-injury (NSSI).

Similarly, a 2015 study found that transgender college students are four times more likely to suffer from an eating disorder and twice as likely to engage in purging. In this study, approximately 13.5% of transgender college students reported using diet pills, and 16% of transgender individuals had been diagnosed with an eating disorder.

College student-athletes

Studies have shown that both female and male student-athletes are also at greater risk of developing an eating disorder as compared to non-athletes. Research suggests that the risk is particularly high for those involved in sports that emphasize body weight or shape and/or normalize disordered eating as part of the sport.

Risk factors for college students

All eating disorders are complex conditions that arise from biological, psychological, and social factors. Among the factors that may make college students uniquely susceptible to these illnesses are:

• Newfound independence and increased responsibility
• Unfamiliar environment; loss of personal space and privacy
• Living away from parents, friends, and other support people
• An abundance of food choices and food-centered activities
• Change in routine; loss of structure
• Increased workload
• Academic and financial pressures
• Desire to fit in
• Exposure to drugs and alcohol
• Fear of the “Freshman 15”
• Increased screen time with online classes

When does disordered eating become an eating disorder?

Disordered eating is normalized in our culture, and especially in college. Examples of disordered eating normalized on college campuses include:

• “Saving up” calories during the day to justify drinking or partaking in social activities in the evenings and on weekends
• Using Adderall, nicotine, energy drinks, and other appetite suppressants in place of meals
• Missing meals because of irregular sleeping patterns or feeling “too busy to eat”

Harmful in its own right, disordered eating differs from an eating disorder. We worry about eating disorders when any of the following are present:

• Is there a pattern of behaviors?
• Is there a preoccupation with food and body?
• Is there impairment?

Eating disorder signs and symptoms

Signs and symptoms of eating disorders in college students are similar to those in other groups affected by these conditions. They may be subtle and kept hidden, especially in the earlier stages of illness.

Physical

• Unusual and rapid weight fluctuations
• Fainting, fatigue, low energy, interrupted sleep
• GI discomfort, dysregulation, bloating
• Dry hands/hair or poor circulation
• Hair loss or development of lanugo
• Chest pain or heart palpitations
• For females, disruption in menstruation

Behavioral

• Dieting or chaotic food intake
• Preoccupation with food, weight, size, and shape
• Excessive exercise
• Frequent trips to the bathroom
• Change in clothing style (sometimes to hide or to flaunt body)
• Eating in isolation

Emotional

• Severe mood swings
• Increased isolation, irritability, anhedonia
• Low self-esteem; complaints about body
• Perfectionistic tendencies
• Sadness or comments about feelings of worthlessness
• Increase of depression and/or anxiety

Screening college students for eating disorders

Eating disorders are not “phases” that pass on their own, but rather illnesses that warrant serious care and attention. The majority of people with eating disorders never receive professional support—but it is available. The earlier detection and intervention happen, the better the recovery outcomes.

Consider these steps to help identify eating disorders in the college students you treat:

1. Start the conversation.

Many young adults who meet the full criteria for an eating disorder never talked about their concerns with a health care provider. Ask all patients about their eating habits, just as you do to assess for drug and alcohol use and/or sexual behaviors.

2. Follow up with additional questions.

If you suspect that your patient may be struggling in their relationship with food, ask if you can inquire further. For example, “I’m concerned about your eating. May we discuss how you typically eat and your relationship with food?”

These six questions, adapted from the SCOFF Questionnaire by Morgan, Reid, and Lacey, can help assess the situation:

• Do you feel like you sometimes lose or have lost control over how you eat?
• Do you ever make yourself sick because you feel uncomfortably full?
• Do you believe yourself to be fat, even when others say you are too thin?
• Do food and/or thoughts about food dominate your life?
• Do thoughts about changing your body and/or your weight dominate your life?
• Have others become worried about your weight and/or eating?

3. Refer as needed.

In this informal survey, two or more “yes” answers strongly indicate the presence of disordered eating. Refer the patient to a professional or program that specializes in eating disorders, such as The Emily Program.

Eating disorder treatment

Those struggling with an eating disorder generally need a multidisciplinary team of support, including therapy, nutritional counseling, and medical services.

Care at The Emily Program is informed by Sackett’s three-legged stool model of evidence-based practice. Incorporating research, clinical expertise, and client preferences, we aim to help individuals:

• Employ adaptive coping skills
• Eat and move in tune with the body’s needs
• Eat when hungry and stop when satisfied
• Eat a variety of foods without fear
• Focus on health, not weight
• Appreciate the body
• Think critically about media

With appropriate and timely care, recovery is possible for college students and others affected by eating disorders. The Emily Program is here to help. Make a referral by calling us at 1-888-364-5977 or by completing our online form, or encourage your patient to take the first step today.

The post Eating Disorders in College Students appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Erica Sunarjo is a professional writer and editor with a Master’s degree in Marketing and Social Media. She writes thought-provoking articles for publications in a variety of media. Even though she is an expert in numerous fields of business, Erica is always dedicated to learning new things. Add her on Facebook and Linkedin. 

My parents were hesitant about letting me attend college three states away. They let me go because I convinced them my eating disorder was under control. I lied, sort of. Maybe it doesn’t count as lying since I also convinced myself that I was perfectly fine.

In fact, I told myself that college would offer the autonomy I needed for my life, my schedule, and my eating to progress. After all, was I really recovering or recovered when my parents were so carefully monitoring and managing everything from my calorie intake to my therapy appointments?

In the months before I left for school, I connected with the three students who would be my roommates. We hit it off beautifully. All of us were student-athletes, we lived in small towns, and this would be the first time any of us lived on the coast.

The only thing that gave me pause was the fact that the conversations turned to food and diet so often. I expected it, though. After all, food is a popular topic among students, especially those looking toward new independence. And any student-athlete knows that carb-loading, weight loss, protein intake, and other habits are simply things that are part of our daily conversations.

Still, I powered through the summer before freshman year with a positive attitude, convinced I had it all under control. (Narrator: She did not, in fact, have it all under control.)

Move-in day was amazing. My roomies were as awesome in person as they were online. Even my parents seemed at ease, and ready to let me experience some independence. Then, classes began, practice started, and I began to feel the pressures of it all. That was on top of the triggers I experienced from all sides as I tried to live in between the free-for-all eating of late-night pizzas and ice cream, and the diet regimen that athletes are pressured to maintain.

In an ideal state of mind, I would have leaned on my parents for support, found a local therapist, and stepped away from triggering situations instead of powering through them. When I failed and fell back into unhealthy behaviors, I would have seen this as part of my illness, not a personal failure.

Unfortunately, that’s not how ED works. Instead, I tracked calories and became obsessed with my body fat percentage. Then I exercised. I worked out with my team, in the dorm gym with my roommates, and then I would sneak across town to a park where I would run until I could barely walk. When my roommates wanted to hang out or share a pizza, I made excuses. That allowed me to isolate myself in my room where I wouldn’t have to make excuses for not eating.

When you’re an athlete, you notice changes in your body quickly. Two months in, my muscles were getting weaker, my speed and reaction time were down, but I convinced myself I would bounce back with this new body. You know, the body I convinced myself was becoming more perfect. I also convinced myself that I was expertly keeping all of my secrets from my roommates, coaches, and family.

Well, I wasn’t. My roommates were the first to confront me. I didn’t handle it well. It got ugly, and in my defensiveness, I said awful things. Sometimes I’m amazed they are still my closest friends. Then, I remember that I do deserve things like unconditional friendship and acceptance. My coaches also noticed. They pulled me off the field pending clearance from a physician that I was fit to play. At that point, I knew I would never pass. So, I quit playing a sport I had loved since elementary school, because my inability to come clean and ask for help was so compromised by my eating disorder.

I never found out who called my parents and told them I needed help. I can’t describe how grateful I am that they did. By the time they came to see me, I was miserable. I felt like a failure because I let my ED take over my life. I also felt like a failure because I hadn’t achieved what my illness convinced me was a perfect body. Whatever energy I had to lie and cover up dissipated the moment I saw my mom. I told my parents everything, and it was absolutely relieving.

They took me home for two weeks where I worked with my doctor, an ED specialist, and the most amazing therapist I’ve ever met. When I returned to school, I connected with another therapist, an ED support group, and arranged continued therapy sessions, this time online.

I also made adjustments to my academic schedule. I arranged for a lighter course load. I also took advantage of help with tough math and writing assignments. I learned there are so many resources available to help with writing papers, including Grammarly, Trust my Paper, Evernote, Supreme Dissertations, even the student learning and success center on my campus. For some people, part of having an ED is dealing with perfectionist tendencies and struggling to ask for help.

Instead of hiding from my roommates, I communicated with them. They helped me stay on track, but let me manage my ED. Eventually, I returned to sports. I took a very slow path, though. My sophomore year was spent training with the team, but I stayed off the roster. My coaches couldn’t have been more supportive. I walked on junior year and earned a spot on the team. But I made the tough decision to give up my leadership position on the team. Right now, my recovery is my top priority, and that doesn’t leave room for that kind of commitment. Sports are fun again.

I also learned that there really weren’t many resources at my school for students with eating disorders. That’s a scary thought, considering that there are so many risks and triggers for college students. I’m proud to say that as part of my recovery, I’ve worked with my university’s mental health services to establish on-campus support systems and education for students who are struggling with ED.

The post Conquering My ED: A College Story appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, or symptom use. Please use your own discretion when reading and speak with your support system as needed.

In this Q&A, author Rosalyn Sheehy tells us about her latest book, Food Fight Club: Rules to Beat Bulimia. Learn the personal story behind the book and what she hopes readers will take away from it.

Tell us about Food Fight Club!

Food Fight Club is the essential handbook on beating bulimia—I simply had to write and share my tips. I suffered with bulimia for too many years, as a teen and into my 20s. I remember buying a book on bulimia years ago and tearing off the front cover; the B-word offended me, and I didn’t want anyone to know about my struggles. I felt the need to address this shame and secrecy. Back then I was absolutely terrified someone would find out and “report” my behavior. Bulimia is terribly isolating and dangerous. I have to warn people of the dangers too.

Food Fight Club gets its name from the Brad Pitt movie. The first rule of Food Fight Club is we do not talk about Food Fight Club—the whole world and its sister doesn’t need to know you have a problem and you are being brave enough to find a solution!

The intended audience is anyone struggling with bulimia who is afraid to talk about it, as well as family and friends who are simply at a loss for what to do. Food Fight Club breaks the ice. I wanted to put a little humor in the tumor that is bulimia and let people know that if I can beat it, anyone can!

How does this book compare to your first one?

My first book, Loopy Loo, is an autobiographical story poem about my rocky road to recovery. Food Fight Club is a rule book with 20 rules to be adhered to and has useful homework at the back. It is interactive. Sufferers grab the bull by the horns and master their own destinies!

What is the role of humor in your eating disorder recovery and writing work?

I created a new genre for fixing twisted sisters: CBT, or Comic Book Therapy. You might like my nun in habit breaking the binge/purge cycle in yoga with Awkward Pose.

What do you hope readers get from the book?

Readers will get rules to hold on to. One of the most important rules is strapping yourself into a seat after a meal for 20 minutes. This is tough, but it gets easier and the urge to purge gets replaced with healthier habits.

I felt bereft when doctors tried to take my bulimia away from me—it was my coping mechanism for horrible feelings I couldn’t deal with. I felt very raw and sad at first, but I learned to FIND and REPLACE. The book lists myriad ways and resources to give you a huge helping hand when you break the binge/purge cycle and find inner peace. You find new neural pathways, and I can honestly say the day when I couldn’t remember the last time I had puked was the happiest day of my life.

How do you see the book complementing eating disorder treatment?

Food Fight Club is empowering and encouraging. It helps sufferers take the first step (the hardest step!) by reaching out to someone for help. The book urges readers not to shrink to fit but to see a shrink! You will also see rock stars at group meetings in the book. I was always petrified, too scared to go to a group—even the thought of it made me want to get sick—buuuuuuuuuuuuuuuuut once I went to a couple, I got to love the way I felt walking out of those groups: buttressed, understood, and determined to make myself well and stop making myself sick.

What are some of your favorite recovery books?

I recommend a book called How to be Brave by Emilia Adler. It was written by a 16-year-old in recovery and is a series of her journal entries. Food Fight Club insists, “Right here, right now—write it down.” Journaling and logging mood/food can be helpful in recovery. Food Fight Club helps you keep the Wolf of Walmart from your door. You will feel so wonderful and strong once you can eat three meals without obsessing and get on with your life—you get energy to climb mountains! Bulimia was my metaphorical mountain. And of all my achievements in life, I am most proud of combating bulimia and giving it the two fingers!

What do you wish you knew as a young adult experiencing bulimia?

Every day I wish I never made myself sick. Every day I miss my missing teeth!

The post Food Fight Club: A Q&A with Rosalyn Sheehy appeared first on The Emily Program.

Tell us about yourself!

Hiyee! I’m Courtney. I’m the Site Director for our Seattle residential location. I started this role in December 2020, but have been with The Emily Program at our Seattle outpatient site since June 2016. I was the Clinical Manager for the Seattle outpatient nutrition team and the majority of my client experience was as a dietitian, primarily with our DBT PHP/IOP program. Prior to that, I worked at another ED residential program in multiple roles (milieu therapist/EDT, diet tech, individual therapist, dietitian). I’m both a therapist and dietitian, and it has been really fun to bring both of those lenses to my new role as Site Director.

What do you like most about your job?

I selfishly love this work because it’s forced me to take a good hard look at myself and my life and really ensure that I’m walking the walk and talking the talk. You cannot pour from an empty cup. To do this work, YOU have to be your top priority. Knowing your limits, holding boundaries, doing your own therapeutic work, doing what you need to do so you can be your very best you – that is how to have a positive impact and how to have a sustainable career. I’ve been incredibly lucky at The Emily Program to be surrounded by both clinical and executive teams who wholeheartedly support this and hold me to following my own advice.

What do you like to do when you aren’t working? 

Given how stressful this work can be, I really strive to keep my life outside of work as interesting as possible! I have a lot of physical energy and I’ve found a number of fun outlets for it, including scuba diving, rock climbing, volleyball, biking, camping – all the activities! I also moved to Woodinville, WA in the last year, so it’s been really fun to explore my new neighborhood as things have re-opened. I’ve especially loved all the breweries and wineries nearby.

What is one thing most people don’t know about you?

I really am an introvert! Despite having lots of physical energy (I’ve been called Tigger a time or two), when it comes to social energy, I get drained pretty quickly. Between engaging with clients and my team, work meets a lot of my social needs. It takes a good chunk of alone time for me to recharge, which is why most of my hobbies are solo or with very small intimate groups of one or two others.

What are you most looking forward to post-pandemic? 

Travel. Travel. Travel! My partner and I were planning a trip to climb and dive in Thailand, our friend group was trying to plan a walk-about tour through Ireland, and my mom and sister had been talking about biking around New Zealand when everything got turned upside down. I love immersing myself in different cultures from the language to the food to the daily rhythm and everything in between, and I’ve missed that greatly.

The post Staff Spotlight, Courtney Saylors appeared first on The Emily Program.

Our understanding of eating disorders in males is limited because the field has historically focused on females. Research has centered on females, diagnoses were organized around them, and screening tools and assessments have been normed to them.

We don’t have research that establishes what it means to have an eating disorder if you are male. We can approximate the population of males with eating disorders as 1/3 of the total number of people with eating disorders—but then the question arises: Why? Why would so many fewer males than females be affected?

It is unlikely that having two XX chromosomes instead of one X and one Y is the reason. Therefore, we must search for other factors to help us understand and explain the significantly lower rate in males. Are we missing the males with eating disorders?

Looking at disordered eating behaviors in areas other than eating disorders is one place the search takes place. When we examine areas where disordered eating may be present in males, we can ask whether these males may be struggling with food and body in a way that has gone unnoticed and untreated.

Two areas of interest are muscle dysmorphia and sports.

Muscle Dysmorphia

Muscle dysmorphia is a condition that involves a preoccupation with muscularity. Like body dysmorphia more generally, it brings anxiety and distress about perceived flaws in one’s appearance. Males affected by muscle dysmorphia perceive their bodies to be lacking in muscle.

These males will likely not talk about a desire to be thin. More likely, they will talk about a desire to build muscle and lower body fat. They might talk about their workout habits, bodybuilding regimens, or supplement use meant to “bulk” up or “sculpt” their bodies. Unlike body image concerns underlying a desire to be thinner, muscle dysmorphia involves a desire to become bigger and leaner.

But if we ask further, we may find that these males are actually obsessed with food and body. It is not uncommon for males experiencing muscle dysmorphia to exercise excessively, adhere to strict diets, and engage in other disordered behaviors. We often find that their preoccupation and impairment are not unlike those suffering from more traditional eating disorders—and that their eating disorders have long gone unnoticed.

Sports

Another area where we may find males suffering from unrecognized eating disorders is sports. We believe that roughly 60% of males with eating disorders are involved with sports, but their symptoms may be masked as “normal” behavior for their sport.

For example:

• Males involved in cross-country running may restrict in an attempt to gain a competitive advantage by becoming leaner and smaller.
• Males involved with wrestling and boxing may engage in bingeing and purging.
• It is not uncommon for males involved in sports to regularly eat an amount of food that could be considered binges.

Disordered eating does not always constitute an eating disorder, but it is a sign that we should ask more. When we ask male athletes about their relationship with food and body, we may find that they are experiencing many of the traditional physical, emotional and behavioral signs of an eating disorder.

When it comes to males and eating disorders, we want to open a wide lens. We want to explore the ways social factors can contribute to the development or maintenance of eating disorders. We want to be aware of how we may approach a male with an eating disorder differently than a female with one, and how we can challenge the stereotype of eating disorders as a “women’s disease.” This stereotype and the stigma associated with it keeps males from seeking help.

We will continue to see people whose symptoms do not fit neatly within the DSM categories but whose underlying concerns about weight and body are identical to those who do fit the traditional categories. It is extremely important that we continue to look at these groups and care for the suffering of anyone struggling in their relationship with food and body.

The post Muscle Dysmorphia, Sports, and Eating Disorders in Males appeared first on The Emily Program.

Episode description:

Kesslee is a young professional, part-time coach, wife, and dog mom. She is passionate about serving others to become the best version of themselves and using her journey to help them along the way.

Kesslee joins us in this episode of Peace Meal to share how perfectionism manifested during her eating disorder and recovery. She begins by recognizing the challenges of being a Division 1 distance runner. Under pressure to be small and lean for the sport, Kesslee restricted food while training more and more. The core issue, she says, was a belief that she was not enough—not for her coaches and not her parents.

Now, Kesslee has tools and strategies for combating the lie that says she is a failure. She offers a practical exercise and recommendations for those similarly worried that they’re not enough, emphasizing the power of therapy and meaningful relationships as well. Equipped with this professional and personal support, she is now focused on adding small nurturing and empowering things into her life. She strives to use her perfectionism for good and carries with her a bold affirmation: “I have been put on this earth to take up space and become stronger.”

Get help from The Emily Program by calling 1-888-364-5977 or by visiting emilyprogram.com/your-recovery/get-help-now.

—

About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 49: Managing Perfectionism with Kesslee appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

While navigating her own recovery journey at The Emily Program, Teresa Schmitz discovered a hidden gift in being known as a great listener with a compassionate heart. Being earmarked as an IT Leader who was more into the people on her teams than the technology they were building, she realized her purpose was beyond her title. She connected the dots and soon realized her purpose was to help empower others. She pursued her dreams of becoming a coach and launched her own coaching business, My Best Self Yet.  She now helps women feel empowered to navigate the journey of loving themselves unconditionally. She also empowers others to know and use their character strengths in the In It Together group coaching program. Learn more about Teresa’s story and follow My Best Self Yet on Facebook, Instagram, and her blog.

“You have to put in the ‘work.’ You have to be willing to put your health and recovery above everything else.”

These are words that I said in my recovery story on the Peace Meal podcast. I can say them now because I am recovered, and putting in the “work” is exactly what it took.

I didn’t think recovery was possible when I was first diagnosed, as my eating disorder had convinced me that I was the problem. “I” just could not lose weight. “I” just could not seem to get a grip on my food consumption. “I” just couldn’t get my act together. There would be a lot of “work” unraveling these and many other beliefs.

My eating disorder convinced me to be so ashamed. At first, I hardly told anyone of my diagnosis. I did not even share it with my nearly lifelong friend, as my eating disorder had convinced me that she would abandon me if she knew the truth. Oddly enough, I told my boss of my diagnosis because my eating disorder convinced me that I was going to get fired if I didn’t tell her. I was going to be in Intensive Outpatient Programming (IOP) for four nights a week, so I thought my performance at work was on the line. At the time, I was convinced that my worth was defined by the performance rating I got each year, and I was not sure I could continue to perform and exceed expectations. If I performed anything less than exceptional, I was not worthy. And I’d get fired. So I told her.

This past summer, after I had been on my recovery journey for two and a half years, I had the opportunity to share my story publicly for the first time. It was as if I was taking back the driver’s seat. I was telling the world for the first time that my eating disorder did not define me. I am worthy simply because I am a human being.

An eating disorder convinces you that you somehow aren’t worthy, so you go about proving that you are worthy in so many other ways—in your job performance, your job title, your bank account, your address, your vacation spots, your relationship status, your circle of friends, the busyness of your calendar. It’s exhausting work to keep up that image. I did that for my entire adult life until it all crashed.

I’m incredibly thankful it crashed. Life after an eating disorder is rewarding. I have hobbies now. I have a healthier relationship with my husband. I gained three really dear friends and made my friendship with my bestie of now 36 years even closer. I no longer get my worth from my job title or my performance review. I’m a better mom, wife, daughter, sister, and friend. I allow space for things I truly enjoy and am pursuing a passion (coaching) that I once only used to dream about on my worst corporate days. I can truly say that I make a better coach having been through this journey.

My dreams are coming true. I had to put in the work—not the work of keeping up an image, but the work of finding worth beyond that image. I had to value my health, my recovery, and my life over my job, my performance rating, my title, my accountabilities, my calendar busyness. . .

I had to put recovery above everything else.

The post Putting in the Work appeared first on The Emily Program.

Eating disorders are complex illnesses. Diverse and multifaceted, they are associated with biological, psychological, and social factors that themselves are complex and interact with one another in complex ways.

One factor often overlooked in conversations about eating disorder development, illness, and recovery is food insecurity. Research about the link between food insecurity and eating disorders has emerged in recent years, as food insecurity has likewise seeped into the public consciousness more generally.  

This article describes what we know about food insecurity and eating disorders to date, how to screen for food insecurity, and how to integrate food insecurity support into eating disorder treatment and recovery. By addressing food insecurity in patients with eating disorders (and eating disorders in patients experiencing food insecurity), providers can play a critical role in intervening and supporting those dually affected.

What is food insecurity?

Food insecurity, as defined by the USDA, is the “limited or uncertain availability of nutritionally adequate and safe food” or the “limited or uncertain ability to acquire acceptable foods in socially acceptable ways.” Assessed on a household level, food insecurity is influenced by multiple factors and occurs at different levels of severity.  

Food insecurity is multi-dimensional.

The four basic components of food security are food availability, access, stability, and utilization. A household is considered to be experiencing food insecurity when any one dimension is threatened or unmet.

1. Availability: Is there adequate food available? Does the household have a sufficient supply of food of an appropriate quality?
2. Access: Is food physically and economically accessible? Does the household have the resources to purchase or acquire food?
3. Stability: Is there a risk of losing access or availability over time?
4. Utilization: Can the food be used appropriately? Can the household prepare, consume, and store the food to meet its needs?

Food insecurity occurs at different levels of severity.

Though we tend to think of food insecurity at only its most severe level, it exists along a spectrum that ranges from food-secure situations to food-insecure ones. Within the range are multiple opportunities for identification and intervention.

The USDA outlines the following four ranges of food security:

1. High food security: Household reports no food access problems or limitations.
2. Marginal food security: Household reports problems or anxiety at times about accessing adequate food, but the quality, variety, and quantity of food were not substantially reduced.
3. Low food security: Household reports that the quality, variety, and desirability of their diets were reduced, but the quantity of food intake and normal eating patterns were not substantially disrupted.
4. Very low food security: Household reports that the eating patterns of one or more of its members were disrupted and food intake was reduced because the household lacked money or resources for food.

Food insecurity is increasing due to COVID-19.

Rates of food insecurity had been falling before 2020, but the pandemic and its associated economic fallout have significantly driven them up. The number of households experiencing food insecurity is increasing across the country, and COVID-19 has only worsened the problem in locations already experiencing high rates.

Food Insecurity and Eating Disorders

Growing research is revealing a link between food insecurity and eating disorders. The studies to date, though limited, show clear indications of overlapping experiences of food insecurity and disordered eating and eating disorders.

Food Insecurity and Disordered Eating Behaviors

Studies show significant eating disorder behaviors among adolescents and adults with food insecurity.

• People living with high levels of food insecurity report higher levels of binge eating, a higher likelihood of having any type of eating disorder, dietary restraint for any reason (e.g., avoiding a food group or types of food), weight self-stigma, and high levels of worry (Becker, Middlemass, Taylor, Johnson, & Gomez, 2017)
• Adult food pantry clients report higher eating disorder symptoms, including vomiting, laxative/diuretic use, fasting, and intense exercise (Becker, Middlemass, Taylor, Johnson, & Gomez, 2017; Becker, Middlemass, Gomez, & Martinez-Abrego, 2019)
• Adolescents in households experiencing food insecurity report higher rates of compensatory behaviors, including laxative/diuretic use, fasting, skipping meals to lose weight (Hooper, Telke, Larson, Mason, & Neumark-Sztainer, 2020).

Food Insecurity and Diagnosed Eating Disorders

The first studies to examine the association between food insecurity and diagnosed eating disorders also show a strong association.

• Food insecurity is associated with binge eating disorder (Rasmusson, Lydecker, Coffino, White, & Grilo, 2019) and bulimia (Lyndecker & Grillo, 2019).
• People with a history of childhood food neglect are more likely to have binge eating disorder, bulimia, or anorexia than those without childhood food neglect (Coffino, Grilo, & Udo, 2020)

These food insecurity studies align with what we know about eating disorders more generally. Limited food intake—for any reason—and fluctuating food availability are known to increase eating disorder pathology. As food intake decreases during periods of scarcity (or other periods of restriction or starvation), it is likely to increase drastically during periods of abundance or availability. Restriction often leads to overeating.   

Taken together, the research findings provide a foundation for future research and highlight the need to address eating disorders and food insecurity as issues that can overlap. There is a clear need to screen for eating disorders in people experiencing food insecurity and to screen for food insecurity in people experiencing eating disorders.

Screening for Food Insecurity

The following two screening tools can be integrated into your clinical work to identify and intervene in situations where patients are experiencing food insecurity. Both are validated in multiple populations and can be used in conjunction with other general screening measures or provider-patient conversations about eating.

Hunger Vital Sign™

The Hunger Vital Sign™ is a simple two-question screener. For each statement below, a patient responds whether the statement was “often true,” “sometimes true,” or “never true” for their household in the last 12 months:

1. “Within the past 12 months, we worried whether our food would run out before we got money to buy more.”
2. “Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more.”

A patient screens positive for food insecurity if the response is “often true” or “sometimes true” to either or both of the statements.

Radimer/Cornell Food Insecurity Measure

A longer, more multi-dimensional screening tool is the Radimer/Cornell measure of food insecurity. This tool can be used as an alternative to the Hunger Vital Sign™ or a follow-up to it to glean more insight into which areas of food insecurity are influencing your patient most.

1. Do you worry that your family may run out of food before you have money to buy again?
2. Do you worry that you may not be able to afford to buy adequate food?
3. Do you wish you could buy more food if you had more money?
4. Has your family ever run out of food because you do not have more money to buy food?
5. Has your family ever eaten the same type of food for several consecutive days because you do not have enough money to buy different food?
6. Have you ever eaten less than you want because you do not have enough money to buy food?
7. Have your children, according to you, not had enough to eat because you do not have enough money to buy food?
8. Do you have enough money to buy healthy and nutritious food for your children?
9. Sometimes a person’s body weight drops because of not eating enough. Has your body weight dropped in the last year because of the lack of food?

Food Insecurity Support

Given that many people experience shame and stigma associated with food insecurity, approach these conversations with sensitivity and empathy. When a patient screens positive for food insecurity, document it in the patient’s electronic health record (EHR) and be prepared to connect the patient to resources.

Case studies show that a two-prong approach to providing resources is most impactful:

1. Providing food or financial support at the moment of detection, AND
2. Providing a list of resources or programs to support the patient’s longer-term needs

At The Emily Program, we currently provide groceries and gift cards to clients experiencing food insecurity via our Food and Supplement Assistance program. This immediate support is paired with opportunities for seeking grant assistance, such as that provided by eating disorder foundations like WithAll, or for federal and local support.

Federal Resources

Three primary federal resources include:

• Supplemental Nutrition Assistance Program (SNAP): Monthly benefits for purchasing food using an EBT card
• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Nutritionally tailored food packages for pregnant, breastfeeding, and postpartum women, infants, and children up to age five
• The Emergency Food Assistance Program (TEFAP): Emergency food distributed through local food pantries and organizations

Other programs cater to children in households experiencing food insecurity, including the National School Lunch Program (NSLP), Afterschool Nutrition Programs, Summer Nutrition Programs, and the Child and Adult Care Food Program (CACFP).

Local Resources

Other assistance is available at the state, county, and/or city level. Look online and in your neighborhood for support via:

• Food shelves and banks
• Community assistance programs
• Large hunger programs

Recovery Support

The support for patients experiencing food insecurity and eating disorders doesn’t end when your patient is provided a bag of groceries or gift card for purchasing food. At that point, the support shifts to helping the patient incorporate the food into their treatment and recovery.

How will they manage the triggers associated with a fluctuating food supply? What support do they need to handle food preparation and storage? How will they fit unfamiliar foods into their meal plans and family menus?

As part of a full eating disorder treatment team, a dietitian can help with meal planning and food preparation skills, as well as education about how a variety of foods can be used to meet the client’s needs in recovery.

If you are concerned about an eating disorder in a patient experiencing food insecurity or food insecurity in a patient experiencing an eating disorder, The Emily Program can help. Submit a referral online or by calling 1-888-364-5977 today.

The post Food Insecurity and Eating Disorders appeared first on The Emily Program.

We all live in diet culture, a society obsessed with thinness and dieting. Weight and food biases permeate the air we breathe, tingeing our thoughts and actions in ways sometimes hard to notice. Providers, patients—none of us—are immune to these biases. They’re often subtle and deeply embedded, and left unexamined and unchecked, they can manifest in interactions between patients and even the most capable, well-intentioned providers.

In this article, we define and discuss weight and food bias, including its perpetuating factors and health consequences. Learn the impact of weight stigma and how to recognize and counter implicit and explicit bias in yourself, your practice, and in our larger society.

What are weight bias and stigma?

Weight bias refers to negative attitudes, beliefs, or assumptions about others based on body weight or size. Internalized weight bias occurs when these negative weight-related beliefs are absorbed and held about oneself.

Weight bias can lead to weight stigma, or the disapproval of someone based on their weight. Stigma is seeing someone negatively because of their weight, which can in turn lead to treating someone negatively because of it. Stigma manifests in stereotyping, bullying, and discrimination on the basis of weight, as well as exclusion and marginalization in media, professional, health care, and other settings. While weight bias harms people of all sizes, those who live in bodies that do not conform to “normal” body size expectations experience the greatest weight stigmatization.

The Centers for Disease Control and Prevention (CDC) describes body sizes using body mass index (BMI), a measure of a person’s weight relative to their height. Importantly, the BMI does not account for sex and racial differences, muscle mass, or overall body composition, and as the CDC acknowledges, it is “not diagnostic of body fatness or the health of an individual.”

The CDC’s BMI categories include:

• For children and teens, “overweight” is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and sex. “Obesity” is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex.
• For adults, “overweight” is defined as a BMI between 25 to <30, and “obesity” is defined as a BMI of 30 or greater. Three classes exist within “obesity”: 30 to <35, 35 to <40, and 40+.

The impact of stigma

Weight stigma manifests in all areas of life. It can be expressed in both private and public settings by family members, friends and peers, employers, health care and other professionals, and institutions. Comments, images, or behaviors that indicate disapproval of, make judgments about, or outright harass or exclude those in larger bodies are examples of stigmatization. Other examples include a reluctance to serve, accommodate, work with, or care for a person because of their weight, as well as marketing and other messages that tout diet products as a way to “fix” the assumed problem of weight.

Additional examples of weight stigma in everyday life include:

• A person in a larger body visiting the doctor for an injury or common illness, and instead of receiving a proper exam or evidence-based intervention, is asked to lose weight [See Rachel Wiley’s ‘The Fat Joke’]
• Airplane seats that do not accommodate people in larger bodies, airlines asking them to purchase a second seat, and judgment from people in seats nearby
• Limited (or no) clothing options at popular retailers, and plus-size sections often hidden away in a quieter part of the store
• Weight-based discrimination in hiring and promotion opportunities
• Comments from family or friends such as “You run fast for your size” or “You’re not fat, you’re beautiful,” which implies that a person cannot be both
• Unsolicited weight loss advice

These examples make visible weight-biased beliefs that associate people in higher-weight bodies with laziness, lack of willpower, poor lifestyle choices, lack of moral character, bad hygiene, a low level of intelligence, and unattractiveness.

Ample research confirms that weight stigmatization is not only pervasive but incredibly harmful. Studies show that people categorized with BMIs considered “overweight” or “obese” are at much greater risk of being stigmatized. According to one such study from the Rudd Center for Food Policy and Obesity (as reported by the WHO):

• School-aged children categorized as “overweight” or “obese” experience a 63% higher chance of being bullied
• 54% of adults categorized as “obese” report being stigmatized by co-workers
• 69% of adults categorized as “obese” report being stigmatized by health care professionals

Weight stigma in media

Popular narratives may contribute to weight stigma by oversimplifying body weight, suggesting that it is a direct result of personal habits and a determinant of a person’s health or character. Such narratives often focus on individual behaviors and perceived failures. With messages like “eat less; move more,” they neglect to take into consideration important biological, social, economic, and environmental factors, including food security, economic stability, and community resources.

As a primary cultural storyteller, media often reinforce weight stigma by perpetuating negative, stereotypical portrayals of higher-weight people. Research shows that 72% of media images and 77% of videos include these stereotypical portrayals. Larger-bodied characters are also severely underrepresented in media. When they do appear, they are often punchlines (“Fat Monica” in Friends, for example), villains (The Little Mermaid’s Ursula), or portrayed as dim-witted (Homer Simpson). They rarely have fully developed characters or storylines.

Health consequences of weight stigma

Shaming, harassing, or criticizing people about their weight and/or eating patterns is often done to “motivate” people to change their behavior. However, research and lived experience reveal the opposite effect.

Like other types of stigmatization and discrimination, weight stigma is associated with significant physiological and psychological consequences. They include:

• maladaptive eating patterns
• poor body image and body dissatisfaction
• low self-esteem and self-confidence
• feelings of worthlessness and loneliness
• avoidance of physical activity
• avoidance of medical care
• suicidal thoughts and actions
• depression and anxiety

Weight stigma can also affect the quality of care for patients who receive it, ultimately leading to poor health outcomes and increased risk of mortality.

Food bias

Weight bias isn’t the only bias pushed by diet culture—food bias exists as well. Our culture often thinks of food in terms of moral terms:

• “Good” vs. “bad”
• “Guilt-free” vs. “sinful”
• “Clean food” vs. “junk food”

Moreover, too often people assign value to themselves for eating so-called “bad” foods. Comments like “I’m being so bad tonight, ordering the pizza instead of a salad” or “I’m cheating tonight” imply that we are better or worse people depending on the food decisions we make.

How can we make a difference?

Know ourselves

As with many changes, the first place to look is at ourselves. The thoughts and feelings we have about our own and others’ bodies influence how we interact with patients, colleagues, and others in our lives.

A good starting point is to examine our implicit biases, which we all have. The Harvard Weight Implicit Association Test (IAT) is a validated measure of unconscious attitudes and beliefs about weight. It is available to take for free.

Other questions to ask yourself include:

• Do I make assumptions about a person’s health based on their weight or size?
• When I say “healthy” and “unhealthy,” do I mean “thin” and “fat”?

Social media and purchasing power

Choose which individuals and organizations to give your social media “likes” and real-life dollars to. Here are some questions to ask yourself when interacting with brands and social media accounts:

• Does this person share diet culture messages that position thinness as superior to fatness?
• Is this brand committed to weight and size inclusivity? Does it offer clothes for a wide range of body sizes?
• Is this company trying to sell me something to “fix” a perceived problem with my size, shape, or weight?
• Who benefits from me feeling bad about my weight or size?

To broaden acceptance of the diversity of sizes, we can also curate our feeds with messages that recognize and appreciate size diversity. We can unfollow or restrict accounts that perpetuate stereotypes about people in higher-weight bodies (or don’t represent them at all), and curate our feed so that it includes weight-inclusive and diverse accounts.

Some body positive spaces and influencers include:

• The Body is Not an Apology: Instagram, Facebook, Twitter
• The Body Positive: Instagram, Facebook, Twitter
• Ragen Chastain: Instagram, Facebook, Twitter
• Jessamyn Stanley: Instagram, Facebook
• Kimmie Singh, MS, RD: Instagram, Facebook, Twitter
• Michelle Rogers: Facebook, Twitter, Instagram
• Aaron Flores, RDN: Instagram, Facebook

Activism and Advocacy

Another way to influence change is by lending your voice to activist and advocacy efforts. Suggestions include:

• Connect with organizations like the Association for Size Diversity and Health® (ASDA) or the National Association to Advance Fat Acceptance (NAAFA)
• Rally around awareness campaigns, such as Weight Stigma Awareness Week (WSAW) or hashtags like #losehatenotweight and #endweighthate
• Speak up in your own life:
  • Have difficult conversations that challenge the idea that thinner is always better
  • Interrupt instances of weight discrimination
  • Advocate for accessible and size-friendly seating, equipment, and layouts at your school, workplace, gym, and the places you shop
  • Let media producers, content creators, or business owners know when you recognize an image or message that is not (or is) weight-inclusive

Ensure eating disorder treatment is weight stigma-informed

Treatment for eating disorders of all types—including binge eating disorder—should not focus on weight loss. Though all of us live in a weight-obsessed world, the importance of weight is compounded for people with eating disorders; the preoccupation is often part of these illnesses.

What’s more, weight is not a behavior, and intentional weight loss does not heal an unhealthy relationship with food or the body. In fact, it often does just the opposite. Recovery, just like eating disorders, looks different on all patients. Some patients experience weight gain, others experience weight loss, and others still experience little to no weight changes at all.

Some practical considerations for eating disorder and other health professionals include:

• Allow patients to get blind-weighed, and ensure their weight remains invisible to them, even on visit summaries
• Ensure your facility has size-inclusive chairs, exam tables, gowns, and blood pressure cuffs
• Recommend evidence-based interventions to people in larger bodies as you do to people in smaller bodies
• Equip patients with tools to develop resistance to diet culture and strategies for handling instances of weight stigma

Remove judgment from food

Adopt an “all foods fit” approach free from food judgment. Removing moral value from food is an important part of a healthy relationship with food for all of us, and especially when challenging distortions present in disordered thoughts and behaviors. 

Ellyn Sattler’s hierarchy of food needs is another way to understand food decisions in a less-biased way. Like Maslow’s hierarchy of needs, Sattler’s hierarchy positions the elements that matter first at the bottom of the pyramid; at the top are more complex needs.

In Sattler’s pyramid, the most basic food need is having enough food to eat. Once that need is met, people can seek food that is acceptable (e.g., not spoiled or rotten), then food that is accessible and reliable. As people move up the pyramid, they can seek food that is good-tasting, then novel, then instrumental.

Embrace health-based focus to care

Weight-inclusive care accepts and respects body diversity and focuses on health instead of weight. Health At Every Size® (HAES) offers an approach that promotes health-related behaviors that improve well-being in a holistic sense. Its basic principles, as presented in HAES pioneer Lindo (formally Linda) Bacon and Lucy Aphramor’s book, Body Respect, include:

Respect

• Celebrates body diversity
• Honors differences in size, age, race, ethnicity, gender, dis/ability, sexual orientation, religion, class, and other human attributes

Critical Awareness

• Challenges scientific and cultural assumptions
• Values body knowledge and lived experiences

Compassionate Self-care

• Finding the joy in moving one’s body and being physically active
• Eating in a flexible and attuned manner that values pleasure and honors internal cues of hunger, satiety, and appetite, while respecting the social conditions that frame eating options

Weight bias and stigma are prevalent and consequential—and it’s on all of us to recognize, acknowledge, and challenge it in ourselves, in others, and in the places and institutions we inhabit.

To help your patient make peace with food and their body, connect them to eating disorder specialty care as soon as possible. Make a referral online or by calling 1-888-364-5977 today.

The post Weight Stigma and Food Bias appeared first on The Emily Program.

We are excited to share that The Emily Program and Veritas Collaborative have merged, joining two of the nation’s leading eating disorder treatment programs.

Both programs are known for their warm and authentic care for people of all ages and genders across the array of eating disorders diagnoses. The Emily Program and Veritas will retain their brands in their respective markets across the Northwest, Midwest, and Southeast and remain committed to maintaining the highest clinical integrity and standards of care, while expanding access to treatment.

“We are so pleased to be part of growing access to care for individuals and families dealing with these treatable, life-threatening illnesses,” said Dave Willcutts, CEO. “Our two companies together will set the standard for comprehensive care from outpatient through inpatient to equip clients and families with the understanding, interventions, and ongoing support they need to achieve recovery. We believe recovery from these fierce illnesses is rooted in relationships, and we are honored to be a part of people’s journey to recovery.”

Collectively, The Emily Program and Veritas currently have 20 locations across Georgia, Minnesota, Ohio, North Carolina, Pennsylvania, Virginia, and Washington, with outpatient individual, group, and family services; intensive outpatient programs; partial hospital programs; residential programs; and inpatient care — with various gender-inclusive programs focused on addressing the needs of children, adolescents, and adults. The combined thought leadership and reputation of our two programs is exceptional and positions us as an industry-leading voice in the eating disorders field for many years to come — all the while focused on how to best meet the needs of those we employ and those we serve.

The two programs have joined under a parent company, which will be named later this year. Dave Willcutts will serve as the CEO of the merged company to be headquartered in St. Paul, Minnesota. Veritas CEO Mike Browder will transition to the board of directors of the merged company. Chris Durbin, chairman of the Veritas board, will serve as chairman for the merged company, and Dirk Miller, founder of The Emily Program, will serve as founding executive chairman. Highly respected clinicians from across the two organizations form the merged company’s clinical leadership team. 

Patients and families will continue to receive the same high-quality care they have always expected from us, at the same facilities, from the same brand names. Referring providers can continue to count on the same high-quality care they have always expected from us, at the same facilities, from the same brand names. We will maintain an unwavering commitment to clinical integrity through quality assurance, community connection, and continued work on improving access to care. Together, we will learn from each other and use our collective resources to bring more care to more people. Additionally, working together, we will strive to enhance initiatives that make our communities, and our world, a more equitable and safer place. 

About The Emily Program

The Emily Program’s vision is a world of peaceful relationships with food, weight, and body image, where everyone with an eating disorder can experience recovery. The Emily Program, headquartered in St. Paul, Minnesota, was founded in 1993 by Dirk Miller, Ph.D., L.P., after his sister Emily recovered from an eating disorder. Recognizing that one size does not fit all, The Emily Program provides exceptional, individualized care for people with eating disorders of all ages and genders leading to recovery from eating disorders, incorporating individual, group, and family therapy, nutrition, psychiatry, medical care, yoga, and more — with locations in Minnesota, Ohio, Pennsylvania, and Washington. If you or someone you know is struggling with an eating disorder, call 1-888-EMILY-77 or visit emilyprogram.com.

About Veritas Collaborative

Veritas Collaborative, based in Durham, North Carolina, is a national healthcare system for the treatment of eating disorders, with locations in Georgia, North Carolina, and Virginia. Veritas provides a full continuum of care for individuals of all ages, including inpatient, acute residential, partial hospitalization, intensive outpatient, outpatient care, and multidisciplinary eating disorders (MED) assessment clinics, in a gender-diverse and inclusive environment. Veritas is determined to change the eating disorders field so that all persons with eating disorders, their families, and their communities have access to best-practice care, ongoing support through our alumni and family advocacy programs, and helpful resources on the journey to recovery. If you or someone you know is struggling with an eating disorder, call 855-875-5812 or visit veritascollaborative.com.

The post The Emily Program and Veritas Collaborative Are Joining Forces to Expand Care appeared first on The Emily Program.

Episode description:

Christie Dondero Bettwy is the Executive Director of Rock Recovery, a nonprofit that uniquely combines clinical and community care to help people overcome disordered eating.

In this episode of Peace Meal, Christie shares with us her personal and professional experience with eating disorders. She first traces her path through illness and healing, highlighting the risk factors that contributed to her disorder as well as the community that helped her find freedom from it. Then she unpacks her decision to enter the eating disorders field–including how and when she knew she was “recovered enough” to translate her personal experience and passion into a career at Rock Recovery. Finally, Christie helps us reflect on the tremendous impact of the COVID-19 pandemic on eating disorders. We discuss how COVID-19 has triggered and exacerbated these illnesses, and how we, as a field, must work collaboratively and creatively to meet the tremendous need for care now and beyond the pandemic.

Learn more about Rock Recovery at rockrecoveryed.org, and follow the organization on Facebook, Instagram, and Twitter.

Learn more about The Emily Program online or by calling 1-888-364-5977.

—

About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 48: Finding Freedom in Recovery with Christie Dondero Bettwy appeared first on The Emily Program.

By Abby Couture

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

At the age of 14, I was diagnosed with anorexia nervosa. My admission into intensive care was sudden. I had gone from starving myself for months to being fed three meals and snacks a day in a hospital bed. Needless to say, I didn’t exactly embrace this abrupt change in routine. Though as traumatic as living through an eating disorder was, I believe I was able to survive for a few main reasons.

The first was my reckoning with control. A common feature of individuals struggling with disordered eating is an underlying fear of lacking control in one’s life, or feeling powerless and uncertain with their sense of self.

Throughout my freshman year of high school, I struggled to feel grounded and secure in shifting family dynamics, redefined friend groups, and a fluctuating identity with academics. In middle school, everything seemed so much easier, my grades were above average, and I felt more or less socially safe. In high school, I found myself frequently shifting between different social groups that were often in conflict. I felt tethered between old ties and new ones, constantly shifting “selves.” This ultimately led me to constantly question how I could be defined. At the end of the school year, my grades had dropped and I was no longer on the honor roll. Compounded by a disconnection with my academic self was a feeling of alienation from my own bodily identity. As I navigated puberty, I began to gain attention from older boys, leading me to objectify my own body as I learned to view it as social capital.

As a Type A personality driven by perfectionist tendencies, I felt intense shame when my end-of-year report card came. This is when the eating disorder made its formal debut, convincing me that the surface area of my body was proportional to the emptiness and confusion I felt in my academics and relationships. The eating disorder voice—or “Ed,” as I call her—told me that as chaotic and confused as I felt in almost every area of my life, there was one thing that only I could control: my body.

Of course, this was only an illusion of control, an empty promise offered by Ed. When I first started cutting calories, I felt powerful, almost ecstatic—a rush of dopamine coursed through my brain when my friends and family first noticed I had lost weight. For the first time in my life, I felt I was totally autonomous, taming the monster that Ed convinced me my body was. However, the few months following led me into a downward spiral of utter chaos. That’s when I realized that the monster had been controlling me all along, and the monster that I thought was my body was, in fact, an eating disorder.

In recovery, I realized that even our bodies have a mind of their own. Genetically, evolutionarily, we need food to survive. That is something that we cannot control; it’s simply a fact of life. But in controlling what I ate, I felt I could escape the intense anxiety I had over not knowing how to control my emotions.

My therapist introduced me to Cognitive Behavioral Therapy (CBT), often used to treat anxiety, OCD, and disordered eating. It helped me to draw a clearer understanding of the interconnectedness between triggering events, thoughts, emotions, and behaviors. By seeing the ED as a maladaptive coping tool, I could learn to regain control by deliberately choosing against the disordered behavior and find new adaptive ways of coping with my emotions.

Not surprisingly, there is rarely one cause that propels someone’s brain into developing an eating disorder. No one willingly chooses to take advice from a tiny sociopath in their brain screaming at them to eat less or eat x. As much as my path to recovery entailed grappling with my longing for control, on a deeper level, I realized this control-seeking was really a longing for self-mastery and self-actualization. In a highly distorted way, controlling my eating was more about a search for meaning than it was a means of shrinking my body. In school, I never felt that I was the best at anything. I was a good student and had a variety of interests but never felt as though I was “the” person in anything in relation to my peers. And so my body became a means of mastering my own domain.

In recovery from anorexia, I began to become increasingly sucked into the world of “wellness culture” and “clean eating,” and convinced myself that though starvation and restriction weren’t the path to the good life, utopia could be achieved through nutritiously dense food. This logic seemed balanced and healthy—I mean, surely it must be since our society values nutrition so much? Once again, I was being manipulated by Ed. But it didn’t feel like I was harming myself since I was eating “enough.” It wouldn’t be until a few years later in university that I realized I had orthorexia, and sneaky Ed was controlling my life—except instead of creating a regimen around calories, it was a regimen around micros and macros.

Food became dogma, and my devotion to the food rules I followed from nutrition bloggers and YouTubers became a means of filling the spiritual void in my being. Once again, Ed came back for a sequel with an adapted script in hand. This time, she told me that the void of meaning and deeper connection to the world was proportional to the “bad” foods I was putting in my body. She convinced me that perhaps I could find connection and purpose through nutrition. I began to view my body as a place of worship, the temple to purge my “sins” and repent.

Throughout my life, my relationship with religion and spirituality has changed dramatically. From a devout Catholic in elementary school to a spiritual relativist in early adolescence and eventually a full-throttle atheist, not only was my sense of self ambiguous and ever-changing, but so too was my trust in a higher power. Not only was the meaning of my life unclear leading up to the start of my eating disorder and eventual relapse years later, but so too was my search for the meaning, or at least some semblance of faith and direction in the universe.

Having a sense of purpose through self-mastery is something that is perceived to be a universal feature of self-actualization. When I realized that my anorexia and orthorexia were a stand-in for the lack of deeper connection that I felt with myself and my purpose in the world, I set out to seek meaning through more adaptive means.

In university, I focused on the ways that I could foster healthy relationships with my friends and become involved with social issues that affected my local and global communities. Every time I felt the anxiety and shame after a night out of drinking and greasy food, I would remind myself of the distortion that Ed was feeding me. The emptiness of my stomach is not in any way proportionate to my intrinsic value. Friends don’t care about my weight, my community couldn’t care less about my BMI, and the burning planet certainly has much bigger priorities than my waist-to-hip ratio.

Finally, I made it a priority to seek out community and challenge my fears of intimacy and vulnerability. Eating disorders are a notoriously isolating experience. Ed’s voice thrives off confinement and secrecy. Restricting food often leads to restricting social ties, something that became a daily reality for me throughout the height of my experience with various EDs. In January of 2021, I began seeing an online support group. Although I have progressed significantly over the years, I recognize that Ed is still a part of me, just tucked away, and there’s still so much I have yet to unpack. The support group has been such a powerfully enriching experience for me. People of all genders, ages, racial and ethnic identities come to this group once a week to share their journey of recovery. The solidarity and genuine love I feel for these people inspire me to want to exercise my experience as a means of supporting others in their path of recovery.

Fostering connection and community played such a pivotal role in my journey. It is so important for overcoming an eating disorder, challenging the parasitic voice that feeds off our fears of social insecurity. The greatest lesson I have learned about an eating disorder’s arsenal is that community is a logical contradiction to Ed. It offers hope for a future where food does not equal fear.

The post ‘Ed’ and All Her False Promises: A Story of Recovery appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Lisa Whalen’s book, Stable Weight: A Memoir of Hunger, Horses, and Hope, is now available from Hopewell Publications. Her writing has also appeared in An Introvert in an Extrovert World; The Simpsons’ Beloved Springfield; Introvert, Dear; and Adanna, among other publications. Whalen has a Ph.D. in postsecondary and adult education and an M.A. in creative and critical writing. She teaches composition, creative writing, literature, and journalism at North Hennepin Community College, where she was selected Minnesota College Faculty Association Educator of the Year in 2019. In her spare time, she is an equestrian and volunteer for the Animal Humane Society. Learn more at her website, and follow her on social media @LisaIrishWhalen. 

“Describe how the antagonist drives your book’s plot.”

Those were the instructions 74 other authors and I received as we prepared to attend a conference in New York City. The conference would teach us how to pitch our books to agents or publishers, which involved a lot more time, research, and effort than I realized. We were told that to get the most out of each session, we should complete some assignments before we arrived. The first was describing how our book’s antagonist (villain) drives our story’s plot. It was a straightforward task for every author…except me. The others had written novels; I had written a memoir describing how The Emily Program helped me recover from an eating disorder. My story doesn’t have an antagonist, I thought, frustrated.

Since I’m a teacher, I couldn’t stand the idea of showing up to “class” without having done the “homework,” so I asked myself, If my story had a villain, who would it be? The answer was obvious: An eating disorder had been my foe at every turn. I considered how ED functioned and how it had affected my life. ED, I decided, is a possessive boyfriend like the main character in Netflix’s You.

ED appeared to be an upstanding guy I could bring home to meet my parents. He introduced himself as a harmless diet who would help me shed a few pounds. Once I let him into my life, however, he never let me out of his sight.

ED seemed to have my best interests at heart when he whispered, “Cutting x calories is good, but y would be perfect.” A master manipulator, he convinced me that perfection was the key to happiness, cooing, “I’ll make you perfect; then you’ll deserve to be happy.” Before I knew what was happening, cutting y calories became cutting z, and z became a.

ED’s sole goal was to maintain our relationship at any cost, so he dangled perfection like a diamond ring, insisting, “Lose a few more pounds and it’s yours.” When I reached for the glittering gem, he moved it just beyond reach while insisting it had been in the same spot all along.

ED’s progression from nice guy-diet to possessive boyfriend-eating-disorder was so gradual that I didn’t notice the change until we were so entangled I couldn’t see any way out of the relationship. He demanded more and more of my time and attention until pleasing him was all I thought about, which isolated me from family, friends, hobbies, and everything else I enjoyed. Each time I thought about breaking free, he lured me back by saying, “You’re so close to perfection; don’t settle for being mediocre.”

Visualizing my eating disorder as ED the villain gave me a simpler, easier way to recognize signs that I was getting lured back into eating disorder habits. I’d seen friends’ growth and happiness stifled by controlling boyfriends, so I knew what to look for. I was determined not to let a slimy guy determine my life’s direction. Whenever I wondered whether a thought or behavior stemmed from my eating disorder, I asked if I would accept a boyfriend expressing that thought or exhibiting that behavior and had no problem shutting it down.

Making ED the antagonist turned me into the protagonist—my story’s hero—who would fight her way to a happy ending. Instead of a disorder that was vague and abstract, pervasive and all-powerful (How can I fight something I can’t see, hear, or touch?), I now faced an entity that was specific and concrete, finite and vulnerable. A disorder cast me as a passive victim, someone who suffered from and relied on to get well. An antagonist cast me as an active participant working toward a goal. I could cheer for myself the same way I cheered for protagonists in the novels I read.

Three years after that conference in New York, I’m celebrating one piece of my happy ending: publication of my memoir, Stable Weight: A Memoir of Hunger, Horses, and Hope. It is now available from Hopewell Publications. My greatest hope is that helps other people who are struggling to kick their ED to the curb.

The post My Eating Disorder Is A Character appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Jason Wood is currently in recovery from orthorexia. He is now determined to turn this battle into a movement aimed at raising awareness of orthorexia as well as eating disorders in males. You may read more about his journey and movement at orthorexiabites.com. 

Trees amaze me with their relentless nature. They bend to the mercy of the wind. They shield from the heat of the sun. We watch them strip in the fall and awaken in the spring. Such a resilient force, rooted into the earth with unwavering confidence. Do you ever stop to think how stout they are?

Imagine what they’ve witnessed and experienced. Scientists have found olive trees in the Middle East that exceed 5,000 years in age. Talk about a lifetime full of memories! In California, redwoods are known to be almost indestructible, thanks to their thick bark. Some trees are even known to regenerate after wildfires. Here in Colorado, I love seeing the evergreens that stick true to their name. Always green, come snow and ice or heat and sun. These trees seem to know their identity and wear it proudly.

Why can’t humans be so courageous, so resilient, and so stout? Well, my friends, I believe we are! Just look at our bodies. They are our only true home. No mortgage or rent payment required. All they need is love and nutrition. And talk about sturdy–the human body amazes me just like the forest full of trees.

When is the last time you broke a bone or injured yourself? My friend demolished my pinky finger several years ago during a game of catch. As the nurse later told me, I am no Jerry Rice, but that’s okay because my body rose to the challenge. Sure, my finger turned several crazy colors, hurt for a couple of weeks, and I had to wear a gaudy brace, but it recovered. My body rebounded like it had a game plan or instruction manual. 

The symptoms we experience when sick are the result of our immune system fighting back. How cool is that? It’s like our own private military. But what about those times when illness doesn’t sound like a stuffy nose or scratch like a sore throat? What about those times when the disease is deeper than that and takes control of thoughts and behaviors?

I was sick for many years and didn’t even realize it. I abused my one true home, my tree, my body. I hated the way it looked and behaved. My eating disorder put glasses on me that only allowed me to see the imperfections. Social media and fad diets made me think that if I only put the “cleanest” foods in my body, then these imperfections would vanish. Perhaps I could live longer and look better. 

As a result of this magic trick gone bad, I actually did more harm than good. My body ached for food. I watched the leaves fall off, leaving me ill-prepared for the long winter ahead. My body’s military went AWOL. Orthorexia turned me into a lumberjack destined to chop down the only thing I fully own.

But now, spring has sprung. My body is rejuvenating and my amazement knows no words. I abused my vessel. I starved it, I snarked it, I scolded it. My body withstood the hurricane-force winds orthorexia sent its way. And now, somehow, it’s forgiven me. What a gift!

Like trees in the forest, my body faced the fire and wind. It faced its own man-made climate change, but now it thrives. My home, my body, grows stronger by the day. I feel new parts of me every day, leaves that weren’t there several months ago. These leaves used to scare me but now I know these are just a sign of mutual love and understanding. They are my warmth, my protection, and my character. I wear this body with pride, like an apple blossom in spring. I’ve learned to love my body, perhaps because I almost lost it. The best part is that my body always loved me. 

Friends, we are our own trees. We are solid and sturdy. We have the opportunity to grow strong roots as long as we listen to our body and ignore the cicada-like chirps of an eating disorder. Love your body for what it is meant to be, not what you want or think it should be. Be that evergreen or redwood that stays true to its word and endures the test of seasons.  

The next time you see a tree, take a moment to admire its journey and then look at yourself and remember your own story. We only get one body, so cherish it, take care of it, and let it grow into a beautiful home.

The post Rooted appeared first on The Emily Program.

Tell us about yourself!

Hi! I’m Alison Paniccia! I am an outpatient therapist in our Pittsburgh, Pennsylvania office. I have been with The Emily Program for just over two years now, doing intakes and outpatient therapy with children, adolescents, and adults. In this role, I have specialized particularly in providing FBT/Maudsley treatment for adolescents with a variety of eating disorders as well as providing CBT-E for both adults and adolescents. I particularly enjoy working with adolescents and their families.

Describe the path that led you to The Emily Program.

The path to the Emily Program for me has been particularly diverse! With a bachelor’s degree in biology from Boston College, I initially worked in a laboratory at Brigham and Women’s Hospital in Boston, Massachusetts that specialized in compatibility testing for organ transplants. While this work was important and very meaningful, I eventually really missed having direct contact with clients.  As a lifelong musician, I was also seeking a way to combine my musical skills with caring for others. 

I completed my master’s in mental health counseling and music therapy in 2013 at Lesley University. Since then, I have worked in a variety of clinical settings, all of which have brought me greater clarity and insight into my particular skills and professional goals. The bulk of my clinical experience prior to TEP was in residential settings with adolescents and young adults with significant mental health concerns and high-risk behaviors. Over the last two years, I have enjoyed learning how to adapt all of my previous training in the treatment of eating disorders. I feel as if I have really found my niche in that!

What have our clients taught you? 

In the treatment of our clients, I have learned the importance of being kind to ourselves and others as well as the need to continually foster patience, open-mindedness, and commitment to personal growth. I am constantly amazed by the qualities of persistence and resilience that I see in our clients on a day-to-day basis—particularly in such a time of great difficulty in the world. 

What three words would you use to describe The Emily Program?

Inclusive, friendly, and effective

If you could do another job just for a day, what would it be?  

President of the United States!

The post Staff Spotlight, Alison Paniccia appeared first on The Emily Program.

Don’t get me wrong, I absolutely believe that what you eat—when, how, and with whom you eat—can make a tremendous difference in your physical and mental health, as well as your overall enjoyment of life. However, we are seeing a disturbing trend, particularly online, that promotes strict adherence to a rigid set of food rules as the path to health and moral purity. This is the world of “clean eating.” 

The concept of “eating clean” has its origins in the early days of alternative medicine. People would become obsessed with obtaining health and curing disease through the strident adherence to various dietary strategies. Dr. Steven Bratman, an alternative medicine physician at the time, noted that many of his more diet-focused patients were “inadvertently harming themselves psychologically through excessive focus on food.” Also, their “exuberant pursuit of physical health had spawned a rigid, fearful and self-punishing lifestyle that caused more harm than good.” He created a name for this hyperfocus on food and obsession with eating the “right” food—“Orthorexia Nervosa” (1).

Today when you hear the term “clean eating,” you might think of minimally processed, preferably organic foods, and the avoidance of food additives, preservatives, etc. There is nothing inherently wrong with this, at least not until it starts to become a rigid, life-interfering preoccupation that causes people to feel great distress, shame, and “unclean” if not followed precisely. In such cases, well-intended food choices can reach a “tipping point.” Good intentions go bad, sending people down the path to increased focus and reliance on inflexible eating habits that can result in disordered eating or even an eating disorder.  

Food fads on social media often go to greater and greater extremes in order to grab our attention and maintain it. What we are seeing now is “clean eating” used to describe an increasing variety of food restrictions that can include avoiding all processed foods, sugar, soy, peanuts, dairy, red meat, nightshade vegetables (e.g., tomatoes, bell peppers), caffeine, gluten, and alcohol. 

Starting to sound like an eating disorder? You bet. Obsessing about every detail of what is or isn’t eaten, continually limiting of allowed foods, and spending high percentages of one’s waking hours focusing on food and eating are all hallmarks of disordered eating and eating disorders. Research shows that this can lead to an obsessional or pathological preoccupation with healthy nutrition with serious physical and emotional consequences brought on by non-adherence to self-imposed nutritional rules (2).  

It is important that individuals with eating disorders pay attention to recovery-focused food and eating patterns, making sure meal plan requirements are met, seeking out variety, practicing flexibility, and accepting feared foods. Let’s focus our National Nutrition Month on balance, variety, and moderation, the time-honored advice from your friendly Registered Dietitian—and let “clean eating” simply mean washing our vegetables.

References 

1. Bratman, Steven, Eat Weight Disord (2017) 22:381-385
2. Cena H, Barthels F, Cuzzolaro M, Bratman S, Brytek-Matera A, Dunn T, Varga M, Missbach B, Donini LM. Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eat Weight Disord. 2019 Apr;24(2):209-246. doi: 10.1007/s40519-018-0606-y. Epub 2018 Nov 9. PMID: 30414078.

The post Clean Eating’s Dirty Secret  appeared first on The Emily Program.

Episode description: 

Charlotte Markey, Ph.D., is a Professor of Psychology and Health Sciences at Rutgers University in Camden, New Jersey. She has researched body image and eating behaviors for nearly 25 years, and is the author of The Body Image Book for Girls: Love Yourself and Grow Up Fearless.

Charlotte joins us in this episode of Peace Meal to discuss adolescent body image. Offering research and practical insight into the multifaceted topic, she notes that body image encompasses far more than whether we like our bodies. She touches on its various dimensions and implications in the everyday lives of adolescents and teens.

Body image has long been considered a women’s issue, and our understanding of the unique experiences of boys and men is still evolving. Research on body image in trans and nonbinary youth lags even further behind, Charlotte notes, but it is clear that adolescents of all genders are suffering from body image concerns. 

Tools for helping this population develop a strong body image are particularly important, especially given that disordered eating and eating disorders often manifest during adolescence and young adulthood. One strategy Charlotte offers is to think of our bodies not in terms of how they look but instead of what they allow us to do. 

“[Our bodies] allow us to experience the world, and so many people grow up feeling like their body is the problem. Instead, I think it’s just so much healthier to think about… no, your body actually allows this all to happen,” she says. 

To help children value body functionality over appearance, Charlotte stresses that adults must model the lesson themselves. They can avoid commenting on their own and others’ physical appearance and shift the focus to internal traits, teaching adolescents that they are valued for who they are instead of how they look. 

Charlotte acknowledges the difficulty of promoting positive body image in an image-conscious, diet-obsessed world. Countering society’s messages about appearance and diets requires careful thought and continual practice.  

But it can be done, she maintains.  

Learn more about The Body Image Book for Girls online, and find Charlotte on Instagram, Twitter, and Facebook.

Learn more about The Emily Program online or by calling 1-888-364-5977.  

—  

About the podcast:  

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.  

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!  

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.  

The post Episode 47: Body Image in Adolescents with Charlotte Markey appeared first on The Emily Program.

Christie Dondero Bettwy serves as the Executive Director for Rock Recovery, a nonprofit that helps people overcome disordered eating by combining clinical and community care. Having gone through recovery herself, she understands the depth of emotional, mental, physical, and spiritual support needed to recover. She is passionate about spreading the message that complete freedom from disordered eating is possible. Christie is an active speaker and shares her story with organizations and media outlets across the country. Christie lives in Washington, D.C. with her husband Ryan. Learn more about Rock Recovery’s work at www.rockrecoveryed.org.

Twenty years ago, I went on a dangerous diet that fueled almost a decade of disordered eating. Everyone around me praised my weight loss. The health magazines I scoured monthly further affirmed my bias that the thinner you are, the healthier you are. It took me years to realize my seemingly small diet had grown into a major problem, let alone to seek treatment.

When thinness is the goal, health will not be the result. Health was never truly my goal; thinness was.

While my eating disorder may have started as a simple desire to lose weight, that wasn’t where it ended, and it isn’t where it ends for millions of Americans. 

Eating disorders are complex illnesses, and a combination of biological, psychological, and environmental factors contribute to their development. An estimated 28.8 million Americans will battle an eating disorder (such as anorexia, bulimia, or binge eating disorder) at some point in their lifetime,  and millions more will struggle with disordered eating, dieting, and an unhealthy relationship with food and body image. Yet, as stigma and misunderstanding remain high, treatment coverage and affordable options remain low.

Until recently, eating disorders were the number one cause of death from mental illness (now surpassed by opioid use), yet too many people consider eating disorders to be a phase, a fad, a choice, or, worse yet, a vanity. 

Now more than a decade into recovery, I have the joy and privilege of serving as the Executive Director for Rock Recovery, a D.C.-based nonprofit that provides affordable and accessible clinical treatment, community support, and educational programs to bridge gaps that keep people from getting the help they need to recover. Countless clients we serve at Rock Recovery come to us feeling like they are failing, ashamed that they can’t seem to get better on their own. Their friends and family members are either at a loss of how to help them or don’t seem to understand why they can’t “get a handle” on their food issues. Can’t they just eat more or go on a diet? 

If only it were so simple. 

Our society continues to demonize fat, idolize thinness, and belittle the severity of eating disorders even though they are life-threatening illnesses. These harmful beliefs and values must change, and we as a society must realize that someone with anorexia can’t just “eat a hamburger” any more than someone with depression can just “snap out of it” on their own.

So, what are a few things that we can do right now to change the conversation around eating disorders and decrease stigma in our own homes and communities?

• We need to check our bias and be willing to consider how harmful societal views about body image and dieting have shaped us, and where we need more education and correction.
• We need to challenge the stereotypes of what we think people with eating disorders “should” look like and realize that all mental illnesses (including eating disorders) don’t discriminate and can affect people of all sizes, genders, races, ages, and backgrounds. 
• We need to remember that we have no idea what someone else is going through based on appearances, and we should take mental health challenges seriously without making jokes or judgments.
• We need to be willing to have hard conversations with the people that we love to get them the help they need to recover. 
• Most importantly, we need to remember that while eating disorders are complex illnesses, with proper treatment and support, recovery is truly possible.

In celebration of the recovery we’ve seen in people and in honor of National Eating Disorders Awareness Week, Rock Recovery will be hosting our annual benefit dinner, Building Bridges Breaking Bread, virtually. We invite you to join us this Friday, February 26^th at 8 PM ET to share a special interactive meal experience, hear inspiring stories from people who have recovered from eating disorders, and consider how you can help change the conversation around eating disorders in your own homes and communities. Together, we can help more people access the care they need in order to return to their own tables so they can break bread with those they love.

Visit https://rockrecoveryed.org/event/building-bridges-breaking-bread-virtual-gala/ for details and to purchase your tickets today!

The post It’s Time for a New Conversation About Eating Disorders: Christie’s Story of Finding Freedom appeared first on The Emily Program.

Most Americans have at least heard of eating disorders. They hit the public’s radar with celebrity news of the 1980s and have faded in and out of media since. More and more people have shared their own stories online and off, and today, more than half of Americans personally know someone with the illness. A staggering 28.8 million people in our country will have an eating disorder in their lifetime.

But awareness is more than knowing that Princess Diana or Demi Lovato or your cousin had an eating disorder. It’s using that information—or any other reason you were introduced to these illnesses—to understand what they mean. Awareness involves learning more about eating disorders so that we can better prevent, identify, and treat them. 

Here are some facts we’d like everyone to know about eating disorders during eating disorder awareness week and beyond.

Eating disorders are complex brain-based illnesses influenced by a variety of biological, psychological, and social factors. 

No one chooses to develop an eating disorder. The etiology is far more complex, and the field’s understanding of it continues to evolve. What is clear is that eating disorders are linked to a variety of biopsychosocial factors, including:

Biological:

• Genetics and epigenetics
• Dieting 
• Puberty/menopause

Psychological:

• Anxiety, depression, and substance use
• Trauma
• Stressors

Social/Environmental:

• Appearance standards
• Weight-based comments and teasing
• Media messages

Eating disorders include a range of diagnoses and symptoms. 

Anorexia is likely the most well-known eating disorder, but it is far from the only one. (In fact, binge eating disorder (BED) is more than three times more common than anorexia and bulimia combined.) Eating disorders manifest across a range of thoughts, feelings, and behaviors, categorized in the DSM-V as such:

Anorexia Nervosa (AN):

• Inability to consume adequate nutrition, leading to low body weight or failure to meet growth trajectories
• Intense fear of food and weight gain
• May include binge eating and purging

Bulimia Nervosa (BN):

• Binge eating, followed by purging (vomiting, laxatives, diuretics) or a non-purging compensatory behavior
• Self-evaluation is unduly influenced by body weight and shape

Binge Eating Disorder (BED):

• Binge eating accompanied by marked distress
• Absence of compensatory behaviors

Avoidant/Restrictive Food Intake Disorder (ARFID):

• Failure to meet nutritional/energy needs due to eating or feeding disturbance
• Associated with weight loss, nutritional deficiency, or failure to meet growth trajectories

Other Specified Feeding or Eating Disorder (OSFED):

• Symptoms are clinically significant and serious, but they do not meet the full criteria for other eating disorder diagnoses
  • Purging Disorder
  • Atypical AN/BN
  • BN/BED of low duration or frequency

It is important to note that no eating disorder diagnosis is “better” or “worse” than another. No matter how an eating disorder presents, it poses serious emotional, psychological, and physical health risks.

Eating disorders affect people across demographic categories.

The stereotype that eating disorders affect only thin, young, white women is pervasive, powerful, and, most importantly, not true. Eating disorders know no bounds. They span the spectrum of age, race, gender, sexual orientation, class, and weight—all demographic categories. They do not look a certain way. 

Though eating disorders affect people of all backgrounds, vast disparities in access to care and quality of care do exist. Much of our field’s research and clinical understanding of eating disorders is based on the experiences of white women, and men and people with marginalized identities are less likely to access care. As our field works toward equity and inclusion, we need to account for the fact that eating disorders cut across all demographics.

Eating disorders are illnesses of secrecy and shame.

Eating disorders live in the shadows of secrecy and shame. They’re rarely obvious in either physical appearance or manner and demeanor. Those affected by the illnesses go to great lengths to hide or minimize their symptoms—it’s part of the illness—and therefore, an unhealthy relationship with food and body can long go unnoticed.

Shame also keeps the illnesses secret. Stigma, stereotypes, and self-criticism contribute to the false belief that an eating disorder makes one weak, vain, or selfish. Eating disorders are not a reflection of a person’s character, but judgment from oneself and others often lead a person suffering in silence to believe otherwise. 

Eating disorders are serious. 

Eating disorders are not a phase, fad, or some eating quirk. They are illnesses with significant, potentially life-threatening consequences to both the mind and body. In fact, eating disorders are the second deadliest mental illness, surpassed by only opioid use disorder. One person in America dies every 52 minutes as a result of eating disorder complications.

In cases where an eating disorder is not lethal, the illness deeply impacts daily functioning. They affect a person’s thoughts, feelings, and behaviors and interfere with work, school, and other commitments. They cause damage to relationships and to a person’s very sense of self.

All eating disorders are worthy of care.

Eating disorders of all types are treatable and worth treating. Many people with these illnesses wonder whether they are “sick enough” for care, usually comparing their illness experience to that of others. 

The reality is that all eating disorders deserve care. The symptoms present in diverse ways, one disorder aligning with DSM criteria differently than the next, but any unhealthy relationship with food or body warrants serious attention and concern.

The Emily Program provides exceptional, individualized care for eating disorders of all types for people of all ages and genders. If you or someone you know is struggling, please call 1-888-364-5977 or complete our online form today.

The post Eating Disorder Awareness: What Everyone Needs to Know appeared first on The Emily Program.

Episode description: 

Melissa Louise Johnson is a Marriage and Family Therapist, adjunct professor at Bethel University, and the founder of the Impossible Beauty blog and podcast. Through her work at Impossible Beauty, Melissa is on a mission to expand and renew beauty, as she believes the American brand of beauty is divisive, destructive, and far too narrow.

Melissa explores the concept of beauty with us in this episode of Peace Meal. She describes how cultural beauty messages impacted her childhood, adolescence, and the development of her eating disorder, as well as how she recognized and reckoned with these messages in recovery.

Appearance standards were set early in Melissa’s life. Animated princesses, sitcom actresses—all of the media’s kind and “good” characters—reinforced a singular image of beauty. External beauty was important, the media showed. And beautiful meant thin.

On top of these media images, another layer of cultural messaging emerged in Melissa’s adolescence and early adulthood. These messages, Melissa sees now, included disordered ideas about food and body. Her peers actively engaged in diets and swapped diet culture messages, all of which reinforced dieting as a means to meet the thin beauty ideal.

It was in eating disorder treatment that Melissa began to critically examine society’s messages about beauty, thinness, and dieting. In group therapy, she observed how these messages had impacted other people’s lives, her heart breaking at all the damage they inflicted.  

“We’ve been so lied to about what beauty is and our worth,” she came to realize.  

Increasingly aware of these cultural lies about physical appearance, Melissa sought to redefine the concept of beauty for herself and others. Toward that end, she created Impossible Beauty, a blog and podcast that aim to expand narrow societal standards.  

In her work at Impossible Beauty, Melissa differentiates between culture’s fleeting, fickle standards of beauty and true beauty, which is eternal and unchanging. The blog and podcast invite others to examine appearance expectations as well. 

“There is actually another path that we can take that actually values our humanity and the sacredness of us as eternal beings—who have so much value beyond how we align or don’t align to this very small picture of beauty,” Melissa says. 

Find Impossible Beauty at impossible-beauty.com and on Instagram and Facebook. Connect with Melissa on Instagram at @melissa.louise.johnson. 

Learn more about The Emily Program online or by calling 1-888-364-5977. 

— 

About the podcast: 

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking. 

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends! 

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information. 

The post Episode 46: Redefining Beauty with Melissa Louise Johnson appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Andrea Kelly is a transformational coach and writer who also has a background in real estate. After many years of struggling silently with anorexia and bulimia, she has found freedom in the last few years. She shares her eating disorder story in Fear Less: Transforming Fear into Courage within Relationships, Career, Society, and Self, available for preorder now. Find her blog at yourbestbeing.com and follow her on Instagram @andreakellylove.

Recovery Conversations is a question-and-answer series that shares voices and stories of eating disorder recovery. In this post, Andrea Kelly describes the ways fear presented itself in her eating disorder and how she learned to confront it in recovery.

You share your eating disorder experience in Fear Less, an anthology of personal stories about recognizing and moving beyond fear. How did fear show up in your eating disorder, Andrea?  

Fear showed up in my eating disorder by food restriction—extreme restriction and very black-and-white thinking. It feels SO good now to be able to have two pieces of pizza, for example, and not feel guilty and also be able to stop when I am satisfied. Earlier it was like “Crap, I screwed up. Well, I may as well just eat everything in sight and then purge.” Fear showed up as self-abuse in so many ways.

What lies did these fears tell you about yourself and your place in the world? 

Although my fear showed up as a “fear of fat,” there was so much to uncover that was behind that. There were deep-rooted fears that had to do with self-esteem, self-worth, and value. I always feared that I was never enough—never good enough. It was associated with a belief that I was not worthy.

Complete the sentence: “Eating disorder recovery required….”

Commitment, faith, and a willingness to give up the idea of perfection. That was an ideal that would never be obtained anyways. 

What important lessons did you learn in recovery?

There will be setbacks; they are part of the journey. Don’t let them get you down—keep moving toward your goal of recovery because it IS possible even though there will be many moments where your mind might tell you that is not true. I learned that there are deeper reasons why things happen; there are lessons, gifts, and meaning in everything if you are able to open yourself up to them. Do not seek perfection; instead, seek to find joy within yourself and within your life. Creation is key, and you CAN create a life you love over time. Also, get comfortable with embracing the journey. I tried many avenues of external resources for help, and there is no need to think you need to fight alone.”

Are there any affirmations you’d give to those currently struggling?

I am loved. I am worthy. I am enough. 

We want to hear your voice of recovery! If you are interested in participating in our Recovery Conversation series, please email blog@emilyprogram.com to learn more.

If you or a loved one is experiencing an eating disorder, help is available. Reach out to The Emily Program today by calling 1-888-364-5977 or completing our online form.

The post Recovery Conversations: A Q&A with Andrea Kelly appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Lisa Whalen’s book, Stable Weight: A Memoir of Hunger, Horses, and Hope, will be available from Hopewell Publications on March 2, 2021. Her writing has also appeared in An Introvert in an Extrovert World; The Simpsons’ Beloved Springfield; Introvert, Dear; and Adanna, among other publications. Whalen has a Ph.D. in postsecondary and adult education and an M.A. in creative and critical writing. She teaches composition, creative writing, literature, and journalism at North Hennepin Community College, where she was selected Minnesota College Faculty Association Educator of the Year in 2019. In her spare time, she is an equestrian and volunteer for the Animal Humane Society. Learn more at her website, and follow her on social media @LisaIrishWhalen.  

Whether we know it or not, language shapes our perception. I never thought much about how the language I speak and the way I view the world were connected until I took foreign language classes in high school. My Spanish teacher explained that translating wasn’t just word-for-word substitution. Unlike the equations I learned in algebra, where I could replace X with a number to answer a question like 4x + 2 = ?, I couldn’t always replace an English word with its Spanish equivalent to answer a question like, “How do you say _X  ?”

Learning Spanish was my first introduction to the idea that each language has a unique structure. Studying Spanish taught me that some structural differences between languages are minuscule, like the English rule that adjectives should come before nouns, as in “the blue car,” versus the Spanish rule that nouns should come before adjectives, as in “the car blue.”

Later, when I began teaching college English classes, I saw how other structural differences between languages affect every aspect of communication, such as English verbs having up to 12 tenses to indicate time versus Hmong verbs having a single tense. English requires us to say I eat, I ate, I have eaten, I will eat, I will have eaten, to tell listeners when the action happened because Western culture perceives time as linear and moving toward the future, while Hmong speakers say I eat yesterday, I eat tomorrow, I eat before sunset because traditional Hmong culture perceived time as cyclical and anchored by the present moment.

The least translatable part of a language is idioms. Idioms are quirky sayings passed from generation to generation that don’t always make sense literally but convey an idea that is widely understood. English examples include quitting cold turkey, giving someone a taste of their own medicine, asking whether the glass is half-full or half-empty, and not looking a gift horse in the mouth. These phrases can sound strange or even nonsensical to lifelong English speakers, because over time, the culture that created them has changed.

So, what does this language trivia have to do with eating disorder recovery? A lot, actually—at least for me.

During treatment at The Emily Program, I learned that the language I use shapes how I perceive my body, myself, my environment, and the world. If I say something negative about myself, I begin to believe it whether it’s literally true or not. What I say and how I choose to say it can even alter what I see when I look in the mirror.

Similarly, what the media says can shape how we perceive ourselves and society. What the media says about celebrities’ bodies, workouts, and diets became The Truth to me, the standard I applied to myself and assumed everyone else did, too. It took a long time for me to understand that just because the media says that something is good or bad, that someone is perfect or imperfect, doesn’t make it true. The rise and fall of fad diets, exercise trends, and beauty standards over time proves that they are mostly subjective. Like idioms, they are a product of the culture and era that created them, and throughout history, they will fall in and out of favor, so why arrange my life around them?

Late in my recovery, when I felt like I’d “turned a corner” (another idiom), I started taking horseback riding lessons and discovered a new way that language—this time unspoken language—shapes perception. Learning the physical language that horses use to communicate changed my perception of my body by shifting my focus from how my body looked to what it could do. Riding made being in my body fun again, the way being in my body had been fun when I was a kid who ran around the backyard, climbed the jungle gym, and flipped upside down on the monkey bars just because I could.

Surprisingly, learning to ride horses also satisfied my curiosity about the idiom “don’t look a gift horse in the mouth.” I knew vaguely what it meant, but I thought it arbitrary and strange until I learned its literal meaning. Now, it’s a touchstone in my recovery—something I repeat when I sense myself sliding backward toward unhealthy thoughts or behaviors.

The idiom only seems strange because of how our culture has changed. From ancient history through the early 1900s, its meaning was obvious because horses were integral to almost every aspect of life: food production (pulling plows in the fields), construction (hauling building materials), transportation, and sport (carrying riders on the racetrack, on the polo field).

Gaining or losing a horse drastically altered a person’s life, so a horse’s value depended on its usefulness—specifically, its health and age. The only way to assess a horse’s age is to measure the length of a groove visible on its upper incisors. Therefore, to look in the mouth of a horse you’d been gifted was the 18^th-century equivalent of looking at your smartphone to find the price of your birthday present. Looking a gift horse in the mouth showed a lack of gratitude. It meant you cared only about monetary value, which would change over time, not the kindness and goodwill intended.

The gift-horse idiom reminds me to accept life’s gifts the way they were intended. Whereas the perfectionism that drove my eating disorder led me to see every glass as half-empty, my body as falling short, and the media’s standards as The Truth, the gift-horse idiom shifts my perception to seeing the glass as half-full. Having strong legs is a gift that allows me to ride horses, not a sign that I should obsess about my legs’ length and girth.

Most importantly, the gift-horse idiom reminds me that I can choose the language I use, which means I can choose to view anything life sends my way as a gift rather than a burden.

The post The Language of Eating Disorder Recovery appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

“Whenever life gets you down / You’ve gotta get up off the ground / and you’re gonna keep climbing up.”

Hi, I’m Robby Swenson, and you just read the ending lyric to my new full-length studio album Anorexia, available on Spotify, Apple Music, YouTube Music, and all other streaming services. But more to come on that later.

About a year and a half ago, I was battling an agonizing battle against anorexia. My days were filled with hatred, guilt, and judgment, and I didn’t see a path out of my situation. However, I was so blessed to have a great support system around me, and today I can say that I am no longer afraid to nourish my body both physically and mentally.

Let’s be 100% honest with ourselves and the world around us: Body image issues are such a real problem for so many people. I think that I lost sight of this fact when I was going through my battle with anorexia. And it completely makes sense how I could do so. In a society where talking about your struggles is taboo, it is easy to turn inward and shield your emotions from those around you who love and care for you. 

That’s why I think we need to “stand up strong and climb the bars” that are holding us back from being the people we are destined to be. The only way we can prosper as human beings is to surround ourselves with love.

My Album

My album focuses on the emotions that I, personally, felt through my process of anorexia. Each individual track captures an emotion that I felt while I was struggling or on my path to recovery. I use an extended metaphor that compares anorexia to a prison cell, where I am “trying to fit through the bars” in order to be accepted into society. 

The first eight songs on the album are heavy and hard-hitting, but the last three are where I start to realize that I can overcome my situation. 

Late into “Realization,” a good friend (and GREAT vocalist) Ella Andrew helps me to realize that “it’s not too late” to choose a better life for myself. She encourages me that “if (I) can start to eat some good food (side note: “good” = enough to nourish me and my needs, not “healthy” as it is typically defined) / you’ll be back kicking and punching just like you knew you could.” She ends the song by encouraging me to “look over the bars” because she knows I can “climb them in no time.”

This message leads me to understand that “(I) can change for the better if (I) want to,” and propels me forward into a better, more sustainable lifestyle. Although it would’ve been “much easier / to fall back” into my harmful eating habits, I learned that I am strong, and I have the power to “push up off the ground” and tell my inner demons that they will “never take me alive.” I’ve finally gotten “Back to a world in which I / Defend myself not attack,” and it couldn’t feel better. 

My final message is one of hope. Although “I’ve felt so lost at times / in the darkest of nights,” I have learned that if I “keep climbing up” that I can escape my feelings of inadequacy and find a more peaceful life for myself. 

And you can, too. 

I believe that nobody should have to feel the crushing effects of an eating disorder. Having an “ideal body” (if that is even a real thing) will never be worth the emotional turmoil caused by disordered thinking. 

Finally, though the process of healing may not always be easy, know that it will always be worth it. If you are struggling with an eating disorder, I implore you to reach out to a loved one and tell them about how you feel. If you are afraid to do so, remember that there is power in vulnerability. Working toward beating my eating disorder is the best decision I have ever made. I hope that, together, as a society, we can ditch our judgment and start encouraging each other to “keep climbing” away from our struggles with body image.

The post Keep Climbing appeared first on The Emily Program.

Tell us about yourself!

Hi! I’m Lucy Chermak, Site Director at our Toogood site for adolescents and young adults in St. Paul, Minnesota. I’ve been at The Emily Program since 2011.

What do you like most about your job?

I love the people I work with. We have such kind, empathetic staff who are just FUN! Working with adolescents definitely draws in a certain personality type which makes every day a blast…not to mention that working with teenagers keeps me spry.

What do you like to do when you aren’t working? 

I really enjoy home improvement projects—from painting walls to full kitchen remodels. It relieves stress while also allowing me to check things off the to-do list!

What has the past year taught you?

The past year has provided a lot of lessons, but my top three would include learning how to balance the different areas of my life, prioritizing the things that bring me joy, and not sweating the small stuff.

Weirdest job you’ve ever had? 

When I was in college, I worked for a race director, which was a really awesome and eclectic experience! I did everything from setting up race courses to screen printing t-shirts to marking triathletes for their races. It was a non-stop work environment where you had to be on your toes.

The post Staff Spotlight, Lucy Chermak appeared first on The Emily Program.

Whether in-person or virtually, you’re invited to assess, assess, assess! In school, we clinicians are taught to ask questions—so many questions. We are taught to ask about our patients’ history, about their current happenings, and about their future hopes and dreams. We are taught to ask about easy things and hard things. We are taught to ask about things that aren’t socially appropriate, things that are extremely uncomfortable outside the confines of medical and mental health settings. We are trained to ask questions about substance use, depression, anxiety, suicide, sexual behaviors, and peculiarities of the human body and its functioning.

Yet, so often, we forget to ask questions about one of the things that sustains life: FOOD! We know that to survive we need to eat. From the moment of conception to the moment of death, we are required to consume, in some way, calories that feed and nourish the systems within the body. Why, then, do we shy away from asking questions about this life-giving, life-sustaining human behavior?

Anecdotally, I hear medical and mental health providers say, “We have never had training,” “I don’t know what to ask,” and “I’m not sure what to do if it seems as though there might be a problem.” However, in the same way that we all learned how to ask and how to respond or intervene following questions about suicidal ideation or even substance use, we all can become more comfortable with integrating questions about eating disorders into our assessments of 100% of our patients.

Why should we ask all patients?

Well, the honest answer is this: If we don’t ask, we will miss it. With 9% of the U.S. population, or 28.8 million Americans, having an eating disorder in their lifetime (ANAD) and a person dying due to complications related to their eating disorder every 52 minutes, it seems essential that we add this area of assessment into our patient evaluations.

In addition, the stereotypical eating disorder patient is often portrayed to be underweight and suffering from body dysmorphia. In reality, fewer than 6% of people with eating disorders are medically diagnosed as “underweight” (ANAD). Asking screening questions of only those who “tip the scales” high or low means that we miss a vast majority of individuals who may be actively struggling with their relationship with food. Questions about eating disorders, as well as screening assessment tools and measures, need to consider that weight may not always tell a story of a person’s relationship with food.  

To truly learn each person’s story, we need to ask questions designed with disordered eating and eating disorders in mind. We must go beyond visible signs to assess whether a patient’s relationship with food warrants further attention and care.

Screening is always important, and it’s especially important now. Many people have experienced worsening eating disorder symptoms during COVID-19, and many others have developed them for the first time. There is a clear need we must address: Millions are currently suffering from eating disorders, many of them all by themselves.  

Rather than wait until “things go back to normal” or we return to in-person appointments more fully, let’s integrate questions about food into our practice now. These questions are just as useful in virtual settings as they are in in-person ones—and the earlier eating disorders are identified and treated, the better the outcomes will be.

What should we ask?

The SCOFF questionnaire (Morgan, Reid, & Lacey-BMJ, 1999) is a very simple, very straightforward questionnaire that addresses people across eating disorder diagnoses.

Here are six questions we recommend asking, adapted from the SCOFF questionnaire:

1. Do you feel like you sometimes lose or have lost control over how you eat?
2. Do you ever make yourself sick because you feel uncomfortably full?
3. Do you believe yourself to be fat, even when others say you are too thin?
4. Do food or thoughts about food dominate your life?
5. Do thoughts about changing your body and/or your weight dominate your life?
6. Have others become worried about your weight and/or eating?

Take some time to read these questions and make them your own. Asking these questions in a way that fits for you, your clinical style, and personality will allow it to feel more authentic and like something a patient can respond to honestly.

If a patient answers “yes” to two or more of the questions, a further assessment should be considered. You could at that time, refer them to The Emily Program for a comprehensive assessment by calling 1-888-364-5977 or by completing our online referral form. If you want to assess further in your own practice, you could consider the EAT-26. If there is a concern, the best course of action is a referral for a comprehensive assessment done by an eating disorder specialist.

What happens following a referral?

Providers often ask what happens following a referral. Patients who are referred for an assessment come (virtually or in person) for an intake. That intake is completed by an intake specialist. During the intake process, the provider completes a clinical interview. Patients are asked about their current and historical relationship with food, including questions about their specific food intake and any eating disorder behaviors (restriction, bingeing, purging, etc.).

Following these guidelines increases positive outcomes in treatment. One of the greatest gifts the referring provider can give to their patient is their support of the level of care (LOC) recommendation. Hopefully, knowing that the professional who made the recommendation used these universal standards and “prescribed” the treatment at that LOC—holding the best interest of the patient in mind—allows you, as a referring provider to support, encourage, and uphold the recommendation made to your patient. When all treatment providers support the patient, it is very helpful for the patient’s recovery journey.

Your patient will then be admitted into the LOC that was recommended. Prior to the treatment start date, patients may need a medical appointment to ensure it is safe for them to begin programming at the recommended LOC. We highly recommended that a patient completes the care plan recommended by their treatment team. With your patient’s permission, you can stay informed as they progress through treatment.

We hope that you will join us in helping change the attitudes and stigma associated with eating disorders and providing treatment for those who struggle every day. Without you, the first line of providers, screening regularly and often, we will miss many of those who struggle. Together, though, we can make a difference in their lives and the lives of families impacted by eating disorders today.

The post Questions You Should Ask Every Patient About Their Relationship With Food appeared first on The Emily Program.

Episode description:

Jaeden Luke is a singer-songwriter who wrote the single “Beautiful” for his older sister Kianna, who experienced and fully recovered from an eating disorder. Kianna is a graduate of St. Martin’s University, a young adult group ministry leader, and the author of a forthcoming book about her healing journey, The Cross That Set Me Free.

Jaeden and Kianna join us in this Peace Meal episode to explore the sibling experience of eating disorders. The brother and sister pair recall how Kianna’s eating disorder impacted their relationship as well as how their relationship—and “Beautiful”—helped her heal.

The siblings have always been close, they share. But Kianna’s eating disorder wedged itself between her and her brother, as is characteristic of these isolating illnesses. Entrenched in the depths of her disorder, Kianna grew distant from the family and friends so meaningful to her. She turned down plans and hid from others, her eating disorder isolating her in misery and darkness. It was hard to accept help and love.

Jaeden describes the difficulty of witnessing the dimming of Kianna’s light and stealing of her spunk. Though he didn’t understand what was happening, he remembers that one feeling was clear: “I just felt like I was losing a lot of her.” Feeling confused and helpless, he turned to a means of expression most familiar to him, music.

Jaeden wrote “Beautiful” for Kianna in the early stages of her recovery. His goal in writing the song, he reflects, was to package a message of comfort that would travel with her anywhere. No matter what, the song would be a reminder that he would always be there.

In a Peace Meal first, Jaeden then plays the song live, sharing his encouraging anthem again with Kianna as well as anyone affected by these illnesses. “You are so beautiful,” he sings, strumming his guitar in rhythm.

Kianna takes us to the moment she heard the song for the first time. She recounts the complex mix of emotions she felt then: shock, love, and determination along with the numbness that often comes early in recovery. “It was incredible,” she says, “and it gives me goosebumps every time.”

The two then unpack the lyrics of “Beautiful.” For Jaeden, they captured Kianna’s journey as he saw it, and for Kianna, they inspired her to commit to recovery more fully and actively. More determined after hearing it, she hoped that one day she would believe its resounding chorus.

Reflecting on their own experience, Kianna and Jaeden offer advice for other siblings, including creative ways to reach out to those struggling in isolation and darkness. They champion support that is less about “fixing” things and more about walking alongside your loved one in love and presence.

Hear “Beautiful” on Spotify, Apple Music, Soundcloud, and YouTube, and learn more about Jaeden on his website and Instagram. Watch for more news of Kianna’s book, The Cross That Set Me Free, soon.

Learn more about The Emily Program online or by calling 1-888-364-5977.

—

About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 45: An Eating Disorder’s Impact on Siblings with Jaeden Luke & Kianna Garmanian appeared first on The Emily Program.

The support of family and friends is key to the process of eating disorder recovery. It is an antidote to the isolation and secrecy of the illness, as well as a powerful, necessary reminder to our loved ones that they aren’t alone in their pain and struggle. 

But it can be hard to know just how to support someone affected by eating disorders. These are complicated, confusing conditions that aren’t “fixed” with simple logic. “Just eat,” “just eat less,” or “just stop doing that” are unhelpful suggestions, as are guilt trips and ultimatums.

What else is there to say or do? Considering your loved one’s love language is a place to start.

5 Love Languages

Introduced in 1992 by counselor and author Gary Chapman, the love language concept outlines five distinct ways people communicate love:  

1. words of affirmation
2. quality time
3. gifts
4. acts of service
5. physical touch

According to Chapman’s framework, some of us feel most loved when we are affirmed by kind words, while some of us value thoughtful gifts or another one of the expressions instead. Knowing our preferred love language as well as those of our loved ones helps us to express and receive love in more meaningful ways. We can learn to “speak” the love language that our loved ones desire and vice-versa.

Originally outlined for romantic couples, the five love languages have since been applied to numerous personal and professional relationships and settings. Among the adaptations are love languages of children and teens, languages of apology, and languages of appreciation in the workplace.

Here we adapt the five languages to eating disorder support. We present five approaches to expressing support for a loved one in recovery, including specific examples of each approach applied.

5 Languages of Eating Disorder Support

Words of Affirmation

Verbally tell your loved one how much you care. Offer genuine compliments and messages of encouragement and hope.

Examples:

• “I love you. No matter what, I am here for you.”
• “I know you can do this.”
• “You deserve to be free from this illness.”
• “I’m so proud of you for challenging yourself with new foods. Keep up the good work!”

Quality Time

Give your loved one your full attention and presence. Avoid distractions and interruptions, making your time together mindful and meaningful.

Examples:

• Ask your loved one how they are doing, listening actively to their response.
• Share in an activity that doesn’t involve food, like playing games or watching movies.
• Take a gentle walk together.

Gifts

Give your loved one a tangible or experiential gift. The gesture need not be extravagant or expensive; the gift’s value is in the thought and effort behind it.

Examples:

• A journal that your loved one can use for therapy and self-reflection
• A book that supports their recovery
• Empowering or inspirational music

Acts of Service

Help your loved one by performing a task. Go out of your way to do something for them that makes their life in recovery a bit easier.

Examples:

• Do the grocery shopping.
• Help to organize insurance or other paperwork.
• Assist your loved one in getting rid of any “sick clothes.”

Physical Touch

Offer expressions of physical connection. Think beyond sexual touch to the ways that simple human-to-human contact can provide a sense of security and comfort.

Examples:

• Offer a warm hug or the gentle touch of your hand.
• Extend high-fives and pats on the back to help celebrate recovery wins.
• Hold your loved one when they are anxious or sad.

As with the original love languages, no one language of support is objectively better or worse than another. What matters is that it matches the desires of your loved one. Connecting with their needs can help to ensure your message of support is not lost in translation.  

For more information on supporting a loved one with an eating disorder, visit our resource page for families and friends. There you’ll find additional tips for speaking to your loved one about your concerns, as well as information about our support groups for family and friends.

If you are concerned about your or a loved one’s relationship with food, The Emily Program is here to help. Take our brief eating disorder quiz and give us a call at 1-888-364-5977 today.

The post 5 Languages of Eating Disorder Support appeared first on The Emily Program.

Episode description:

Rachel Wilshusen is a dynamic writer with liberal arts degrees from the University of Pennsylvania, University College London, and the University of Cambridge. After an extensive battle with anorexia, she wrote Emancipated Love Junkie: Liberating Myself From Anorexia to embolden others to follow her path toward recovery.

Rachel shares with us her experience of eating disorder recovery in this episode of Peace Meal. She illustrates it as a multi-step, nonlinear journey that began the moment she first reached out for help and continued well into and after her stay at an eating disorder center.

Treatment provided the necessary structure, education, and tools to help Rachel launch her healing, and then her task was to implement the lessons learned into her own life. To actively value her health, she says she relied on continued support from eating disorder professionals and a regular practice of self-care. She reminded herself again and again, even when she couldn’t quite believe it was true: She deserves to treat herself well.

With repetition and practice, Rachel has been able to quiet her inner critic and treat herself as she would treat her best friend. Self-kindness allows her to handle slips along the way and to reframe her perspective when negative, self-defeating thoughts come. It also helps her to keep her perfectionism and desire for control at bay.

Some of the biggest gifts of Rachel’s recovery include the ability to respect, trust, and affirm the power of her body and the opportunity to learn more about herself. She shares how her relationship with her body evolved with pregnancy, as did her appreciation of nutrition.

These big and “mini-wins” along the way, Rachel concludes, are what make her recovery. It has indeed been a nonlinear process—but a beautiful one.

To put it short? It’s a “manifestation of self-love,” she says.

Rachel’s book is available in print and digital form on Amazon. Her blog, Live Free & Happy, is on her website, rachelwilshusen.com.

Learn more about The Emily Program online or by calling 1-888-364-5977.

—

About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 44: Recovery as a Journey with Rachel Wilshusen appeared first on The Emily Program.

Karen R. Koenig, LCSW, M.Ed., is a psychotherapist, international, award-winning author of 8 books, and popular blogger. She has 30-plus years of experience in the field of eating psychology teaching chronic dieters and emotional, binge, and over-eaters to become “normal” eaters through using a non-diet, non-weight focus on eating intuitively and creating joyous, meaningful lives. Her eighth book, Words to Eat By: Using the Power of Self-talk to Transform Your Relationship with Food and Your Body (Turner), is due out January 26, 2021. She lives and practices in Sarasota, Florida. Her website is http://www.karenrkoenig.com.

It is January 2021, a time when many people are chiding themselves for their holiday food intake and psyching themselves up to change their eating, exercise, and self-care habits. But more often than not, our standard self-talk is so judgmental, punitive, and bullying that it fails to generate sustainable positive change and leaves us frustrated and hopeless before the first quarter of the new year has gone by.

To turn this pattern around, it’s crucial to understand that self-talk is not simply mindless mental chatter but instead a major way we humans have evolved to get our brains to take action. Whether conscious or unconscious, self-talk is what governs our emotions and behavior. That is, the brain interprets whatever we say as a directive to feel or behave in a certain way. It awaits our instructions and then executes them.

For example, if you say, “I’m upset about what I ate over the holidays,” your brain thinks that you did something wrong and want it to feel distress. It hears your comment as “Be upset,” and makes sure that you are. Alternatively, if you say, “I’ll relax around food and trust in my body,” your brain hears “Relax and trust yourself” and you feel a good deal better.

Unfortunately, a lot of self-talk does nothing to move people forward and instead keeps them stuck. Speaking badly to and about yourself actually decreases motivation when what you’re trying to do is increase it.

Here are examples of self-talk to avoid:

• Commands like “I should or shouldn’t eat that” are well-meaning ways to pressure ourselves to do things we’re ambivalent about doing, especially in the arenas of food and exercise. We use words like “should,” “shouldn’t,” “must,” “need to,” and “have to” as motivators, but such self-bullying often makes us feel resentful and rebellious, resulting in our doing the opposite of our expressed intent. This rigidity and distancing from our natural appetites are part of why weight-loss diets fail long-term.
• Put-downs like “People won’t like me because of my size” or “I’m too lazy to take good care of myself” attack our self-esteem and make us feel awful about ourselves. They are zingers we likely would never let other people get away with saying to us, yet we don’t think twice about zinging ourselves.
• Negative thoughts like “I’ll never be able to eat normally” or “Whenever I feel good, something bad happens to ruin my mood” keep us from taking and sustaining positive actions. Dwelling in negativity makes us feel helpless and like a victim. The more pessimistic our self-talk, the more disempowered and hopeless we become.
• Anxiety-generators like “With all my friends dieting this year, I’ll end up dieting, too” or “Eating this meal will cause me to gain weight” keep us focused exclusively on what we fear might happen. Worry increases inner tension and detracts from efforts at genuine problem-solving.

To flip your self-talk from destructive to constructive, make a point of listening to your thoughts. Stop. Listen. Notice your words and tone. Notice how what you say makes you feel. Use only self-talk that is intentional, hopeful, challenging, empowering, inspiring, and self-loving. Feed your brain only healthy thoughts.

Here are examples of healthy self-talk to practice in the new year:

About Food:

• I’ll eat when I’m hungry.
• I’ll relax around food.
• I’ll listen to my body and nourish it well.
• I’ll eat mindfully.
• I’ll stop eating when I’m full.
• I’ll eat what I want and not defer to others.
• I’ll find pleasure in food and feel satisfied.

About Body Size:

• I will take good care of my body.
• I value my body as is, even if I wish it were different.
• I love taking care of my body.
• I want to be healthy.
• My body loves to be well-nourished.
• I’m proud of the way I treat my body.
• I decide if I am enough for myself and for others.

About Self-Care:

• I speak only kindly and compassionately to myself.
• I’m lovable being imperfect.
• I enjoy learning how to motivate myself with loving thoughts and kind words.
• The more I practice compassionate self-talk, the better I feel.
• I am enough.
• I am worthy and deserving.
• I can handle stress.
• I will manage my emotions.
• I can take care of myself effectively.

Worried that not actually believing your positive self-talk will prevent it from moving you forward? Good news: Scientific studies on the fake-it-till-you-make-it mindset tell us that you need not believe what you’re saying for it to have a profound impact on improving your attitude and behavior. You simply have to say the same thing over and over to generate change at the brain level. After all, all those unhealthy things you’ve repeated about your eating and body for years have led you to today’s negative beliefs about yourself.

This January, do something radically different. Instead of watching what you eat or the number on the scale, pour your energy into watching what you say to yourself and making sure that every word nourishes your hopes and dreams and validates your self-worth and lovability. You’ll be amazed at how much better you feel and how much easier it is to reach your goals in the new year.

The post Nourishing Self-talk for the New Year appeared first on The Emily Program.

Read the first part of Carie’s story here. 

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

After college, I found myself taking my first professional job hours away from my friends and family in a tiny town. It turns out ED loves isolation. I told myself it was the only job I could find since I didn’t have any experience, but it also turned out to be the perfect haven for ED. I hardly knew anyone. I could go to work, come home, and just spend time with ED for the entire evening, just as he would like it. Then, I would drive the hours back to spend time with friends and family for the weekend and pretend like nothing was wrong. I had a good job. A nice apartment. I was dating someone. Life was good.

Meeting ED Head-On

At some point, my family and a great friend confronted me about my behaviors. It turns out I wasn’t as secret as I thought I was. ED was furious. Furious that they knew. Furious that our little secret was out. Now I was really going to have to actually face these issues I was dealing with. I began my first treatment with a social worker, registered dietitian, and some group work. It opened my eyes to what therapy really involved, and it was truly helpful at the time. Even then, though, I could not truly open up to my family and friends about what I was really feeling, thinking, and doing.

Relationship with ED and ED Alone

Throughout the time that I struggled with ED, I was in several relationships. I was looking for something that I could not find within myself: love. I needed acceptance and affirmation from someone outside of myself to prove that I was worthy. But, as many who have dealt with an eating disorder know, there is no room for a relationship with a person and ED at the same time. ED lives and breathes secrets, lies, manipulation, self-doubt…leaving no room when trying to figure out who you are as a person, let alone when trying to be in a relationship with someone. As soon as one relationship would fail, I would find myself in a new, exciting one. This behavior can only mask inner turmoil and troubles for so long.    

I struggled with ED coming in and out of my life for close to 20 years—throughout my teens, 20s, and 30s. Some days, weeks, even years were better than others. I sought treatment after encouragement from loving family and friends. I got better. Then I’d have a setback. I would seek treatment again. Get better. And something would trigger me, and I would relapse again. I learned that setbacks are a part of the journey, and I also learned to celebrate each and every victory. I met my meal plan tallies for this meal? Victory. I went three days without using symptoms? Victory. I just ate an ice cream cone and feel good about it? Victory. I learned to celebrate each and every hour of positive recovery. What might seem like a small win to some might be a major milestone to another.

My treatment was always spent in an outpatient setting, sometimes intensive outpatient (IOP), and sometimes just a monthly check-in appointment. The tricky thing about an eating disorder is it does not always show up and look the way some think it should. I was not always underweight. In fact, many of my most unhealthy times were at higher weights. I am so happy to see more awareness being brought to this fact, but there is still a lot we have to do in terms of education, even within the medical field.

Setbacks are Just Part of the Journey

I am a work in progress, but what I cherish about being in my late 30s is finally understanding who I am and being comfortable in my own skin. And truly embracing that saying, “What others think of you is none of your business.” I have a hard time saying that I am recovered because I know that I will always have to stay cognizant of that old ED voice in my head trying to creep back in, especially when I’m in a vulnerable place. I continue to work on what made me susceptible to an eating disorder in the first place; in some ways, I feel like the true work is just beginning. I think it is important to remember that ED provided something to me at one time. It was not healthy, but it clearly showed up for a reason. I was not sure how to handle emotions or feelings, so when they would come up, I found a solution to not having to deal with them: my eating disorder. It took me years to recognize my sensitivity as a human being. And, more importantly, that my sensitivity is not a negative trait. In fact, it is an amazing human trait. It allows me to experience life in a beautiful way.

And I am constantly listening—life transitions provide a great space for ED to creep back in. I learned this the difficult way after our son was born. He was born four weeks early and with a birth defect known as Tracheoesophageal Fistula and Esophageal Atresia. This means that his trachea (“airway or windpipe”) and esophagus (“food pipe”) were connected at birth, and his esophagus formed in two parts instead of one. He endured surgery when he was three days old and nine subsequent weeks in the hospital, his little body struggling to accept breast milk and put on weight. I stayed at the hospital every day and night that he was there. Throughout this, I thought I was doing self-care: seeing family and friends when I could handle it; going for walks and jogs; talking to a small group of other NICU mothers; and so on. It turns out it wasn’t quite enough. Enough anxiety and uncertainty had built into my brain that ED crept his way back in. I turned to old coping mechanisms, which continued off and on once we got home from the hospital. And then the isolation of maternity leave in the winter with a fragile newborn kicked in. I didn’t seek out help at first, although that is exactly what I needed. I waited and finally opened up to my husband about what I was experiencing, who lovingly encouraged me. I quickly rebounded with the help of a team through outpatient services. I still have a hard time seeing pictures from that time of our son’s life, which indicates that I likely suffered some PTSD during that time. When you are in a situation where your child’s life is in danger and each day can bring a new setback, you are led through these extreme highs and lows. You are in survival mode. You are making it each and every day for that little person in your life that you would do anything for. Once you stop and slow down for a moment and things start to catch up to you, only then do your needs come into play.  

Eating disorder recovery is hard. It is really hard. I love how Glennon Doyle put it in her recent book, Untamed, “The truest, most beautiful life never promises to be an easy one.” It is opening up yourself in ways you never thought you could or never thought you wanted to. It is about learning to sit in what I like to call the “icky,” those moments that are uncomfortable when uneasy feelings and emotions come up. Even though it is hard, it is completely worth it. Having a life free from an eating disorder is so much more than what an eating disorder appears to bring to you.

Finding Running…Again

During the years that ED was most prevalent in my life, I still ran off and on, but I lost the love of it. I even trained for a few marathons while using eating disorder symptoms. I tried to qualify for the Boston Marathon twice while using eating disorder symptoms. I used to cringe (after the fact) at the thought of what I was putting my body through and asking of it; I experienced one stress fracture in my ankle and countless other lower leg injuries that definitely can be attributed to my lack of self-care and, even worse, self-harm that I was doing to my body.

I was at war with my body for so long that I could not truly appreciate running. Now I am thankful that I found a renewed love for this sport that has given me so much more than it has taken. My renewed love came after I became a parent, especially a parent of a child with acute medical needs in his early stages of life. It brought me a new kind of joy: time to reflect and pray and time to sort through my thoughts and feelings, an opportunity to set goals and do the work to achieve them, and, most importantly, wisdom to Appreciate. The. Journey. Moving my body provides an outlet for my anxiety, which was a vulnerability that helped open the door to my eating disorder.

Running has provided a safe space for me to open up about ED with friends. What you share on the run with friends can be so sacred, it’s truly amazing. There’s no better way to get close to someone than to spend a few hours sweating out some miles with them. Running constantly provides metaphors in life. A marathon training cycle is so reflective of the cycles we go through in life, whether it’s relationship or friendship cycles, career cycles, or eating disorder recovery cycles. Some days are easy, some are hard, then when you get to your end goal, whatever that might be—a job promotion, an addition to your family, a move across the country, a PR—you realize, wait, it wasn’t about getting to this exact point. It was about the journey all along.

Vulnerability When True Secrets are Revealed

An eating disorder thrives on secrecy, manipulation, mind games, negative self-talk, and isolation. During the times I was seeking professional treatment and doing the things that I needed to do to recover, I still could not fully open up about what I was dealing with to loved ones. Not really. I would open up just enough so they knew I was working to get better, but it was superficial. I was still embarrassed, even ashamed. Being that vulnerable to my loved ones was harder than being vulnerable to strangers.

Can we ever be truly, truly vulnerable? I used to think not. I didn’t even understand what it meant to be vulnerable—to put aside your ego, your worries about what others think of you, your preconceived notions. My husband was the first person that I was truly, truly vulnerable with about ED, meaning I could tell him when I was in the middle of a bad spot. And I had to work very, very hard against my instincts and learned traits to get to that point. I still have to work at it. But it is amazing when you finally realize that vulnerability opens up so much in our lives. The more vulnerable I am with someone, the closer I feel to that person. And, hopefully, the more vulnerable I can be, the more vulnerable they feel comfortable being as well.  

The idea that sharing my story might help just one other person is motivation enough for me to stop worrying about what others think and truly get real. This led me to sharing my story with The Emily Program community. To be this vulnerable to such a wide audience was truly scary for me. It’s taken me a long time to get to this point, but I know that by opening up, I am stronger in my recovery. I am not a medical doctor, scientist, or professional researcher, but I am an expert in my own experience, which I am only now truly embracing. If you are dealing with an eating disorder, please know that there is help out there. You do not need to go about this alone. I have been there. So many of us have. Have faith. Have hope. It will get better.

The post Setbacks, Vulnerability, and Running Again: Carie’s Story, Part 2 appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

My name is Carie Wille, and I am a 38-year-old wife and mother of a two-year-old toddler with our second baby due at the end of April. I own my own consulting business and I love staying active, especially running and waterskiing. I am also a sister, daughter, friend, Christian, and a bunch of other descriptive nouns I could continue listing, but we’ll leave it at that!

Although my family and I now live in Traverse City, Michigan, I am originally from Minnesota and spent my entire childhood and most of my adulthood up until last year there. I dealt with an eating disorder on and off since I was about 17 years old, although my disordered thoughts around body image and eating manifested at an earlier age. 

Although I won’t say I’m fully recovered because I still have to watch for those pesky eating disorder thoughts, I do not actively use symptoms and am ready to share my story to potentially help others in their journey toward recovery after having time to look back and reflect on… So. Many. Things. So many aspects of not only my eating disorder journey, but also life after an eating disorder. I have always felt that there was a reason God was sending me through these difficult seasons of my life that centered around disordered eating and body image complexities; I just didn’t know why. Sharing my story through The Emily Program is just a start for me – I feel called beyond this, but I have to start somewhere! By being vulnerable and sharing my story, I hope to help others through what they are dealing with. And, shhhhhh, just letting you in on a little “non-secret” secret: It is helping in my own recovery as well.

I have learned so much about myself and what made me susceptible to an eating disorder in the first place, and I continue to work on this in therapy. I am a continued work in progress! For me, my eating disorder has been an almost lifelong journey through several seasons, including as a pre-teen, teenager, through my 20s and into my 30s, through several (failed) relationships and finally really being vulnerable with my husband, through pregnancy and the challenges it can offer to someone with a disordered eating past, into motherhood, and also as a runner/lover of moving my body.

Journey With Ed

Somewhere along the line, I became aware of trying to please others, keeping emotions in check, doing and saying the right thing, maintaining a smile on my face, and staying modest. These traits, along with a Type A, perfectionist personality and a tendency for anxiety, opened the door for my eating disorder to step in. This is the story of a journey with an eating disorder and continuing to find my true self throughout the voyage.  

Food Feelings

I can recall at a very young age being very happy with how food made me feel. I even recall a family member one time saying, “You seem to really enjoy food.” They did not mean this in a negative way, but as a sensitive kid, I remember that comment and it has stuck with me so many years later.  

Even before my eating disorder made its first official “debut” with symptoms in my senior year of high school, I had thoughts and behaviors that started much earlier than I even realized. (By the way, for those that have not read the book Life Without Ed by Jenni Schaefer and Thom Rutledge, I highly recommend it! They describe Jenni’s eating disorder as a unique personality separate from her own. This technique was extremely helpful for me throughout my journey, and I will refer to my eating disorder as “ED” from here on out.) Looking back, I could see signs of ED wanting to creep into my life long before high school. He was a careful observer…a lurker in the shadows waiting for those perfect moments to pounce on a new victim when they were most vulnerable. I have memories in early adolescence eating and eating until I was beyond full. I would get so uncomfortable and feel physically ill; I didn’t know when to stop.

Was my brain responding to food in a slightly different way than others do? Probably. In my recovery, I learned that I was likely receiving slightly elevated rewards from food. Research has identified specific neurobiological differences in the brains of people with anorexia, bulimia, or binge eating disorder, which affect how we eat, as well as things like mood, anxiety, personality, and decision-making. This knowledge was comforting to me in my recovery journey; it was as if I needed scientific research to help explain why I was dealing with something like this. So, I was dealing with elevated responses to food early on in life; using food to numb myself from uncomfortable feelings would come later.

Body Changes and Body Comments

Early in puberty when my body began changing, I didn’t like it. I didn’t understand it. I would look in the mirror at my changing body, and negative thoughts would come flooding in (in came the body image dissatisfaction). My sister and best friend didn’t experience changes in their body like that, why was I? (in came the comparison game). I would obsess over specific parts of my body; my thighs were getting bigger, my butt was rounding out, I was growing breasts. And the sad reality at the time was that I could do NOTHING about it.

Eating disorders can affect anyone, regardless of their gender or sex or life story. I had a wonderful childhood with very supportive parents and great friends. I did not experience a traumatic event. I did not have a difficult upbringing. I used to feel guilty for not having a specific reason to pinpoint for developing an eating disorder. It wasn’t until later in my therapy that I realized there is no one cause for eating disorders, and it involves a complex variety of biological, psychological, and sociocultural factors.

I can still recall comments made regarding my body shape when I was growing up, and even regarding others’ body shapes that I personalized. They were said in innocent fashions, but the fact that I have carried the comments throughout my life is indicative of my sensitive personality: “You’re built like a sprinter, not a long-distance runner.” “College runners come in all shapes and sizes.” “Your sister is so thin.” These were comments made so incredibly long ago, and yet I can still remember who said them to me and where I was at the time. I don’t mention this to shame whoever made these comments; it’s more as an awareness.

Anxiety Comes A Creepin’ 

I would not learn until later in life that I was developing generalized anxiety, as well as mild obsessive-compulsiveness, throughout my adolescence before ED really reared his ugly head in my life. “Common co-occurring issues” was the proper terminology I would later learn. I was a worrier as a child: I would project my worries onto my loved ones, including my sister. She used to say in a teasing manner, “I don’t need a second mother.” My anxiety began manifesting itself in physical forms as well: pinching the skin on my arms and biting my nails. For those who deal with nervous habits like these, you often don’t even realize you are doing them at the time; they become automatic and seemingly out of your control.  

Although I experienced some compulsive actions like checking the oven three or four times before leaving the house, it was more in the form of obsessive thoughts. For instance, I can remember running through the streets of my hometown with my cross-country team and counting house address numbers to see if they were divisible by three. But the obsessive thoughts grew beyond quick arithmetic in my head…I worried what others thought of me, my low self-esteem charging ahead: Was I saying the right thing? Was I doing the right thing? Was I being too “bossy”? Was I getting good enough grades? Was I choosing the right major in college? Does this guy like me? Why won’t he call me back? Did she just look at me in a weird way? Does my boss like the work I’m doing?  

First ED Symptoms

My high school years were spent heavily defined by the sports I played, the activities I was involved in, and the good grades I maintained. The busier I stayed and the more accepting smiles I could gather from others, the happier I was. Or so I thought. 

My love of sports began at an early age. I would try any sport—volleyball, soccer, softball, tennis, etc. Eventually, I would land on my two loves: basketball and running. This happened after following in my older sister’s footsteps. She ran cross country and track? Okay, I’ll try those! She played basketball? Okay, I’ll try that! I was hooked. I loved being part of a team. I loved moving my body. I loved working hard. And I loved that hard work paid off. And I was coachable and a good student of the game, no matter what sport it was. If there was a club in high school, I joined it. Student Government. Yes. National Honor Society. Yes. TARGET. Yes. Peer Helpers. Yes. Key Club. Yes. Choir. Yes. Okay, that’s not entirely true—I did not join theatre or the debate team. They should be happy I refrained from those.    

Things began shifting toward the end of high school. I was tired. I was tired of being involved in everything, I was tired of trying to be the best at everything, I was tired of trying to prove something to myself and other people. And then my world as I knew it at the time came crashing down when I tore the ACL in my knee at the end of my senior year basketball season. What was I going to do now? Sports were my life, and not only could I not finish my basketball season, I was out for track as well. I was maybe even going to try out for the basketball or cross-country team at the small college I was planning to attend the following year.

So, here we had a people-pleasing perfectionist with a tendency for anxiety (unidentified by myself at the time), teetering on the brink of something, who just lost what was a major part of her world: sports. In came the eating disorder big time. ED promised to save the day! I began controlling what I ate and restricting in a major way. I withdrew from friends. I stopped doing the things I liked to do. My grades began slipping. I didn’t know what I was looking for, but ED helped me not deal with the emotions I was feeling. It also brought me a sense of control after feeling like things were slipping between my fingers.

CO-ED…College and ED

College brought on a different sense of anxiety for me. I had no idea where I wanted to go. I thought I wanted to be a physical education teacher, so I decided on a small public college in Wisconsin. It was only an hour and a half from my hometown, my parents, my high school boyfriend, and my best friend was going there. A safe choice. I didn’t feel I was mature enough or independent enough to even consider going to a school farther away. At a time when the world was my oyster and I should have been exploring everything, I was anxious about driving back to college on Sunday nights in snowy and icy weather because I went back home every weekend. I settled into what I felt was a comfortable existence.

During my freshman year, I decided I wanted to try architecture as a major. This brought on a transfer in my sophomore year of college to the University of Minnesota-Twin Cities campus. Here, I found myself both a very small fish in a huge sea, but also a big fish in a small sea once I settled on my major, which happened to be very small. I avoided specific eating disorder symptoms until my junior year of college when I dove into bulimia. I thought I had my roommates and family fooled. Leaving the room after meals to go into the bathroom. No big deal. Turning on the shower to mask any noises. They wouldn’t even notice. It turns out I was wrong.

Read the second part of Carie’s story here.

The post In Came an Eating Disorder: Carie’s Story, Part 1 appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Lisa Whalen’s book,  Stable Weight: A Memoir of Hunger, Horses, and Hope, will be available from Hopewell Publications on March 2, 2021. Her writing has also appeared in An Introvert in an Extrovert World; The Simpsons’ Beloved Springfield; Introvert, Dear; and Adanna, among other publications. Whalen has a Ph.D. in postsecondary and adult education and an M.A. in creative and critical writing. She teaches composition, creative writing, literature, and journalism at North Hennepin Community College, where she was selected Minnesota College Faculty Association Educator of the Year in 2019. In her spare time, she is an equestrian and volunteer for the Animal Humane Society. Learn more at her website and follow her on social media @LisaIrishWhalen.  

Years ago, a graduate school professor showed my class a documentary on restoring famous paintings and frescoes, like Da Vinci’s Mona Lisa or Michelangelo’s Sistine Chapel. Guardians had managed to protect the fragile masterpieces from vandals, fires, and rain, but they couldn’t prevent centuries of dust, pollen, soot, candlewax, cigarette smoke, and the other pollutants of daily life from accumulating on the surface. The grime dulled paint colors so rich, vibrant, and complex that modern technology hasn’t been able to reproduce them.

Experts used Q-Tips to clean a single, square-inch section at a time. The work was taxing, tedious, and seemed like it never progressed, until one day, restorers stepped back and saw what looked like a miracle. Cleaned sections of the painting leapt from the surface. Their colors sang. Their backgrounds deepened. Their foregrounds glowed with light.

Occasionally, restorers discovered treasure: an artist’s signature hidden in the corner, a coded message scrawled across the background, a self-portrait layered within a battle scene, a sketch visible beneath the paint. One group of experts found what they think is a Da Vinci fresco, Battle of Anghiari, thought lost to history. It’s barely detectable behind a false wall on which another artist’s work is featured.

I’m not an artist or art historian, but restoration kept coming to mind while I completed eating disorder treatment. Years of photoshopped images, fad diets, poor self-image, and negative beliefs had accumulated in my psyche and dulled the vibrant person I’d once been. My therapist, nutritionist, and I were like restorers cleaning my mind. They shone a light on my thoughts, taught me techniques to create gradual change, and handed me tools I could use to strip away symptoms. Sometimes it seemed like I spent months of tedious, taxing work on a single self-destructive habit without any sign of progress. Then, I’d step back and see that compared to six months prior, parts of me shone.

Perfectionism was my most stubborn pollutant. I struggled to dismantle the false wall it had constructed in front of an original work I thought laughably inferior. Learning to cultivate gratitude was the only tool that convinced me that a flawed original is always preferable to fake perfection.

Much later and with hindsight’s clarity, I’m grateful for what my eating disorder has taught me. If I hadn’t needed treatment, I wouldn’t have discovered pleasures like yoga and riding horses—activities that help me appreciate my imperfect body. I wouldn’t have written a book or risked being vulnerable enough to let the real me shine through.

I’ve been out of treatment for years now, but I hold on to the idea of restoration, knowing that if I continue working to clear away destructive habits a little bit each day, eventually I’ll uncover a masterpiece.

The post Restoring a Masterpiece: Myself appeared first on The Emily Program.

Eating disorders are very troubling in these circumstances.

As many of us are now well aware, the stress of 2020 has exacerbated eating disorder thoughts and behaviors in many people. In some cases, those who were already struggling have experienced even more intense symptoms, and some who were previously in stable recovery have found themselves struggling again. Others who had never experienced these illnesses have found themselves dealing with one for the first time. It is painfully clear that there are millions of people who need attention and care for their eating disorders.

Yet, now that the holidays have passed, we face additional stressors without some of the season’s typical joys and pleasures. Many of us did not have the opportunity to be with family, friends, and loved ones in the ways to which we are accustomed. We had to drop or adapt our holiday traditions. We were unable to travel, hug, and share physical space with one another. These stressors pile onto the many others of 2020.

In the swirl of pandemic-related stress, we are also bombarded by messages that do not protect our physical, mental, and emotional health during this time. Seemingly everywhere you look, there is another message about dieting or exercising at home in this post-holiday season. Each spreads fear about weight gain—be it holiday weight gain or the “quarantine 15”—and offer diets and exercise as a magic solution. 

These messages are examples of diet culture and our society’s obsession with weight, size, and shape. They are distractions from the pandemic, and, though they can trigger disordered thoughts, they are not directed at people experiencing eating disorders. We know they are not written or shared with you, your illness, or your recovery in mind.

We also know the things that would normally keep us healthy will keep us healthy still. The ways you have previously protected your recovery are ways to try again. What has given us hope before is what we can tap into now. 

In this time of resolutions, we often resolve to make changes on a personal level. But hope comes not only from a connection to oneself, but also from a connection to others. This year, let’s also resolve to be part of a better community. Let’s work to make our community healthier and stronger so that we can all live with greater peace, health, and joy within it.

It can be hard to reach out, but do it. You can make the video call. Send the text or email. Reach out to family, friends, and loved ones who know how to speak to your heart. If you do not have these people, reach out to us. Reach out to recovery organizations and online communities. Reach out to support groups. There are other people in your situation, as well as many others who are ready and able to help.

It is our sincere hope that 2021 is better than 2020. With a vaccine now available and distribution underway, there is promise that it likely will be. So, please tune out the noise of diet culture. Block out the chatter of weight loss resolutions. Tune in to the people you love and the community we share, and let’s bring forth a better year.

The Emily Program has help available for you, your loved ones, and your patients suffering from an eating disorder. If you are seeking help for yourself or a loved one, get started by completing our online form or by calling 1-888-364-5977. If you are a provider, learn more about the signs of these illnesses in your patients and others, and make a referral online.

The post Hope and Healing for the New Year appeared first on The Emily Program.

Episode description:

Kiera Russo is a student at The University of Notre Dame, studying Film, Television, and Theatre. An eating disorder survivor, she hosts the podcast Heavier Than I Look, which aims to empower other survivors, educate listeners, and foster conversation surrounding eating disorders. By finding meaning in her own suffering, Kiera hopes to fight against the silence that eating disorders demand and to liberate others from the same demand.

In this episode of Peace Meal, Kiera shares with us her eating disorder and recovery story. She traces the beginning of her illness to the time following eighth grade. During this period of transition, stress, and anxiety, Kiera started running to prepare for her school’s track team. But, she says, “it easily and quickly turned into…a mechanism for me to control not only how many calories I would allow myself that day, but also how much weight I could possibly lose.”

While Kiera’s eating disorder was taking root, people around her inadvertently reinforced it by remarking positively on her behaviors and body changes. These comments validated the disordered behaviors, all the while worsening her illness.

After years of struggling in silence, shame, and confusion, Kiera opened up about her illness in a class poetry assignment. She recited the poem in front of her classmates, uttering the words “eating disorder” for the first time and acknowledging that she had one. At this moment, Kiera gave herself her voice and revealed it to others.

While sharing her experience was an important step in Kiera’s overall story, it did not resolve her eating disorder. She continued to struggle with restricting and bingeing in secret, experiencing a taste of freedom only temporarily when she entered college. Surrounded by friends who had healthy relationships with food and their bodies, she was able to eat without concerns about weight and body. It was a “blindingly euphoric” time, she says.

Unfortunately, additional comments about her weight triggered food and body concerns again. Immense fear returned to mealtimes, and darkness encroached upon her life. At this point, Kiera revealed to herself that she needed help.

Despite the obstacles to seeking help, Kiera successfully advocated for the professional care her eating disorder required. Equipped with proper support, she pursued recovery while quarantining last year. She ditched the scale, journaled, and rethought her identity, relationship with food and body, and vocational plans. Born out of her recovery was Heavier Than I Look, her podcast which has transformed her plans for her future and kindled her sincere desire to amplify her and others’ voices.

Listen to Heavier Than I Look on Apple Podcasts, Google Podcasts, Spotify, and PodBean, and follow the show on Instagram and Twitter.

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 43: Giving Voice to Eating Disorder Stories with Kiera Russo appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Josh Person is a Minneapolis-based freelance writer and brand communications consultant who has worked with a number of startup companies in the natural foods industry. In addition to his work, he believes in spreading awareness about and educating others on eating disorders and other mental health issues. Follow him on Instagram @thejoshperson.

Recovery Conversations is a question-and-answer series that shares voices and stories of eating disorder recovery. Among the many things Josh Person shares in this post are the lessons he has learned in recovery, the support and resources helpful to his healing, and the wisdom he’d give to his younger self. 

What do you wish more people knew about eating disorders?

It isn’t about looking a certain way or eating certain types and quantities of food. Rather, these are just the tangible manifestations of something so much deeper. An eating disorder is the loop of internal dialogue that cannot be turned off. The feelings of lack and unworthiness. These are emotions not easily put into words.

Another thing I think is important for people to know is that eating disorders are not the result of “bad parenting,” as parents of clients seem to think. So many are unnecessarily blaming themselves (including my own) for “causing” their child’s eating disorder, which is not the case!

How much did you know about eating disorders before being diagnosed with one yourself?

I was first diagnosed with an eating disorder when I was just 15 years old (I am now 25), and fell into the behaviors in the name of “good health.” Although, yes, my eating disorder was well aware of what it was doing, I, JOSH, was very ignorant to the world of eating disorders.

How has being a man affected your eating disorder or recovery experience?

So much of what is shown in the media targeting men in regard to “perfect health,” the “ideal body”, “clean” eating, etc. is completely toxic, and is sadly normalized — especially within the fitness industry. This disordered messaging definitely had an effect on me. I have battled my ED throughout adulthood and have never been ashamed of it. But I know for many men who struggle, they suffer in silence. I do think with the trend toward normalizing treatment (therapy, medication, etc.), more men will share their stories, which is why I am eager to share my own. 

Why did you decide to seek help and recover? 

My recovery began after a visit to the hospital for low vital signs, which subsequently led to being admitted to an inpatient treatment program in Winter 2010. In the 10 years since being first diagnosed, I have, unfortunately, relapsed a number of times. My most recent relapse resulted in some legal trouble, which has been a major motivator in healing. Because I know the person I am when I am sick is not the person I desire to be. I do still struggle and have moments of weakness, but reminding myself of this brings everything back into focus.

What surprised you most about the process of recovery? 

The clarity I feel when I am in a healthy place, physically and mentally. It just feels good to be honest and at peace with myself. 

What type of support from others was most helpful to your recovery?

I think the most helpful thing for me has been open dialogue and complete transparency, especially with my family. 

What resources have supported your recovery? 

Really educating myself on what proper nutrition looks like has been major in supporting my recovery. Understanding that everyone has different dietary needs and that we are all on a journey to finding what works. There are so many great websites with a focus on functional nutrition, wellness, and personal growth… Some of my favorites include: Louis Hay’s writings and affirmations, Byron Katie’s “The Work,” Jewel’s Never Broken Foundation, Tom Bilyeu’s Impact Theory, Mosaic Eye Unfolding, and Vibrate Higher Daily. Also, only recently did I come across the Law of Attraction and the phenomenal teachings of Abraham by Jerry and Esther Hicks, which resonates to my core! This has led me down the rabbit hole of self-discovery. 

Also, a song that stood out to me is called “Ablaze” by Alanis Morissette. It is not about recovery, but about the innocence and joy of youth. The lyrics are so powerful; read them for yourself! 

What do you do today that helps you maintain or protect your recovery? 

2020 was a year of personal growth and discovery for sure. Something that I didn’t learn until earlier this year is the practice of setting personal boundaries, and communicating and sticking to them! It is important to put your own health first. 

I have a pretty established morning routine, but it’s not too rigid, which has only led to disordered behaviors in the past. Especially since the start of COVID and social distancing, my anxiety has been quite high as a big part of my job is keeping up with social media and news. I value my work, but I also have learned the necessity of logging off and taking time to RELAX, too.

What advice would you give to your 15-year-old self?

Embrace who you are, live for YOU. Growing up, and still today, I was the mediator… the peace-maker… the one who lived to make others happy. The one who everyone else turned to for support. I really lost alignment with my own identity. 

I have always been loved by others, and this love has always been genuine. But if I had only known how to love myself unconditionally, too, I would not have been in such a vulnerable place for my ED to creep in.

What words of hope would you give to those currently struggling? 

You are safe within yourself. So much of my disorder is rooted in fear of growth and change, and feelings of unworthiness and lack — always running from myself, looking for some kind of escape, comfort, and safety outside of my own being. 

I’ve learned that when you allow yourself to relax into the flow of life, learn to trust yourself, and look for the joy in everything, life really is great. There is no reason to suffer… to constantly be striving for perfection. What’s the point in that? Keep growing and have fun, too! 

We want to hear your voice of recovery! If you are interested in participating in our Recovery Conversation series, please email blog@emilyprogram.com to learn more.

If you or a loved one is experiencing an eating disorder, help is available. Reach out to The Emily Program today by calling 1-888-364-5977 or completing our online form.

The post Recovery Conversations: A Q&A with Josh Person appeared first on The Emily Program.

Navigating holiday conversations can be challenging in even the best of years. In a year of a pandemic that has dominated our lives and interactions with others, it may feel even more so.

What is there to talk about with family, friends, and acquaintances this year? How can we meaningfully engage in yet another video call, or make new conversation among our small, in-house pods?

When the goal is connection—and it often is, especially for those struggling with the isolation of an eating disorder—the topics of conversation ought to be thoughtful and appropriate.

As an eating disorder treatment organization, we often recommend what not to talk about in social settings: food, diet, body, weight, and appearance. For those struggling with eating disorders or disordered eating, these food- and body-centric comments are often highly triggering. They exacerbate eating disorder thoughts and feelings, sparking urges to restrict, binge, purge, or engage in other disordered behaviors. They serve to disconnect those struggling with food or body concerns from the present moment.

Instead of small talk about holiday food, weight changes, and/or diets planned, we hope you and your loved ones can engage this year in conversations of connection. To that end, we’ve prepared 15 conversation-starters or topic-changers to help steer your holiday dialogue in a safe, nurturing direction. Use them to initiate or redirect conversations in order to respect and protect those currently experiencing or recovering from an eating disorder.

1. What is everyone’s favorite holiday/winter tradition?
2. What is the best holiday gift you have ever given and/or received?
3. Which holiday songs do people enjoy—and which make them cringe?
4. Which holiday movie is a must-see every year?
5. What does everyone remember about the holidays as a child?
6. If you could instantly add anyone to this video call (or home dinner table), who would it be and why?
7. Real or artificial tree—and white lights or colored ones?
8. What trip would you most like to take once it’s safe to do so?
9. What is everyone most proud of this past year?
10. What shows, movies, music, or podcasts have kept people entertained lately?
11. Has anyone picked up any new hobbies?
12. Who has a funny video call moment to share?
13. Who has a pet to show us?
14. Any bizarre quarantine purchases to report?
15. What is everyone most looking forward to in the year ahead?

This holiday season and always, recovery should be a top priority for those struggling with and healing from eating disorders. If you are supporting someone with an eating disorder this year, consider these suggestions in addition to these conversation topics. For more guidance on navigating the holidays in recovery, check out this post and this podcast episode.

If you are struggling with an eating disorder this holiday season—or anytime—reach out to The Emily Program, where we provide specialized treatment for all types of eating disorders. Give us a call at 1-888-364-5977 or complete our online form to get started.

The post Holiday Conversation Topics That Aren’t Food, Diets, or Weight appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Recovery Conversations is a question-and-answer series that shares voices and stories of eating disorder recovery. In this post, Abigail lends advice to others struggling with an eating disorder and then shares how she protects her recovery and practices self-care.

What advice would you give to someone currently struggling with an eating disorder?

I don’t mean to sound corny, but I think it’s important to tell anyone struggling three things: 1) you’re not alone, 2) it’s not your fault, and 3) it won’t be this way forever. You probably feel like this is some weird problem that you’re supposed to fix on your own, but it’s actually a real disorder that millions of people have. Many professionals understand and know how to help you overcome an eating disorder. If you’re scared about living your whole life worried about food and weight, you should know that you don’t have to. You can recover with help from professionals who know how to treat these disorders.

What do you do today that helps you maintain your recovery?

The COVID-19 pandemic has definitely made recovery harder, but I am glad I have some tools to fight my eating disorder with everything else going on. The one I use a lot lately is reminding myself that I don’t have to do what my eating disorder tells me to do. For example, if I have a disordered thought that I should restrict, I don’t have to immediately restrict. Instead, I can label it as just a thought and follow through with my usual meals and snacks anyway. It seems obvious, but I couldn’t do this when I was sick with my eating disorder.

What are your favorite forms of self-care?

Reading inspirational books or following inspirational social media accounts is a good way to get into a better mindset. Sometimes I just scroll through them to get into a good mental space, and other times I journal them down and write about how they relate to my life and recovery at that moment.

(I also love the usual self-care things like baths and sheet masks!)

Favorite recovery quote?

“The worst days in recovery are better than the best days in an eating disorder.”

This quote is a good reminder that the hard days in recovery are temporary and will hopefully lead you to a better place eventually. On the other hand, the best days in an eating disorder will just keep you stuck.

If you were to write a book about recovery, what would it be called?

Recovery Is A Choice Worth Making!

We want to hear your voice of recovery! If you are interested in participating in our Recovery Conversation series, please email blog@emilyprogram.com to learn more.

Eating disorder help is available. Find care for you or a loved one by calling The Emily Program at 1-888-364-5977 or by completing our online form. 

The post Recovery Conversations: A Q&A with Abigail appeared first on The Emily Program.

Episode description:

Dr. Shauna Frisbie is a Licensed Professional Counselor, an approved Supervisor for Licensed Professional Counselors (LPC-S), a Certified Eating Disorders Specialist (CEDS), and a National Certified Counselor (NCC). She has taught psychology, family studies, and counseling since 2001 and is currently a Professor of Clinical Mental Health Counseling at Lubbock Christian University.

Shauna joins us in this episode of Peace Meal to discuss the value of sharing and discussing visual content in therapy. Her phototherapy techniques are described in her 2020 book, A Therapist’s Guide to Treating Eating Disorders in a Social Media Age.

Images, Shauna explains, and the stories we attach to them provide insight into deep emotional processes and responses.

“When I do phototherapy with clients, I’m really trying to help them explore the meaning behind these images,” she says. In treating images as communicators of meaning, she and other trained therapists can help facilitate emotional awareness and processing with clients. 

Shauna outlines how social media and smartphones have made images more relevant than ever, especially for young adults in a developmental stage of identity searching and relational skill development. For those susceptible to eating disorders, this increased exposure to images can be especially problematic. Shauna explains how phototherapy can help uncover how visual content impacts clients’ relationship to their bodies and/or sense of identity, as well as offer means of healing.

Learn more about Shauna at drfrisbie.com, and find A Therapist’s Guide to Treating Eating Disorders in a Social Media Age at norton.com/author/22703/shaunafrisbie. 

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcast, Spotify, Stitcher, or Google Play. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 42: Phototherapy as a Healing Technique with Shauna Frisbie appeared first on The Emily Program.

Intuitive eating, aptly named, is an approach that trusts in the body’s intuition to guide eating decisions. Unlike a diet that prescribes rules about what and when to eat, intuitive eating emphasizes attunement with natural signs of hunger and fullness. These internal signals replace any externally imposed rules, and the body is situated as the expert of its physical and psychological needs.

Dietitians Evelyn Tribole and Elyse Resch first outlined their model of intuitive eating in a 1995 book of the same name. The book’s fourth edition, Intuitive Eating: A Revolutionary Anti-Diet Approach, was released earlier this year. Tribole and Resch’s paradigm continues to garner public and clinical attention, and its evidence base continues to grow (Tribole, 2017).

Though the intuitive eating approach is rooted in the body’s intuition, it can (and often does) feel far from intuitive for many. Diet culture’s “health” and “wellness” messages, as well as dieting, disordered eating, and eating disorders all serve to distance the mind from the body. Without a firm mind-body connection, the mind often acts as a micromanager of the body’s needs, tending to or ignoring them based on external rules and restrictions.

Relearning how to trust and honor internal body cues takes time—and often, courage—in a culture so steeped in diets and unreliable markers of health. The word “revolutionary” in the book’s title is intentional. Intuitive eating is an anti-diet, Health At Every Size-aligned approach that requires us to actively challenge commonly held assumptions about health and weight.

The approach includes ten principles that help to foster a strong mind-body connection. These principles are “tools, not rules”—not strict standards, but instead guidelines for examining our relationship with food. Taken together, the principles can aid in recognizing and challenging any barriers to intuitive eating that may be present in our lives.

The 10 Principles of Intuitive Eating

1. Reject the diet mentality.

Intuitive eating is not a diet. It is not something done to “prepare for” a season or event or to “make up” for other eating. It does not set rules around any food or food group, and it does not chart appropriate “windows” for eating. There is no counting of calories or “points.” These types of rules are antithetical to this approach. Becoming attuned with our body signals requires ditching external rules and restrictions.

2. Honor your hunger.

Despite what diet culture would have us believe, we don’t need to fear or fight hunger. We need not ignore or “curb” it, and we don’t need to attach pride to it, either. Hunger is simply a bodily cue, as natural as those that tell us when we need water or sleep.

Only by feeding our bodies adequately and consistently can we meet our energy and nutritional needs. When we do this, we decrease the likelihood of bingeing after a period of restriction. Honoring hunger cues also helps to develop trust in our bodies, and our bodies similarly learn that they can count on us for getting their needs met.

3. Make peace with food.

Food is not the enemy. In instances of disordered eating and eating disorders alike, it is not food that is the problem; it is an unhealthy relationship with food. Making peace with food requires that we work to strip it of its power over us.

To challenge the idea that food is dangerous or something to be feared, some people find it helpful to reframe food as medicine, or what the body needs to heal from disordered eating or an eating disorder. Others reconceptualize it as energy, the fuel needed for other activities in life. Others still redefine it in even simpler terms: food is just food.

4. Challenge the food police.

The “food police,” in broad terms, are any sources of food judgments. It implies that food has an inherent moral component—that it is either “good” or “bad.” The food police might manifest in a thought that says a slice of dessert is “sinful,” for example, or a comment that suggests someone is “being good” by choosing a salad.

In intuitive eating, food is neither good nor bad. Different items provide different nutrients, but there is no moral value attached to any of them. All foods fit in this paradigm.

5. Feel your fullness.

In addition to honoring our hunger, intuitive eating asks that we feel our fullness. This principle is rooted in mindfulness. How do we feel throughout a meal? What signals are we receiving from our bodies? What signs tell us that we are comfortably full? We can practice recognizing and then honoring these cues.

6. Discover the satisfaction factor.

Eating can be an enjoyable experience, especially when it involves food that is personally satisfying. Intuitive eating aims to include meals and snacks that we find tasty, nourishing, and interesting. We can work to incorporate pleasure into our meals with ingredients that delight our senses or invoke positive memories of childhood, special occasions, and other fond times.

7. Cope with your emotions with kindness.

Eating for emotional reasons happens, and in many cases, it is part of normal eating. It becomes problematic, however, when eating is our only coping skill. Finding ways to cope outside of food equips us with a bigger toolbox for tending to our emotions in a balanced, sustainable way. We can learn to sit with and feel our feelings, rather than numb or ignore them through food.

8. Respect your body.

Body respect doesn’t require full body confidence or body positivity. It simply asks that we treat our bodies respectfully even if we don’t like the way they look. We can nurture our bodies with kindness and compassion by tending to their physical and psychological needs.

9. Movement—feel the difference.

Exercise should not be a chore. It is not something we must do to “earn” food or to “burn off” food we’ve eaten. Instead, movement (a term preferred over “exercise” by many eating disorder professionals), should take the form of physical activities we actually enjoy. It’s about making our bodies feel good, no matter how they look. Movement—when appropriate in eating disorder recovery—should be for pleasure, not punishment.

10. Honor your health with gentle nutrition.

Intuitive eating takes a holistic view of health, including its physical, mental, and emotional dimensions. Nutrition is more than eating vegetables, and health is more than food and fitness. Gentle nutrition is a concept that allows us to continuously explore what makes us feel well and why.

Intuitive Eating in Eating Disorder Recovery

An intuitive hunger/fullness approach to eating may not be appropriate for all people at all times. Those actively struggling with an eating disorder, for example, may not receive reliable signals of hunger and fullness and therefore cannot rely on them. Often, these signals are hijacked or overpowered by disordered rules and judgments.

Until these natural signals return, a more structured meal plan is often recommended in early eating disorder recovery. As recovery progresses, professionals can help these individuals eventually transition to more of an intuitive eating approach. The help of a specialist can ensure that the eating disorder isn’t gaining a foothold in this more flexible style of eating.

While a hunger/fullness meal plan is typically reserved for later stages of recovery, intuitive eating has far more than a meal plan to offer. The strategies are designed to identify and challenge external food rules to restore our connection with internal cues. Beyond any meal plan, the principles are useful for people at all stages of eating disorder recovery, as well as anyone else looking to improve their relationship with food.

If you are concerned about your or a loved one’s relationship with food, take the first step toward help by calling 888-364-5977 or completing our online form. For book recommendations beyond Intuitive Eating: A Revolutionary Anti-Diet Approach, check out our page of book recommendations.

The post What is Intuitive Eating? appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. This story includes mention of self-harm. Please use your discretion when reading and speak with your support system as needed.

This blog was submitted anonymously by a person in eating disorder recovery.

My eating disorder never really “started.” It just happened. At least, that’s what I used to think.

When I was 11, I was diagnosed with diabetes, and for the first time in my life, I craved food. Sure, I had been a typical kid with a typical candy-shaped stomach. But this craving was different. My body was starved from weeks of cellular fasting, and it told me to eat. Ok, so far so good.

Through my teenage years, those beloved hormones began to race through my system. My body started to change, and with it, so did my metabolism. I cut lunches and felt guilty when I couldn’t resist the urge to fill my blossoming belly (although in truth I was still quite petite). Evening snacks evolved from a handful of nuts to a cup or two—in any case, more than I intended. I felt weak, unable to control this ever-persistent desire. But it never interfered with school or work. It was a mild case of disorganized eating.

Well, soon enough I graduated high school. My family and I moved from China to Seattle, Washington. China had been our home for the past eight years and we were bombarded with culture shock. As far as eating habits were concerned, I had to adjust to an increase in baked versus cooked foods, the pattern of large portions, and longing for foods that would remind me of “home.” 

The biggest causative factor was yet to come. Yep, it was that coming-of-age moment when my parents shoved me out of the nest. Or rather, they fled the nest with me still in it. As they moved overseas, I was left in my parents’ condo with few friends, no hobbies, and perfect grades to maintain. What better environment for an eating disorder to take wing? When I was lonely, I ate. When I was bored, I ate. When I was upset, I ate. Fast forward a couple years, I was bingeing at least every few days. I was so disgusted with myself, and always felt fat. I exercised late into the night, avoided eating around people, and even scarfed down whole meals in public bathrooms. I hated myself so much that I considered self-harm as a way to punish myself as well as provide an outlet for my pain. My anxiety was like a fountain quickly rising under the pressure of the need to find a job, the medical school admissions test (I was an aspiring pre-med student), and new family challenges that came with my family’s return to Seattle the summer of my graduation. Without realizing it, I had developed generalized anxiety and depression. They were simultaneously fueling and being fueled by my eating disorder. 

After another year of failed attempts to control my behaviors, I finally agreed to regular counseling—perhaps my second major step toward healing. My first major step was confiding in trusted friends not only about bingeing that was now a daily occurrence, but also about the powerfully destructive self-hate that was only growing. These friends urged me to seek professional help. So, I saw a therapist weekly for nearly three months before she referred me to an ED specialist. My specialist has slowly walked with me on this long journey to recovery. “It’s gonna take time,” she would always tell me when I came in and repeated the same sad story of my miserable life, as I perceived it. Even while seeing her regularly, I engaged in self-harm and had suicidal thoughts. Sometime, maybe I’ll tell her that I would also binge just before coming to her office, ironically because I knew I would be inspired to “be good” after the visit. 

As it turns out, however, experts are usually right. After much tender pestering from my counselor, I finally saw a psychiatrist who helped me tackle this mental distress from a medical perspective.

This was my third major healing step. Many tears and sleepless nights later, I realized that it had been two months since my last binge. The emotional joy and physical freedom were indescribable. Not only did I lack the urge to binge, but I also ate what I wanted without counting calories, exercised for the fun of it, and woke up in the morning with energy for a new day. It took some deep digging into my memory bank to pull up the old urges and feelings associated with bingeing. Half-worried that I’d forget my painful experiences and miss out on opportunities to share my story as encouragement to others, I put it down in writing.

Different people find motivation and endurance from different sources. For myself, I don’t believe I would have made it without God walking right beside me. My hope for people struggling with eating disorders is that we seek help before our breaking point, because we are worth the “trouble” it takes to scoop us up from the pits of despair. We are worth the finances, heartbreaks, late-night talks, and nutritious meals that the voices in our heads scream against. We can recover in due time. And we are worth it.

The post It Started Innocent appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Lisa Whalen’s book, Stable Weight: A Memoir of Hunger, Horses, and Hope, will be available from Hopewell Publications on March 2, 2021. Her writing has also appeared in  An Introvert in an Extrovert World; The Simpsons’ Beloved Springfield; Introvert, Dear; and Adanna, among other publications. Whalen has a Ph.D. in postsecondary and adult education and an M.A. in creative and critical writing. She teaches composition, creative writing, literature, and journalism at North Hennepin Community College, where she was selected Minnesota College Faculty Association Educator of the Year in 2019. In her spare time, she is an equestrian and volunteer for the Animal Humane Society. Learn more at her website and follow her on social media @LisaIrishWhalen.  

I have always disliked yardwork—or any outdoor work, for that matter. I hated that it was dirty, sweaty, and left me with sore muscles despite regular exercise. Worst of all, it turned me into Sisyphus, a character from Greek mythology who was sentenced to an eternity of pushing a boulder uphill, watching it roll down, and then pushing it up again. It seemed I would just finish mowing, weeding, or raking, only to find that the grass had grown, new weeds had sprouted, and more leaves had fallen.

But COVID-19 changed my attitude.

Like many people, I saw my life turned upside-down last March. Suddenly, I couldn’t walk to the neighborhood coffee shop and write. I couldn’t sit in a patch of sunlight at the library and edit my book about eating disorder recovery. I couldn’t participate in group fitness classes on the YMCA’s roof and savor spring’s increasingly blue skies. I couldn’t attend weekend horseback riding lessons, which were the only outdoor activity I enjoyed. Overnight, my work and social life had been reduced to sitting in front of my laptop. I couldn’t escape staring at a screen. I needed an outlet—a way to shake off stiffness in my body and mind.

I wandered outdoors with an audiobook, which I considered a necessity for completing tedious household tasks. I began pulling weeds in the backyard, and before long, yardwork seemed like a breeze. Mowing and raking became excuses to discover what happened next: Would the main character find her long-lost sister? Accept the job in Australia? Save her marriage? Heal from heartbreak?

I pulled weeds so enthusiastically that bare spots appeared in the yard. An excuse to start a new book! I thought. I bought topsoil, scattered grass seed, watered daily, and became a doting lawn parent.

Spindly green blades peeping through the soil seemed so fragile. They had to overcome squirrels who dug in the soft new dirt, birds who nibbled every visible seed, sun that baked the soil until it crumbled, and downpours that threatened to wash it all away. The blades’ determination to grow in spite of everything inspired me. Caring for them made me protective. I checked on them through the kitchen window when I refilled my coffee cup and from the alley when I took out the trash. Each millimeter of growth felt like a victory.

Nurturing grass seed became a model for nurturing myself—a part of recovery I often struggled with. Assessing each patch’s state, identifying its needs, and promoting its health felt like oiling self-care mechanisms my eating disorder had stilled and COVID had allowed to rust. Checking on the grass each evening led to checking on myself: noticing whether I needed food, water, sun, sleep, conversation, or quiet. I forgot all about the audiobooks because yardwork became a form of meditation: repetitive, yes, but also calming and restorative.

Nature has a way of renewing itself. We witness that every spring—something I can look forward to until May 2021. In the meantime, I’ll continue my nightly meditation by caring for indoor plants.

If COVID has disrupted your recovery, find an excuse to nurture something small or delicate. That habit might lead to nurturing yourself, too.

The post Nurture Yourself Through Nature appeared first on The Emily Program.

Charlotte Markey, Ph.D., is a professor of psychology and a founding director of the Health Sciences Center at Rutgers University (Camden). She is the author of The Body Image Book for Girls, as well as a forthcoming companion book for boys.

While body image has typically been regarded as a female issue, body image concerns can affect people of all genders. Here, we chat with body image researcher, Charlotte Markey, Ph.D., about body image in boys and men.

Describe your interest in body image. 

My interest in body image dates back to my childhood experiences as a ballet dancer. The intense focus on your body when you are a dancer is unfortunate and really fueled my own body dissatisfaction.

It wasn’t until I was an undergraduate psychology major that I started to look at the scars from my years as a dancer. Intellectualizing these issues was (and is!) a great coping mechanism for me. I began doing research on body image and eating attitudes during my undergraduate years and continued to do so when I completed my Ph.D. in psychology. I love doing research and teaching as a professor, but I also really love to make the research accessible to more diverse, public audiences. This has led to my work on book projects, including my recent The Body Image Book for Girls and the forthcoming companion book for boys.

Why has body image traditionally been thought of as a “women’s issue”? 

Diet culture and the beauty industry have targeted women for decades. It has long been commonplace for girls and women to want to change their appearance—in terms of both their bodies and their faces. This is not the only reason, but it is one of the primary reasons why body dissatisfaction is normative and festers among girls and women. In contrast, “manly” men have historically been conceptualized as natural, unadorned, and uninterested in fashion or beauty.   

How do body image concerns present in men and boys as compared to other genders? 

Something that stands out to me is how boys and men often engage in disordered thoughts and behaviors under the guise of “getting healthy.” Of course, girls and women do this as well.  However, it seems more common among boys and men. They are going to the gym to “get in shape” and only eating certain foods to “improve their health,” but if any of these things become compulsions, they are very unlikely to actually be healthy. Further, it worries me that boys and men often don’t seem to have the vocabulary to articulate their concerns. It’s not as socially acceptable for boys and men to have mental health problems and they don’t have practice admitting that they feel bad, so they set off engaging in all sorts of maladaptive behaviors instead.

How can we continue the dialogue about body image in boys?

I think we first need to have more widespread appreciation that body dissatisfaction and eating disorders do not necessarily manifest the same among boys and girls and you can’t tell who has a problem just by looking at someone. Someone can be very slender and still be dissatisfied with their body. Someone can be relatively heavier and have an eating disorder. These are mental health problems that are serious and can be life-threatening. When it comes to boys, the dialogue about mental health issues needs to expand so that boys (and men!) appreciate that they do not need to suffer in silence and can and should get help when they need it. 

How can people get involved with your research or learn more about your work? 

The Body Image Book for Girls has a web page that I hope to update soon to include more information about my forthcoming book for boys as well. My ongoing research is discussed on my web page at Rutgers University, and I am also on Facebook, Instagram, and Twitter.

I’m currently recruiting teen boys and young men who may be interested in talking with me as I finish up writing my book for boys. Although my books are based on empirical research, the personal stories I include are a favorite feature. I think it is especially important for young boys to hear from older teens and adults about the struggles they’ve had with their body image. It is important to normalize boys’ discussions about their feelings and how they have grown and learned to be accepting of themselves. Interested individuals can email me at chmarkey@camden.rutgers.edu (and do not need to be identified by their real names).

The post It’s Not Just Girls: Body Image in Boys and Men appeared first on The Emily Program.

Tell us about yourself!

My name is Antoinette Johnson, and I have been the Office Manager at The Emily Program – Cleveland Outpatient site since 2015. My husband Curtis and I have been together for 32 years and have two wonderful sons—CJ, 29, and Alex, 21. We have a sweet beagle, Hailey—she’s 6 years young!

What do you like most about your job?

It is rewarding to be a part of a group of staff that truly believes in working as a team to help clients in their individual recovery journeys. We have such a wonderful group of clinicians and administrative staff that collaborates seamlessly in the coordination of client care. To oversee these efforts and assist in ensuring everyone knows they play an essential role in the organization as a whole is just as important as the care we provide to our client base. I look forward to returning to all of the onsite activities that I coordinate for our site, which is a really worthwhile way for everyone to connect and decompress from daily stressors.

What do you like to do when you are not working? 

My first love is spending time with my husband and our two adult sons. Anyone that knows me also knows that I am obsessed with any and everything that involves interior and exterior home improvement and décor! We create our own art, wood carvings and some furniture pieces, and I’ve done everything from hauling river rocks and mulch to designing beautiful rooms from beginning to end… from floor installations, painting walls, hanging lights… to the final step in making the decision of the final throw pillow… until it’s time to change it again!

How are you managing the COVID-19 situation? 

It has been a huge adjustment for everyone, but I have honestly taken this time to reflect on being grateful for what we have, opposed to focusing on the restrictions that this pandemic has placed on all of us. I try to find solace in music or resting my mind from the constant “rush” of everything. There are some really good meditation videos out there!

I try to look at the positives. Going out for date nights aren’t a thing right now, but—on the bright side—we’re saving a ton of money and still spending time together! We can’t really sit and visit with our elderly parents, but trying to get them to download Zoom and telling them they don’t have to talk so loud when they finally do see us makes for a good laugh! I’ve also been doing a lot more talking on the phone, checking in with friends and loved ones so that the human connection doesn’t get totally lost. This has been a year we’ll never forget!

The post Staff Spotlight, Antoinette Johnson appeared first on The Emily Program.

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. This episode includes mention of sexual assault. Please use your discretion when listening and speak with your support system as needed.

Episode description:

Miranda Snyder is a student in the Honors College at the University of Maine, where she is studying to be a high school ELA teacher. A strong proponent of storytelling-based advocacy, her past and current advocacy efforts emphasize the power of lived experience.

The power of Miranda’s lived experience is on full display in this episode of Peace Meal. She shares with us her eating disorder story, charting it from illness to “quasi-recovery” to full recovery.

When Miranda first underwent treatment for anorexia in eighth grade, she felt she had little say in the matter. She received ample support from friends, teachers, and friends, but her participation in care was more passive than active. Although she achieved nutritional rehabilitation, she continued to struggle with strict food rules and routines for the next several years. She lived in so-called “quasi-recovery.”

“I figured, ‘This is as good as it’s gonna get,’ she says, reflecting on that time. “I would be doing the best I could and be achieving so well, but I would always have an ED in the back of my mind.”

And then came a turning point.

Earlier this year, Miranda realized that she is “worth so much more than a quasi-recovered life.” She entered treatment again, this time on her own terms as a 21-year-old.

Miranda put her whole self into recovery, making it a project that received her full focus and dedication. She voraciously took notes in virtual “eating school,” relied on support from family and friends, and regularly journaled affirmations and plans for her future. 

In moving beyond quasi-recovery, Miranda has found space for things far more meaningful than disordered rules and routines. She’s better able to engage in coursework, research, and advocacy, she says, as well as relationships with others. She’s more present, more centered. She has claimed a sense of self rooted in her true values—and a life fully free from the leech that is an eating disorder. 

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcasts, Spotify, Stitcher, or Google Podcasts. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 41: Beyond Quasi-Recovery with Miranda Snyder appeared first on The Emily Program.

We hope that this season brings you connection with friends and family (even if you won’t physically be in the same place!) or time for reflection on growth or goal setting for the coming months or years. May these few recovery ideas help you successfully navigate this year’s holidays in recovery.

1. Keep Your Appointments.  

Your health should always come first! Around the holidays, it can be tempting to cancel appointments. Instead of canceling, consider working to reschedule. Your treatment team can be a place of support, encouragement, and guidance to plan your meals and other social events. Stock up on time with supportive people, including time with your treatment team! 

2. Plan Ahead.

This is especially important if you will be eating away from your typical places or with people unaware of your condition or your mealtime needs. Plan who will be with you, how you will adhere to your meal plan, and who can support you in achieving that goal. Visualize yourself being successful in completing your plan. Ask for help before you need help, just in case.  

3. Eat Regularly and Follow Your Meal Plan.

There are lots of disordered thoughts and attitudes about holiday eating. In reality, you don’t have to eat differently than you do on non-holidays. Make a plan to eat regularly and follow your meal plan. You can choose this for you. Tell the people around you what your needs are and what you need in order to stay on your recovery path.

4. Know the Menu and Offer to Participate. 

You could offer to bring a part of the meal that you feel comfortable with and is on your meal plan. This may help reduce stress about the meal. You can also ask about the menu, assuring that you feel confident that you can meet your needs with the food that is expected to be provided.  

5. Identify a Support Person Before the Event or Meal.

Support people can help provide distraction, offer support when you are distressed, or direct conversation away from triggering topics. Asking someone in advance and telling them how to help you can be very helpful.  

6. Don’t Leave Home Without Your Tools.

You have worked hard in recovery and learned new coping skills. Taking time to think about which tools will be most helpful to you at various holiday events, before the events, can be helpful. Write down the tools, and put them in your pocket or bag. Taking these tools with you will make it easier to use them. If you need help creating your list, ask your therapist or treatment team. They can help you! 

7. Practice Self-Compassion.

Beating yourself up will only make you feel worse. This might be the first holiday you’ve had in a while without engaging in eating disorder behaviors or the first time you’ve shared your diagnosis and/or recovery journey. In these situations, you are facing your fears or operating out of your comfort zone, so it might not be perfect. Recognize how brave you are each time you take these steps, as perfect or imperfect as it may look. Write down some positive compassionate self-statements that you can recite to yourself (or have your support person say to you). Remember that you’re stronger than you believe.  

8. Don’t Forget to Breathe.

Practice breathing before and during events this holiday season. Deep breaths can help you to re-center, reduce anxiety, and produce a sense of relaxation. Breathe deeply and breathe slowly. It seems so simple, but a long, deep breath can help you to choose something different, think more clearly, or just give you a few seconds of space in a difficult moment.

For more advice on navigating the holidays with an eating disorder, check out this list of “holiday dos and don’ts” as well as this podcast episode. If you, your patient, or a loved one could use additional help during the holidays and beyond, please reach out to The Emily Program at 1-888-364-5977.

The post May The Holidays Be Peaceful With These 8 Recovery Tips appeared first on The Emily Program.

Episode description:

Brittany Braswell is a Registered Dietitian/Nutritionist (RDN) who runs a virtual private practice for those struggling with food and body image concerns. In both individual and group settings, she helps clients reduce their anxiety and disordered behaviors so that they can achieve lasting freedom from the bondage of their eating disorders.

Brittany joins us in this episode of Peace Meal to explore recovery from a faith-based perspective. For many, she explains, faith is a belief system more powerful than an eating disorder, one in which people can trust when distancing themselves from their illness.

To place trust in faith during recovery, Brittany emphasizes the importance of intentionality.

“I think being able to reconnect to those values or to your faith is really about turning down the eating disorder volume and getting really intentional about identifying and listening for those healthy voices,” she says.

As those healthy voices become louder in recovery, people can also strengthen their connection with their bodies and nutritional needs. Faith can augment a non-diet approach like intuitive eating, Brittany says, highlighting the alignment she sees between scripture and intuitive eating principles. She explores this connection in greater detail in her eBook, Faith Over Fear.

A key to recovery—for people of faith and otherwise—is finding eternal worth and an identity separate from the eating disorder.

“Once you know your worth and identity,” Brittany says, “place your identity in that thing that’s unshakeable.”

To learn more about Brittany and her faith-forward approach to recovery, visit her website at brittanybraswellrd.com. There you can find her free eBook, Faith Over Fear: Ditch Food Rules and Nourish Your Body Without Guilt, information about the services she offers, and other resources. Brittany is also on Facebook and Instagram.

Learn more about The Emily Program online or by calling 1-888-364-5977.

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About the podcast:

Peace Meal is an Emily Program podcast that discusses topics related to eating disorders, body image issues, and how society may contribute to distorted thinking.

You can find Peace Meal on Apple Podcast, Spotify, Stitcher, or Google Play. If you enjoy our show, please rate, review, subscribe, or tell your friends!

Are you interested in being a guest on Peace Meal? Email podcast@emilyprogram.com for more information.

The post Episode 40: Faith-Based Recovery with Brittany Braswell appeared first on The Emily Program.