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Eating Recovery Center
Media Presence
2012
Table of Contents
January..................................................................................................
**Digital Outreach: pages 14-16
February.................................................................................................
**Digital Outreach: pages 32 & 33
March.....................................................................................................
**Digital Outreach: pages 50 & 51
April........................................................................................................
**Digital Outreach: n/a
May..........................................................................................................
**Digital Outreach: pages 80 & 81
June........................................................................................................
**Digital Outreach: pages 91 & 92
July.........................................................................................................
**Digital Outreach: pages 98, 99, 103, 104
August.....................................................................................................
**Digital Outreach: pages 113 & 114
September..............................................................................................
**Digital Outreach: n/a
October....................................................................................................
**Digital Outreach: page 135 & 136
November...............................................................................................
**Digital Outreach: pages 150 & 151
December................................................................................................
**Digital Outreach: n/a
page 4 to 19
page 21 to 37
page 39 to 51
page 53 to 68
page 70 to 81
page 83 to 93
page 95 to 105
page 107 to 117
page 119 to 128
page 130 to 142
page 144 to 153
page 155 to 171
January
2012
page 4
page 5
January 1, 2012
The Fear of Food | Lindsey Koehler
page 6
In a previous blog, I shared the concept of the three As in the recovery process: ADMITTING you have a
problem, becoming AWARE of when you are engaging in the behavior and taking ACTION to change. For most
of us in recovery, taking the first step to admit we have an eating disorder is difficult enough; however, taking
the additional step to share our story with someone else is an entirely different issue in itself.
Whether or not you share your struggles is a personal choice. However, in my own experience, discussing the
issues with others can be crucial in developing a strong support system throughout your recovery process.
I would like to share some points to consider when talking to others about your eating disorder and/or
disordered eating behaviors. I hope you find them helpful and meaningful.
Understand your “intent” in sharing.•	 Be clear from the beginning why you want to share with this
person and the details you’re willing to share. You can’t be certain as to an individual’s response;
therefore, set realistic expectations and be prepared for any reaction. Also, be willing to ask for what
you need from the individual, as he or she may not know how to support you.
Consider your audience.•	 How you approach a family member, friend or a colleague may differ. Be
thoughtful in how and where you decide to have the conversation. Make sure there is appropriate time
available for you to share your thoughts and feelings. If needed, have a support person with you when
you share your story.
Provide educational and support materials.•	 It’s important that individuals are educated about eating
disorders; many people don’t understand the complexities of these diseases, which can lead to saying
the wrong thing. By offering support materials such as pamphlets, books or websites for the person
you’re telling about your eating disorder, you can help him or her better understand what you’re going
through.
Location, location, location.•	 Be sure to find a quiet place to talk away from distractions. Distractions
will only make the situation more difficult for both of you.
Communicate effectively.•	 Prepare yourself and what you want to say, be focused and speak in a clear
voice. Let the person know that what you’re saying is important and you’d like them to listen closely.
Give the individual time to absorb what you’re saying.•	 Hearing that a friend or loved one is struggling
with disordered eating behaviors or body image issues can be startling at first and a lot to take in. Give
the individual a few minutes to process what you’re saying.
Discuss next steps.•	 A common question after telling someone about your eating disorder is “What
do you and/or we need to do now?” Perhaps you want the individual’s assistance in moving forward
with a treatment plan; so be prepared to discuss your treatment options and plans. For some helpful
treatment resources, see my previous blog, “Getting Help for Anorexia and Bulimia: Eating Disorder
Resources You Can Use.”
Be kind to yourself.•	 Give yourself praise for taking this big step. Remember, it takes courage, strength
and bravery to tell others our story.
My hope is that in sharing your story, you’ll continue to gain the support you need to build lasting recovery. For
additional support, you can always contact the Clinical Assessment Team at Eating Recovery Center.
For those of you who have shared your story with others, what were some things you did to get the support
you needed?
January 2, 2012
Telling Your Loved Ones “I Have an Eating Disorder” | Julie Holland
page 7
For most people, each new year brings about a new set of resolutions for change; changes in our lives, our
ambitions or ourselves. My advice: Why make the same ‘resolutions’ that typically are unsuccessful? Instead,
forget a ‘resolution’ and each day make a commitment to being healthy and living happily in every part of your
life.
Far too often New Year’s resolutions focus on weight loss or diet in an attempt to kick start the new year and
the “new” you. I think it’s far more important to focus on who you are and what you can do rather than how
you look. It’s time to make a commitment to improve who you are as a person, rather than a resolution to
change yourself.
Here are a few recommendations for facing each day with a positive focus:
Make healthier choices for your body through movement.1.	 Instead of taking the elevator, try taking the
stairs. You’re sure to have an extra bounce in your step when you reach your office. Instead of circling
endlessly in the mall parking lot searching for the perfect, close parking spot, go ahead and take that
spot near the back of the lot.
Focus on what your body does for you, rather than how it looks.2.	 Recognize the strength of your
body and praise it for what it’s capable of doing for you each and every day. This year, shift the focus
of exercise away from burning calories or losing weight. Instead, find an activity you enjoy – dancing,
horseback riding, hiking – and experience what your body can do.
Remember and use your five senses when making food choices.3.	 Look at your food, smell your food,
touch your food and listen to what is happening during each meal. Enjoy the process of eating and
move way from labeling food as “good” or “bad.”
Look at how far you’ve come, not how far you have to go.4.	 Maybe one of your commitments for 2012
is to find a new job or buy a house, but it just isn’t happening right away. That’s OK. Focus on what
you’re actively doing to meet those goals, whether it’s looking through the want ads, revising your
resume or saving money each paycheck for a down payment. These small steps each day will help you
meet your commitment. Just give it time and be kind to yourself.
At Eating Recovery Center, we strive to help patients realize how far they’ve come with eating disorders
treatment and what an amazing commitment they’ve made to their health by seeking treatment. It’s not an
easy path to take, but it’s certainly not impossible. So let’s start with nixing New Year’s resolutions and instead
make commitments to be healthier each and every day.
What healthy commitments are you going to make starting today? And, how will you start your day differently
tomorrow? I look forward to hearing your comments.
January 18, 2012
Nixing New Year’s Resolutions | Julie Holland
There’s no argument that childhood obesity is a serious health concern. More than one-third of children ages
10-17 are obese or overweight* and obesity rates among U.S. children grew from 14.8 percent in 2003 to 16.4
percent in 2007.**
Obesity is related to more than 20 major chronic diseases, including heart disease and diabetes, and
January 24, 2012
Anti-Obesity Ads: How Far is Too Far in Addressing Childhood Obesity? | Julie Holland
page 8
children who are obese are more than twice as likely to die prematurely before the age of 55 compared to
healthy-weight children.***
Education and nutritional intervention is key to combating childhood obesity rates; however, are anti-obesity
ads effective in addressing the issue or are they crossing a line into body shaming?
As some of my readers may already know, I struggled with eating disorders from the time I was seven years old
through much of high school. From a very young age I battled with negative body image and a low self-esteem;
being perceived by my peers as the “fat girl in class” was never easy. This perfect storm of factors triggered an
onset of binge eating disorder, anorexia nervosa and bulimia nervosa until I was nearly 20 years old.
Many obesity prevention campaigns promote balance and moderation, practices I agree with and that I think
we can all support. However, a recent anti-obesity campaign in Georgia has come under fire for, according to
critics, shaming and stigmatizing children who are obese. It probably goes without saying that this anti-obesity
campaign hits close to home for me. Although I’ve been in recovery from my eating disorder for 30 years now,
maintaining a positive body image and self-esteem is something I work on each and every day. When I see TV
ads identifying overweight children as “fat” and placing a negative connotation on that label, I worry about
what someone genetically predisposed to an eating disorder might think and feel.
Many people – including children – are at a higher risk of developing an eating disorder, either because
eating disorders run in their family or because they have a temperament that’s more susceptible to eating
disorders development. For these individuals in particular, any number of events or life experiences can trigger
disordered eating behaviors or a full-blown eating disorder. Having someone tell you, “you’re fat” or “you need
to lose weight” can be emotionally and mentally traumatizing, especially for a child. We need to be extremely
cautious in how we approach the childhood obesity epidemic so as not to stigmatize our children or make
them feel less valued or loved.
Because obesity – with its associated health risks – is a growing health issue, it’s certainly an issue to be
addressed. However, it’s equally important that we accept body diversity and ensure that obesity prevention
efforts take into account our children’s body image and self-esteem. Healthy bodies come in all shapes and
sizes.
If you’re concerned your son, daughter, friend or loved one may have an eating disorder, visit www.
EatingRecoveryCenter.com to chat confidentially with a member of our Intake Team and get all your questions
answered about eating disorders and eating disorders treatment.
What do you think of the anti-obesity ads? Comment and share your thoughts below!
--
*http://healthyamericans.org/report/88/
**http://healthyamericans.org/reports/obesity2010/
***http://healthyamericans.org/reports/obesity2010/
page 9
Women aren’t the only ones who struggle with body image issues. New research revealed that 35 percent of
men would sacrifice a year of their life to achieve an ideal body weight or shape.
This study, collaboratively conducted by the Centre for Appearance Research (CAR) at UWE Bristol, The
Succeed Foundation and Central YMCA*, examined British men’s attitudes toward their appearances.
Researchers found that more than four in five men (80.7 percent) regularly engage in conversation about
one another’s bodies and that most are unhappy with their muscularity. The study, which was released in
December 2011, also found that more than half (58.6 percent) of men said that “body talk” affects them
personally and mostly in a negative way.
Findings of this nature underscore the importance of breaking down “body ideals” and reinforcing body
acceptance at any shape or size for both women and men. You’ve all heard me talk about “fat talk” on the
blog and discuss how critical it is to be aware of the body-focused comments we make about ourselves.
Talking about having a “fat day” or rejoicing when you fit into your “skinny day jeans” can have a profound and
negative impact on your own body image as well as on the body image of those around you.
The same goes for the male-focused body-related comments we make. Noting a “six pack” versus a “beer
belly” or calling someone “chubby” can elevate male body image issues and cause men to strive for an
unrealistic body ideal.
For both women and men, it’s time for us to stop placing value judgments on the way we look and start
appreciating our bodies for what they can do.
Are you concerned about your own body image or does a friend seem to be preoccupied with body image
issues? Visit Eating Recovery Center’s website to get your questions answered or chat confidentially with a
member of our Intake Team.
--
*http://www.sourcewire.com/releases/rel_display.php?relid=69377
January 30, 2012
STUDY: Body Image Issues Aren’t Just for Women Anymore | Julie Holland
January 3, 2012
Eating Disorders and College Freshmen
Dr. Kenneth L. Weiner was interviewed for a morning show segment about eating disorders and
college freshmen as they return home for the holidays.
See the CD at the back of this clipbook for full video.
page 10
January 5, 2012
College Students Can Face Eating Disorders | Sarah Jones
page 11
January 10, 2012
The Truth Behind Common Eating Disorder Myths | Ken Weiner
A recent study revealed that 40 percent of Americans have themselves experienced or know someone who
has experienced an eating disorder, such as anorexia or bulimia.* Despite rising awareness among the general
population and health care professionals alike, misconceptions about these serious diseases, which have the
highest mortality rate of any mental illness, remain pervasive.**
Myth: Eating disorders revolve around food.
Truth: Eating disorders are complex illnesses with biological, psychological and sociological underpinnings.
While behaviors associated with eating disorders may begin with a fixation on calories and weight, eating
disorders generally stem from issues beyond food and body size. They also signify an attempt to control
something of substance in an individual’s life.
The mistaken belief that eating disorders are about food compels friends and loved ones to encourage
individuals to “just eat,” when in fact, the disorder from which they’re suffering is incredibly complex.
Myth: Eating disorders are an illness of choice.
Truth: Eating disorders are a mental illness, and no one chooses to have an eating disorder. The women, girls,
men and boys suffering from eating disorders are generally wonderful people with a horrible illness. They’re
often the best and the brightest and come from good families that care deeply about their well-being. On the
surface, these individuals look like they have everything in the world going for them, and
page 12
recovering from the disease is far more complicated than simply making healthy lifestyle choices.
Myth: Eating disorders aren’t serious illnesses.
Truth: The mortality rates associated with eating disorders are higher than any other mental illness, including
depression, bipolar disorder and schizophrenia. Anorexia nervosa, which is characterized by refusal to maintain
a healthy body weight and an obsessive fear of gaining weight, is the most lethal eating disorder. Half of one
percent of patients die every year from anorexia, and it has a mortality rate of 20 percent within 20 years,
meaning that one in five people that have had anorexia for two decades will die as a result of the illness.
Even for patients whose eating disorders don’t prove fatal, there are often severe medical complications
associated with starvation and purging, including bone disease, cardiac complications, gastrointestinal distress,
organ failure and infertility.
Myth: Dysfunctional families cause eating disorders.
Truth: While previous models of eating disorders treatment viewed families and dysfunctional dynamics
therein as a contributing cause of these illnesses, the community has moved away from the blaming of families
toward an understanding that families aren’t a cause, but rather an integral part of eating disorders recovery.
While families don’t cause eating disorders, these illnesses have been shown to run in families and are as
inheritable as bipolar disorder and schizophrenia. Between 40 and 50 percent of the risk of developing an
eating disorder is genetic, and a woman with a mother or sister who has anorexia is 12 times more likely than
the general population to develop the disease and four times more likely to develop bulimia nervosa. Those
that develop an eating disorder likely had a latent genetic predisposition toward the illness and a precipitating
event, such as going on a diet, a traumatic event or significant life change, triggered their anorexia, bulimia or
related disorder.
Myth: Eating disorders are a women’s illness.
Truth: While eating disorders involve many women’s issues and females represent a large part (90 percent) of
the affected population, research suggests that male eating disorders now account for at least 10 percent of all
cases. Interestingly, despite significant biological, psychological and sociological differences between men and
women, the etiology of eating disorders remains fairly constant between the two genders. Like in their female
counterparts, eating disorders in men and boys are genetic in nature and are often supported by psychological
and sociological pressures such as traditional gender roles and socially accepted ideas about masculinity.
Eating disorder myths can prevent individuals, families and professionals from recognizing these illnesses and
seeking appropriate treatment. Education and awareness are the strongest antidotes for misinformation, and
promoting a better understanding of eating disorders among the general public and the healthcare community
can support early identification, effective intervention and lasting recovery for the men, women and children
suffering from eating disorders.
Learn more about eating disorders and debunk eating disorders myths here.
--
*http://www.nationaleatingdisorders.org/uploads/statistics_tmp.pdf
**http://www.huffingtonpost.com/kenneth-l-weiner-md-faed-ceds/eating-disorders_b_872057.html
page 13
January 12, 2011
Parents: Important Advice About Your College Student and Eating Disorders | Pamela
Cytrynbaum
Eating Disorders Can Be Fatal: Here’s What Parents Should Say and Do If They Think Their Child Has an Eating
Disorder
College students have tremendous pressures on them these days. As parents and grandparents we read,
hear and worry a lot about binge drinking and drug use on college campuses. There are quieter but equally
destructive – in fact, even deadly – ways college students are harming their health as well: eating disorders.
In Parents: 10 Winter Break Warning Signs of Eating Disorders in Your College Students, I shared expert advice
on what parents should look out for while your college students are home for the holidays. Experts stressed
that parents and other family members should be “vigilant,” especially with college freshmen.
Here, I’d like to share more expert advice on what to do and say if you suspect a loved one is suffering from
an eating disorder — especially a college student coming home for visits. Maybe they are starving themselves
with anorexia or bingeing and purging with bulimia. Or both. Whatever disordered relationship they may have
with food, it means they are in crisis, in pain, and need your intervention.
Elizabeth Easton, PsyD, is the clinical director of child and adolescent services at Eating Recovery Center. She
offers some “dos and don’ts” for parents or other family members who become concerned about a loved one’s
eating habits.
As Dr. Easton explains, there are two possible scenarios as your loved one returns home from college for a visit
and you suspect an eating disorder:
Signs and Symptoms:
Weight Loss and Depression: “Your loved one has lost a significant amount of weight, become very isolative or
socially withdrawn and appears more pre-occupied with weight and/or food.”
Obsession with Exercise: “Additionally, there’s a significant change in his or her exercise drive and/or
compensatory behaviors (vomiting after eating, abuse of diet pills or laxatives, etc…). These behaviors often
mean the person is more entrenched in the eating disorder and is relying on eating disorders behaviors to cope
with stress, depression and anxiety.”
Eating Little, and in Ritualized Ways: Maybe he or she is eating a small amount but is cutting it into tiny pieces,
eating in some private pattern.
page 14
If this sounds like your child:
What To Do: “The first priority is your child’s physical health. Your son or daughter needs to be taken to a
physician for an assessment (current weight versus ideal, any weight loss since leaving for college, current
blood work and vitals). If your child refuses to go to the medical appointment or cooperate with the
assessment, stress how critical it is to be healthy, especially if he or she wants to successfully return to school
the next semester. In other words, if he or she wants to return to independent life back at school, he or she
needs to demonstrate that he or she can manage his or her health and well-being through cooperating with
the process.”
Parents Stay Focused on Health: “Parents should focus on what needs to be done, rather than simply asking,
“Are you OK?”. Kids can easily ‘skate’ around yes or no questions and give parents answers without details.
Also, he or she may not be willing – or capable – to identify the illness and engage in the treatment process.
They often need others to take the lead and help them face this issue head on.”
Be Firm: “Parents need to be firm and stay involved. If you are concerned about your child’s health and
potential for an eating disorder, tell your son or daughter what’s going to happen, instead of asking for
permission. For example: ‘In an hour (or tomorrow or this afternoon), we’re going to see a physician and
explore what’s going on with your weight and overall medical functioning. We need to make sure you’re
healthy.’”
Some Kids ‘Wake Up’: “Parents should also remember that some kids will ‘wake up’ when they find out there’s
a medical concern. Other kids, especially those who are deeply entrenched in the eating disorder, will see it as
a challenge and hear the confirmation of weight loss as a motivator to continue to use the eating disordered
behaviors.”
Stay Connected - Be Supportive and Tough: “Although parents should be firm, it’s important to stay involved
and acknowledge the stressful and painful process your child is going through. Making threats such as he
or she can’t return to school until they “get better” can be shaming for a child and won’t foster productive
conversations. Instead, validate how hard and invasive the assessment and treatment process can be, while
firmly insisting that you’ll be there to support them and follow through on getting them the help they need.
In my next post, Dr. Easton explains what to do if your child or loved one falls into a second category of possible
eating disorders.
January 17, 2012
Parents’ New Year’s Resolution Weight Loss Behaviors Can Contribute to Eating
Disorders in Children
As millions of Americans resolve to lose weight in 2012, parents’ new diet and fitness regimens may have an
unintended, negative outcome—triggering disordered eating behaviors or body image issues in their children.
Because children often will mirror what they observe in their adult counterparts, Eating Recovery Center, an
international center for eating disorders recovery providing comprehensive treatment for anorexia,
**Digital Outreach**
page 15
bulimia and binge eating disorder, urges parents to be mindful with their food- and body-focused words and
behaviors while undertaking New Year’s resolutions.
“Children and teens are very susceptible to picking up value judgments about body shape and size,” said
Elizabeth Easton, PsyD, clinical director of Child and Adolescent Services at Eating Recovery Center. “If we teach
them – through dieting, over-exercise behaviors and critiques of our own bodies – that there is a ‘good’ body
type, then that is exactly what children will strive for at all costs if they are susceptible to an eating disorder or
poor body image.”
According to the National Eating Disorders Association, weight and body consciousness among children begins
at very young ages, with research finding that 81 percent of 10-year-olds are afraid of being fat and 46 percent
of 9- to 11-year-olds are “sometimes” or “very often” on diets.
More than one-third of “normal dieters,” many of whom begin dieting at young ages, progress to pathological
dieting, a condition marked by continual dieting and from which 20 to 25 percent of individuals develop
eating disorders. When considered alongside a recent Thomson Reuters and National Public Radio poll, which
reveals that one-third of Americans have made a New Year’s resolution to lose weight in the last five years, this
research illustrates the perfect storm parents can unknowingly initiate by adopting aggressive or unhealthy
weight loss regimens.
Eating Recovery Center encourages parents to follow these four tips to model healthy behavior, help their
children embrace healthy attitudes about their bodies and minimize the chances that children will adopt
negative thoughts and behaviors related to food and body image.
Do not diet.1.	 Instead, resolve to eat healthier, well-balanced meals. Through their own behaviors,
parents can teach children how to focus on moderation without rigidly labeling foods as “good” or
“bad.”
Shift your perspective on exercise.2.	 Instead of looking at exercise as a dreaded weight loss tool,
approach it as a fun activity for feeling good and improving overall health. Plan family outings and
activities and children will follow their parents’ example.
Be aware of comments you make about your body.3.	 Children are far more astute than parents may give
them credit for, and they often mirror observed behaviors. Offhand comments about having a “fat day,”
failing at your weight loss resolution or feeling too snug in an old pair of jeans can have a bigger effect
on a developing child’s body image than many may think.
Be aware of comments you make about others.4.	 Criticizing others for “gaining a few pounds” over the
holidays or complimenting someone for resolution-driven weight loss can lead children to believe that
there are “good” and “bad” body shapes and sizes.
“Because eating disorders have a genetic component, children with a family history of anorexia, bulimia or
binge eating disorder are particularly susceptible to negative diet- and body-focused words and actions,”
explains Dr. Easton. “In these children, seemingly innocent body image comments or dieting behaviors can
quickly spiral out of control.”
Parents are encouraged to seek an eating disorders assessment if they notice troubling food- or body image-
oriented behaviors in their children. Recovery is entirely possible with early intervention and proper eating
disorder treatment from qualified professionals.
page 16
January 17, 2012
Parents’ New Year’s Resolution Weight Loss Behaviors Can Contribute to Eating
Disorders in Children
**Digital Outreach**
page 17
January 20, 2012
Status Update
Could your weight loss #resolution have unintended consequences for your kids? Find out more! http://bit.
ly/Amxh5b
January 12, 2012
Does Your Child Have an Eating Disorder? | A.V. Flox
Eating disorders affect five to ten million young and
adult women and one million men in the United
States. What is a parent to do when we suspect our
child may be exhibiting symptoms of disordered
eating? Come to think of it -- what are symptoms of
disordered eating?
To answer these questions, I called up Liza Feilner,
a licensed professional counselor and senior
therapist at the Eating Recovery Center’s Child
and Adolescent Behavioral Hospital who for nine
years has been working inpatient with individuals
suffering from eating disorders.
A lot of us don’t always have the opportunity to observe our children’s eating behaviors throughout the day,
meeting up with them only at dinner time. In the following list, Feilner offers some tell-tale signs that a child
may be exhibiting symptoms of an eating disorder.
“Remember, you’re looking for changes to previous patters that they’ve set with their eating,” says Feilner.
Symptoms of disordered eating
Weight loss or weight fluctuation. These are well-known indicators, though Feilner warns that neither of these
in themselves are the only determinant that somebody is struggling with an eating disorder.
page 18
Significant changes in food behavior. “If suddenly they’re cutting out a particular food group, that may signify
a change in food behavior,” warns Feilner. “For example, they may cut out fats or carbs or certain foods and
begin getting more rigid with what they are willing to eat.”
Limiting intake. “I already ate.” “I’m not very hungry tonight.” If your child is consistently skipping meals or
otherwise trying to limit their food intake by pushing food around the plate or taking really small bites to make
it seem like they are eating, watch closely for other symptoms of disordered eating.
Ritualistic behavior. Eating disorders tend to turn the consumption of food into a very rigid ritual. Any peculiar
eating behaviors -- such as finishing one item on the plate before moving on to another, for example -- should
signal a parent to become more observant.
Overindulgence. If your child is getting several helpings of something -- and this is a change from their
previous behavior -- it might indicate binging. “Usually people who are binging will be drawn to what they have
identified in their minds as ‘bad’ foods, so overindulging might involve desserts or carbs, of whatever they
believe to be ‘worse’ for them,” says Feilner.
Increased time spent in the bathroom. Any increase in the amount of time spent in the bathroom, or going to
the bathroom immediately after a meal could be a sign that your child is purging. “Vomiting is a way to purge,”
says Feilner. “But you also need to be aware of other forms of purging. Is there any evidence of laxative use or
diuretics?”
Rigidity in exercise behaviors. There is healthy working out and disordered working out. If a child is
prevented from working out, does it cause them a disproportionate level of distress? “Most people would be
inconvenienced if they couldn’t do their normal workout routine, but they would get on with their day,” says
Feilner. “Somebody with an eating disorder has so much anxiety -- they’re using exercise to alleviate their guilt
around food -- that they’ll become very agitated if they can’t exercise.”
Changes is style of dress. “You see this go both ways,” says Feilner. “Some kids might start wearing more
revealing clothes, showing off what they have accomplished, and other kids may start wearing really baggy
clothes to hide weight loss.”
Negative evaluations. You might hear your child talking more about their bodies, making comments about
being fat or giving a generally negative evaluation of their appearance.
Obsession with health. It’s important to mention that disordered eating doesn’t always look like a disorder.
An emphasis on healthy eating can also lead to an increased preoccupation with food. “It almost is socially
acceptable, because it looks like self-control or discipline, when in reality it might be making food increase in
importance until their rules surrounding food and general preoccupation begin dominating their lives,” says
Feilner.
Increased involvement in food purchasing decisions. “Some kids will insist on going to the grocery store
or going over the food labels,” says Feilner. “They want to exert some control over what is bought and
consumed.”
So what are some things a parent can do when they come across these behaviors? Communication, seeking
support and being a good role model are key to responding to your child’s unhealthy eating behaviors:
page 19
Response tactics
Don’t take a heavy handed approach. Eating disorders are about more than food, emphasizes Feilner. “Don’t
take a heavy handed approach and say, ‘you’re going to eat this.’ A more effective approach is expressing your
concern,” she says.
Show concern.
“Don’t interpret their behavior for them,” says Feilner. “Mirror back their behavior by saying, for example, ‘I
notice you’re going to the bathroom a lot after meals and I’m concerned that maybe you’re struggling and I’m
wondering if something is going on. Why do you think you’re going to the bathroom so much?’ or ‘I notice that
you’re losing weight and I’m worried about that.’ Express your concern in a way that invites conversation rather
than says, ‘you’re doing this, therefore you have an eating disorder and you’re going to eat.’”
Seek outside support. If you have evidence that your child is exhibiting disordered eating, seek outside
support from a medical doctor who can assess your child; a dietician who can give some information about
healthy meals and listen for some of the behaviors that can be problematic; and a therapist to discuss the
underlying issues. “Ideally, you want people who already work together and can function as a team, but at
the very least, seek people who are willing to communicate with each other. It’s really important to have a
cohesive group of people who can support the kid and the family,” says Feilner.
Watch your body judgments. Parents can impact on their children with their behaviors and attitude. Be
mindful of your body attitudes, try to cut down on talk about weight and physical imperfections, and avoid
assigning judgments to people based on their weight. “We see a lot of kids whose parents make negative
comments about people who are overweight,” says Feilner. “Some kids internalize the fear that they may
become a person who is rejected because of how they look.”
Consider food attitudes. Assigning values to food, even simple labels like “good” and “bad” can inform
disordered behaviors. This also extends to attitudes about people -- judging people based on their behavior
with their food as “good” or “bad” can impact a child’s perception of consumption and later inform disordered
eating.
Beware your exercise habits. As a parent, you should model that exercise is healthy, but be careful not to show
that it is connected to your ability to function. “One of the tells that exercise is becoming a problem is when a
person can’t be without it for a day,” says Feilner. “If there is a disruption in a parent’s exercise routine are they
distressed and upset? Showing your kids how to be flexible is important.”
Careful with compliments. Limit the amount of compliments that are appearance-based. “You look thin.”
“You’re very fit.” “I was that small when I was your age.” These body-focused comments are intended as
compliments, but they shift an unnecessary amount of pressure on your child to maintain a physical ideal.
Don’t assume. Eating disorders don’t just affect women. As mentioned above, there are at least one million
men who suffer from disordered eating in the U.S. alone. Just because your child is a boy, or of normal weight,
or even fit, does not mean they are immune to developing an eating disorder.
February
2012
page 21
page 22
February 1, 2012
Feeding Frenzy | Sunny Sea Gold
page 23
One shocking recent statistic, released by the American Academy of Pediatrics in fall 2010, is that from 1999
to 2006, hospitalizations for eating disorders increased sharply - 119% - for children younger than 12 years old.
The academy also noted significant increases in prevalence of eating disorders among minorities and males.
I spoke to Ovidio Bermudez, MD, medical director of child and adolescent services at Denver’s Eating Recovery
Center and a board member of The National Eating Disorders Association (NEDA). The 119 percent rise in
hospitalizations for such young children, Dr. Bermudez said, is “likely to be a good proxy for a rise in incidence,”
meaning that as incredible as it sounds, it probably accurately reflects the increase in the number of kids under
12 who are suffering from eating disorders, especially, as Dr. Bermudez points out, when you consider how
carefully third-party reimbursing organizations scrutinize hospital stays, and how reluctant they are to okay
them.
The reasons for this scary rise in children’s hospitalizations, says Dr. Bermudez, are complex, the result of a
variety of forces that have created a “perfect storm very likely related to changes in the environment and
changes in people’s experience.”
Here’s how Dr. Bermudez believes this “perfect storm” has taken shape: Imagine that we can divide children
our society into two groups, one that is genetically protected from eating disorders (meaning they have no
family history of them), and another that is “genetically vulnerable” (meaning there is a family history of such
disorders). Suppose a child in the latter group grows up in a “protective environment,” let’s say where there
is no dieting peer group, no obsession with fashion and popular culture, or perhaps no obsessively dieting
parents. Such a child is not likely to develop an eating disorder. “If that environment is altered and becomes a
‘promotive environment,’” explains Dr. Bermudez, “even someone who is more genetically protected” might
be affected. The child who is really going to be adversely affected, though, and who is most likely to develop an
eating disorder is the genetically vulnerable child exposed to the promotive environment.
Dr. Bermudez speculates that what we’re seeing now is a cultural shift from a “protected” environment to a
“promotive” environment and notes, “in a lot of ways we’re seeing the same thing in other areas: childhood
obesity, diabetes, and respiratory illnesses. My sense is that we are changing, the earth is supporting
seven billion of us and that brings all kinds of added challenges, not only from a physical, and environment
standpoint, but from an emotional and socio-cultural point of view.”
Dr. Bermudez cited 2010 findings from the American Psychological Association’s annual Stress in America,
survey, which found that the number one stressor on families is their financial situations, and that nearly
half of all children reported feeling saddened or worried about family problems. He calls it “stress by proxy,”
meaning that kids “are not living the financial difficulties to the extent that their parents are, “but they were
picking up the stress because we don’t live in isolation.” He adds, “the world in general, is becoming a more
stressful place to grow up, in. Everyone has access to mass media and there are things being promoted that
aren’t healthy, about body image, fitness, about the tolerance of violence.....and we know that exposure
matters.”
February 7, 2012
What’s Behind the Dramatic Rise in Childhood Eating Disorders Hospitalizations? |
Nancy Matsumoto
page 24
In addition to be bombarded by potentially triggering mass media messages, kids face other challenges: “social
competition, pressure to perform, to be multitalented, and engaged in so many things,” adds Dr. Bermudez.
The pace of change and the level of tension in our society, he believes, are creating a culture that’s very
difficult for our kids to get a stake in.” The message: “If you’re not a super go-getter, you may not make it,” and
not everybody takes that message well.
So what can parents do? “First of all,” says Dr. Bermudez, “alleviate stress for yourself, and for your family.
Maybe you do with less: work two jobs instead of three, and take care of yourself in appropriate ways.” (The
American Psychological Association Stress in America report notes that managing stress levels, eating right,
and getting enough sleep and exercise are key.)
Another thing: “Without kind of pushing your kid outside of the space within the bell curve, you want your kid
to skew toward the side of less intensity, and fewer expectations of immediate performance.” When he speaks,
Dr. Bermudez tells audiences, “I’m so grateful that a good chunk of my childhood was in Cuba, playing in the
streets and flying kites...I didn’t take any lessons...now kids take everything, and if they’re not doing that,
they’re out of the mix.”Instead of trying to cram in sports, arts, academic and enrichment programs all at once,
Dr. Bermudez suggests rotating them “rather than all of them all the time at all costs.”
Another way you can help counteract an increasingly “promotive” environment is to, as Marcia and I advise
in our book, model healthy attitudes and behaviors when it comes to food, eating, shape and size, and make
exercise an enjoyable and regular part of your lives.
It’s National Eating Disorders Awareness Week, and this year’s theme is “Everybody Knows Somebody.”
Increasingly, that “somebody” might be a woman in her 30s, 40s, 50s or beyond. Although eating disorders
often appear in adolescence, or (as I wrote in my last blog post) even earlier, they are also becoming more
prevalent among middle-aged and older women.
Emmett R. Bishop, MD, a founding partner and medical director of adult services at the Eating Recovery Center
in Denver, told me about the noticeable rise in older women seeking treatment for eating disorders at his
facility. Although hard data is hard to come by, Dr. Bishop, who has been treating eating disorders for 30 years
now, says, “I’ve been around long enough to see the trend, and we’re seeing considerably more” such older
women. At the time of my recent conversation with Dr. Bishop, at least six of the 28 or so inpatients at the
center were older women. Several were over 40, a couple patients were in their 60s and there was one 80-
year-old patient. Dr. Bishop called this a patient demographic “that you would not have seen ten years ago.”
Often, these patients have been in treatment before and are returning after a relapse. Usually there has been
a triggering incident, which might be a stressful life event such as divorce or medical illness. Gastrointestinal
illnesses that cause inadvertent weight loss can trigger a new onset of dieting, and “exacerbate a fight [the
patient] is already fighting,” explains Dr. Bishop.
In other cases, the eating disorder has been obvious to family members but ignored by all, until physical
complications make it impossible to do so anymore. When they do start, the physical problems can be
numerous. Years of under-eating leads to “deterioration of the body, which leads to everyone becoming
alarmed,” says Dr. Bishop. “It’s a common theme in this group: body decline.” Even so, Dr. Bishop notes that
February 27, 2012
Rise in Middle-Aged and Older Women with Eating Disorders | Nancy Matsumoto
page 25
February 9, 2012
Eating Disorders Treatment Saves Lives: An Interview with Scarlett Ramey | Julie
Holland
these patients are most often coerced by their families to come in for treatment, whether because of shame or
entrenched denial, or both.
The pattern among patients in their 30s and 40s, however is different. Often worried about the effect of
their eating disorder on their children, they are more motivated to seek treatment on their own. Dr. Bishop
frequently hears the comment, “I’m concerned about what kind of example I am for my teen-aged daughter.”
In many cases, the daughter is also struggling with eating issues, he notes, but there are also the instances
“where I’ve had daughters come in and react in opposition. For as many who identify with their mothers, there
are those who react and want their mother to ‘get her act in order,’ so to speak.”
The physical symptoms that tend to affect the long-term eating disorder patient, says Dr. Bishop are
gastrointestinal and bladder dysfunction. If a patient has purged for years, chronic esophageal problems
demand treatment, while long-term food restriction can lead to constipation-related issues that are very
difficult to treat. Dr. Bishop is puzzled as to why bladder problems are so prevalent among the long-term eating
disorder patient, but says it’s been an emerging issue, “even among patients in their forties.”
Another condition Dr. Bishop says is prevalent among “the chronically semi-starved individuals,” as he puts
it, is poor cognition, noting, that besides lack of clear thinking, “it’s hard for them to shift gears [mentally].”
Even though insurers can be reluctant to cover nutritional rehabilitation for such patients, Dr. Bishop has seen
dramatic improvements in cognition with nutrition counseling and weight restoration, and an increase in
motivation to get better on the patient’s part. His belief, one that clinicians often must do battle with insurers
to uphold, is: “We should never give up on patients.”
Only one in 10 men and women with eating disorders receive treatment.* Only 35 percent of people
with eating disorders that receive treatment are doing so at a specialized facility for eating disorders.**
Understanding the importance of seeking treatment is a crucial step in the recovery process. I thought it would
be interesting to hear another treatment professional’s point of view on eating disorders treatment and what it
means for lasting recovery.
So today my colleague, Scarlett Ramey, MS, RD, CD, founder and president of Ramey Nutrition (www.
rameynutrition.com), shares her thoughts on qualified eating disorders treatment and what it can mean for an
individual struggling with anorexia, bulimia or binge eating disorder.
Question: Why do you think eating disorders treatment is so important?
Answer: Our society has a growing concern with body image. It’s becoming one of the most important
determinants of self worth and identity. Eating disorders treatment helps people to understand what their true
self worth is and deal with their body image issues and eating disorders behaviors. Treatment also helps to
empower patients so they can see an enjoyable life without the eating disorder. Additionally, treatment raises
page 26
awareness of eating disorders and serves as an educational tool for friends and families wanting to know more
about the diseases affecting their loved one.
Q: What about treatment do you believe is so valuable to the patients?
A: For someone seeking inpatient or residential eating disorders treatment, I think the most beneficial part
is the 24/7 care provided by a medical treatment team. A chronic eating disorders patient requires constant
medical care and observation in order to break the eating disorders behaviors and move forward.
There are so many “parts” to treating eating disorders, from the different types of therapies to the meal plans,
but each “part” has its place—as long as the patient is present and willing. Not every therapy is right for every
patient, but allowing the patients the option to express themselves through body movement or art projects
creates a treatment plan and atmosphere that the patient can embrace and make the most of.
For individuals seeking treatment, remember to do your treatment center research. Different centers do
different “parts” of treatment really, really well. Make sure the treatment center you decide on fits your
individual needs, medically and emotionally.
Q: What advice do you have for individuals seeking eating disorders treatment?
A: My advice to an individual needing treatment: You’re worth it. It’s no secret that treatment can be
expensive, hindering it for some. For this reason, I tell all my patients that they’re worth the treatment; they’re
worth living. Taking the step to treatment is scary and patients need to feel someone “in the corner” as they
make those decisions.
For the family of someone needing treatment, I think they want to have all the answers about eating disorders
to feel supportive. These are complex, mental illnesses and families don’t need to understand them completely
to support a loved one in treatment. It’s also important to note families need their own therapy too. As a
family member, when your wife, husband, son or daughter is struggling with anorexia or bulimia, you’re
struggling too. Many treatment centers offer family support groups; I encourage you to take advantage of
these groups and deal with your own questions and concerns.
Q: When do you think eating disorders treatment is most successful?
A: Nobody is ever excited to go to treatment, even if you’re making the choice for yourself. So, in order
to increase the chance treatment is successful, I believe a patient needs an ongoing support group that
encourages them to push through with treatment. By validating a patient’s feelings and telling him or her,
“you’re right, you need this treatment,” the patient feels supported and confident in his or her decision to seek
treatment.
Additionally, the collaborative approach to treatment with an entire team of medical professionals, from
doctors to therapists to nutritionists, helps effectively address the biological, psychological and sociological
parts of eating disorders.
Q: Anything else you’d like to share about eating disorders treatment?
A: At Ramey Nutrition, we don’t offer 24/7 care for our patients, so when those patients return home and
transition out of inpatient or residential care, we strive to make that transition as seamless as possible. At
treatment centers like Eating Recovery Center, a patient arrives back home with a full report on their treatment
program and experience helping the “aftercare” treatment team – people like me – continue the care and
treatment plan a patient has become accustomed to while in a treatment center.
Thank you, Scarlett, for sharing your experiences with eating disorders treatment. It’s always great to hear
another colleague’s point of view on the reasons qualified treatment is so important.
page 27
Comment below with your own advice for individuals seeking treatment or people helping a friend or loved one
make that important step towards recovery.
--
*Ruth Striegel-Moore, et al., One year Use and Cost of Inpatient and Outpatient Services Among Female and Male Patients with an
Eating Disorder: Evidence from a National Database of Insurance Claims, International Journal of Eating disorders 27 (2000).
**Characteristics and Treatment of Patients with Chronic Eating Disorders, by Dr. Greta Noordenbox, International Journal of Eating
Disorders, Volume 10:15-29, 2002.
February 14, 2012
Are Models Too Thin? A Look at the Fashion Industry’s Efforts to Ensure Healthy
Runway Models | Julie Holland
Twenty years ago the average fashion model weighed 8 percent less than the average woman. Today she
weighs 23 percent less.*
As this season’s fashions were revealed at Fashion Week, which began February 9, I commend the Council of
Fashion Designers of America (CFDA) for taking a stand to prevent eating disorders through its model health
guidelines. Every year for the past five years, the CFDA releases model health guidelines, which designers are
encouraged to follow, in order to ensure girls under the age of 16 aren’t hired to walk in the shows and address
the concern that some models are unhealthily thin. While unhealthily skinny models continue to be hired by
designers, these guidelines represent a small step in the direction of making a healthful change.
In the CFDA’s Health Initiative, Diane Von Furstenberg, CFDA president, stresses the importance of all designers
sharing the responsibility of protecting women and encouraging positive body image by emphasizing that
“beauty is health.” According to the CFDA, the Health Initiative is about awareness, education and safety, not
policing. Although a specific body mass index isn’t required to work, models are recommended to receive
regular medical care to ensure their wellbeing.
A brief overview of the CFDA Health Initiative’s guidelines:
Support the well being of younger individuals by not hiring models under the age of 16 for runway•	
shows.
Develop workshops for the fashion industry (models and their families) to raise awareness about eating•	
disorders including their warning signs, complications and treatment options.
Provide healthy meals and snacks backstage at Fashion Week and at shoots. In addition, offer fitness•	
and nutrition education.
Source: New York magazine’s fashion blog, The Cut**
It’s my hope that guidelines such as these will spur cultural change in the fashion industry, and encourage
designers to place health above size. Changing the idea of “size zero fashion” and society’s warped views of
what is “healthy” and “beautiful” won’t happen overnight. But everyone – from individuals to the fashion
industry – is responsible for urging that change along. Remember, it’s not what you’re body looks like; it’s what
it can do for you. Embrace the unique.
Are you concerned about a friend or loved ones potential disordered eating habits? Visit the Eating Recovery
Center website to confidentially chat with a member of the Intake Team and have all your questions answered.
page 28
How will you appreciate your body and embrace a change in society this Fashion Week? Comment and share
below!
--
*http://www.foxnews.com/entertainment/2012/01/11/new-magazine-editorial-highlights-shocking-differences-between-plus-size-
and/
**http://nymag.com/daily/fashion/2012/01/cfda-releases-model-health-guidelines.html
February 20, 2012
Parenting a Healthy Body Image | Julie Holland
Childhood is a place for dreams, imagination and growth. It’s the time in life when we’re free to let our natural
curiosities take the wheel as we bloom both physically and mentally.
As parents, we play a significant role in encouraging this growth as our children go through every day, learning
about the world around them. In our society, which is hyper-focused on dieting methods and unattainable
beauty ideals, the role of parenting is especially important in children’s development of a realistic and healthy
body image. Knowing this, parents should monitor how they speak and act around their children; it’s a key
factor in ensuring that each child receives a chance to develop a healthy self-concept and body image.
Here are some quick tips to jumpstart your success as a healthy body image role model:
Avoid dieting.1.	 Dieting is an unrealistic way of thinking for children. In order to help your child develop a
healthy understanding of food as nourishment, provide well-balanced, healthy meals and avoid labeling
certain foods as “diet foods” or “good” or “bad” foods.
Make regular exercise fun for everyone.2.	 We all have those days where we dread the very thought of
exercise. It’s human nature! However, it’s important to remember how our own attitudes can easily rub
off on our children. Try referring to exercise as a healthy activity rather than a means to lose weight. In
doing this, you can lead by example and plan family trips to the park, pool or local recreation center.
Remember that exercise doesn’t just occur in the gym or on the treadmill. There are many fun and
exciting family activities that involve body movement.
Practice positive self-talk.3.	 Children are notorious for mimicking observed behaviors; after all this is how
they learn. Although negative “fat talk” may come as second nature every now and then, these small
comments could have an intense affect on your child’s own body image down the road. Instead, aim to
offer comments of confidence and positivity. Remember, you’re beautiful and so is your child.
Develop a consciousness of others.4.	 Growing up, our parents always told us, “If you have nothing
nice to say, don’t say anything at all.” Well, they were right. This idea is just as important for parents
to practice as their children. Negative comments about the size and shape of others might lead our
children to believe there’s a certain way the human body is supposed to look. Guide your child to
define his or her own positive definition of beauty.
Not only will these tips lead you to model a healthy body image for those around you, but you’ll also find
the positivity improving your own health and happiness. If you’re concerned about a friend’s or loved one’s
negative body image, visit Eating Recovery Center’s website to learn more about what a negative body image
can do to your overall perception of self.
What healthy changes or improvements will you make to your own body image behaviors to ensure a positive
environment for your child? What do you already do that you are proud of? Comment and share below!
page 29
February 27, 2012
National Eating Disorders Awareness Week: It’s Time to Heighten Our Awareness
and Increase Our Understanding Because ‘Everybody Knows Somebody’ | Julie
Holland
More than 10 million women and 1 million men currently struggle with an eating disorder. The significant
– and growing – prevalence of eating disorders in the U.S. makes eating disorders awareness extremely
important, especially as we observe this year’s National Eating Disorders Awareness Week (February 26-March
3) with the theme, “Everybody Knows Somebody.”
Eating disorders are the deadliest mental illnesses and they can have a damaging effect on an individual’s
body image, self-esteem and mental health. During this National Eating Disorders Awareness Week, as well as
for the rest of the year, I invite you to educate yourself and loved ones about eating disorders and help raise
awareness of these diseases, which can alter the lives of men, women, boys and girls.
Remember, eating disorders can happen to anyone, regardless of their age or gender. As eating disorders
continue to grow in “nontraditional” demographics, it’s important to be aware of eating disorders warning
signs and vigilant for unhealthy food- and body-focused behaviors in all of the people you love.
During National Eating Disorders Awareness Week, we should all make an effort to recognize risky behaviors
associated with eating disorders and learn how we can all provide support for individuals of all ages and
genders who struggle with anorexia, bulimia, EDNOS or binge-eating disorder. Please join me in reducing the
stigma that surrounds eating disorders by learning to recognize five passive behaviors or mindsets that may
indicate that someone has an eating disorder.
Although I have previously discussed a few of these on my blog, National Eating Disorders Awareness Week
puts them at the forefront of our minds.
Cycles of Dieting.1.	 Repetitive cycles of dieting can go hand-in-hand with patterns of weight fluctuation.
For some, this constant change in weight may lead to the development of body image problems and
can even trigger the development of an eating disorder.
Family History.2.	 If a woman’s sister or mother has anorexia, she is 12 times more likely to develop the
illness and four times more likely to develop bulimia. It’s especially crucial for these individuals to be
conscious of disordered behaviors such as over-exercise and unhealthy attitudes toward food.
Labeling.3.	 It’s important to be aware of how we label foods and food groups. Placing “good” or “bad”
labels on foods because of their nutritional make-up could lead to unhealthy attitudes and patterns of
consumption. Rather, we should focus on moderation.
Negative Talk.4.	 Making negative comments about our own appearance or the appearances of those
around us can contribute to the development of an eating disorder or hinder eating disorders recovery.
These comments can affect ourselves and those around us, like our children and loved ones.
Food Habits.5.	 Emotional, reward or punitive ties to food can foster an unhealthy relationship with
those foods or food groups. Instead of using food to reward positive behavior, refer to it as fuel to help
develop a positive mindset.
Visit www.nationaleatingdisorders.org for more information about National Eating Disorders Awareness Week
and learn how you can get involved across the country.
page 30
February 9, 2012
Eating Disorders: Hope for Recovery | Susan Hickman
Dr. Johnson did a recorded interview for Susan Hickman’s radio show on eating disorders, treatment
and recovery.
See the CD at the back of this clipbook for full audio.
For additional support and resources on eating disorders recovery and a complete listing of National
Eating Disorders Awareness Week events sponsored by Eating Recovery Center, visit the website at www.
EatingRecoveryCenter.com.
How will you help raise awareness and reduce stigma surrounding eating disorders this week? Comments and
share below!
February 15, 2012
Is Your Teen into the eTriggers Trend? | Julie Weingarden Dubin
Tech Triggers
Though not a clinical term, eTriggers is a shortened
way of referring to electronic- or technology-based
activities that could potentially trigger someone
to engage in dieting, exercise or disordered eating
behaviors, says Ovidio Bermudez, M.D., the medical
director of child and adolescent services at Eating
Recovery Center in Denver, Colorado.
Kids and teens may use game consoles, computers,
tablets and phones to study diet and exercise
techniques. For example, calorie-counting smart
phone or tablet apps that manage calorie intake or
exercise-focused video games that measure current
weight and calories burned. Healthy when used in
moderation, but when taken too far, they can enable
page 31
damaging behaviors.
In addition, there’s a myriad of websites, such as pro-anorexia or pro-bulimia websites or forums, that offer
harmful tips to help children and adolescents learn and practice disordered eating behaviors, Dr. Bermudez
adds. It’s important to recognize that these activities do not “cause” eating disorders. Eating disorders are
complex, heritable diseases that involve bio-psycho-social factors, says Dr. Bermudez. “These triggers can
simply kick-start one behavior that may be taken to an extreme, and they can serve as enablers for unhealthy
food- or exercise-focused behaviors that have already begun.”
They want to be the best
Through websites, phone apps, games and social media forums,
technology can trigger or enable an eating disorder. “An important
part of the mindset of individuals struggling with eating disorders is a
desire to learn ‘how to do it better’ and how to compete with others,”
says Dr. Bermudez. “Both of these can be cemented by accessing
information related to losing weight.”
Plus, they compare themselves to other people with eating disorders
and motivate themselves to “do it better” by learning new ways to
drop weight and bond with others around their successes or failures
in eating disorders behaviors.
Need to Know
It’s not just kids genetically predisposed to eating disorders who
have to worry about the dangers of e-Triggers. Any kid can get lured in. Parents are ultimately responsible
for monitoring the appropriateness of their kids’ screen use.Keep an open dialogue with your children about
healthy habits and technology.
Be aware of the technology your kids have access to and the amount of time they spend using it on school
days and weekends. Keep an open dialogue with your children about healthy habits and technology.
February 17, 2012
Interview with Enola Gorham
Enola did a live interview about eating disorders and warning signs while traveling in Nashville.
See the CD at the back of this clipbook for full video.
page 32
Four in 10 Americans have either suffered from or know someone who has suffered from an eating disorder,
according to the National Eating Disorders Association. During National Eating Disorders Awareness Week
(February 26-March 3), Eating Recovery Center ( www.EatingRecoveryCenter.com), an international center for
eating disorders recovery, highlights eating disorders pervasive impact on Americans of all ages and genders.
A classic misconception of eating disorders is that they are a teenage girls disease, when in fact, we are seeing
more older women, younger children and men of all ages entering treatment, said Kenneth L. Weiner, MD,
FAED, CEDS, founding partner, chief executive officer and chief medical officer of Eating Recovery Center.
Genetic risk factors and environmental triggers for these diseases don’t discriminate based on age or gender.
The 2012 National Eating Disorders Awareness Week theme is Everybody Knows Somebody, which is truer now
more than ever, as eating disorders and body image dissatisfaction continue to experience what experts term
epidemiological drift, which is marked by a conditions swift growth in incidence in new populations.
Older women: Eating Recovery Center has seen a marked increase in older women seeking treatment•	
for eating disorders. From 2010 to 2011, admissions of women over the age of 30 increased from
27 percent of total admissions to 33 percent of total admissions. In the same timeframe, admissions
of women over the age of 40 increased from 13 percent of total admissions to 15 percent of total
admissions.
Men: A recent British study shows that more than 80 percent of men regularly engage in conversation•	
about their bodies, that three in five men are unhappy with their muscularity and that more than one-
third of men would trade a year of their life to achieve their ideal body weight or shape.
Younger children: From 1999 to 2006, hospitalizations for eating disorders increased sharply 119•	
percent for children younger than 12 years of age, according to recent analysis by the Agency for
Healthcare Research and Quality.
Its important to be aware that eating disorders can happen to anyone—men, older women and younger
children, continued Dr. Weiner. Do not discount disordered eating behaviors or concerning body image issues
just because they are displayed by an individual believed to be outside of the traditional eating disorder
demographic.
Eating Recovery Center encourages individuals to quickly respond if they notice troubling food- or body
image-oriented behaviors in their loved ones, regardless of age or gender. Eating disorders recovery is entirely
possible with early intervention and proper treatment from qualified professionals.
If you notice troubling behaviors in an adult friend or loved one•	 , find a quiet time and place for a
private, respectful meeting to discuss your concerns; and ask if he or she has considered whether or
February 21, 2012
Eating Recovery Center Raises Awareness of Eating Disorders in “Nontraditional”
Groups During NEDAW
**Digital Outreach**
page 33
not he or she may have an eating disorder. While you continue to express your support, offer to help•	
your friend or loved seek treatment.
If you notice troubling behaviors in your child or adolescent•	 , engage your child in conversation
and speak to what you have noticed instead of making accusations; visit a medical provider if you
are concerned about your childs physical health; and identify a mental health provider for an eating
disorders assessment.
For more information about National Eating Disorders Awareness Week, visit www.nationaleatingdisorders.
org.
Join Eating Recovery Center at these events during National Eating Disorders Awareness Week:
An annual candlelight vigil honoring those who have passed away from eating disorders, hosted by The•	
Eating Disorder Foundation, Thursday, March 1, A Place of Our Own, 1901 E. 20th Ave., Denver, Colo.
Mind and Body Fair, hosted by the University of Northern Colorados Womens Resource Center,•	
Monday, February 27, 10 a.m. to 1 p.m., Greeley, Colo.
Eating Recovery Center Patient Art Show, February 27 to March 2, an exhibition of patient artwork,•	
1830 Franklin Street, Denver, Colo.
A National Eating Disorders Awareness Week informational table in the Colorado State University•	
Student Center, Wednesday, February 29, 8 a.m. to 5 p.m.
National Eating Disorders Association Walk, hosted by The Eating Disorder Network of Central Florida,•	
Saturday, March 3, Orlando, Fla.
February 24, 2012
What to Do If Your Friend Has an Eating Disorder | Jennipher Walters
The signs are all there. Your friend is intensely afraid of being
fat, she talks nonstop about how many calories are in her food
and what she weighed this morning, and she’s starting to avoid
situations where she’s expected to eat. While you don’t know for
sure, you start to get worried that your friend might be developing
— or already be suffering from — an eating disorder.
It’s a tricky subject. You want your friends to be healthy and you
want to be fit with them, but what happens if your best friend
starts to take it too far? Do you stand up and say something? Do
you risk hurting your friendship or making her angry and pushing
her away?
It’s worth it to speak up even if you’re not sure, says Bonnie
Brennan, clinical director of Eating Recovery Center’s Adult Partial
Hospitalization Program.
page 34
“I think that it is a mistake not to address your concerns with a friend for fear of hurting his or her feelings,”
Brennan says. “If a friend does not have an eating disorder and is offended by your inquiry, that emotion will
usually last a very short time, even a few minutes. On the other hand, if you are correct about your friend’s
eating disorder, you may be saving a life, as eating disorders have the highest mortality rate of any other
mental illness.”
With numbers of those suffering from eating disorders on the rise and societal pressure to be a certain size
at a fever pitch, it’s estimated by the National Eating Disorders Association (NEDA) that as many as 10 million
females and 1 million males in the United States are fighting a life and death battle with an eating disorder
such as anorexia or bulimia, and millions more are struggling with binge eating disorder. That’s why the
theme to this year’s National Eating Disorders Awareness Week — which is this week — is “Everybody Knows
Somebody.”
“I often have patients lament that no one ever challenged them or said anything,” Brennan says. “They will
admit that they might have reacted angrily at the time but that it is more painful to think that no one cared or
that others were afraid of them.”
Although the signs of an eating disorder vary from person to person, Brennan says, they can include an
intense fear of being fat, weight loss, avoiding situations in which expected to eat food, using the bathroom
directly after a meal, excessive exercise, having conversations that are highly centered on food or calories or
weight, “having to” prepare separate meals, and fear of not knowing what ingredients are included in foods
(such as at a restaurant).
So just how do you go about talking to a friend who might be suffering? Brennan recommends finding a neutral
setting and time to meet, and then expressing your concerns and asking if anything has been particularly
distressing to her lately.
“When speaking with your friend, use non-judgmental language and ‘I’ statements,” she says. “It is OK to point
out behaviors and emotions you have lately noticed, but avoid blaming or shaming. Be prepared to listen and
don’t try to problem solve. Offer to help your friend find a professional to talk to.”
If your friend acts negatively or defensively, Brennan recommends reminding her that you care for her and
that you’d rather ask about the troubling behaviors than let them go unnoticed. Then, offer to talk when she’s
ready and be available if she wants your help. If your friend admits that he or she is struggling, offer to help
him or her find a professional, she says.
“Avoid playing the food police,” she says. “Rather, ask your friend if he or she needs support if you notice that
he or she eats too little or too much.’
It’s important to also understand that eating disorders are not a choice, Brennan says. They are biologically
based mental illnesses, and some people are genetically hard-wired to be more at risk for an eating disorder
than others. Furthermore, eating disorders in men is on the rise, so don’t rule out the possibility of an eating
disorder with your male friends if the signs are there.
Bottom line, one of the most important things you can do as a friend is to let your friend know he or she is
loved and accepted by you, even if he or she is suffering from an eating disorder, Brennan says. And it’s always
best to speak up — because it might save your friend’s life.
Have you ever confronted a friend about disordered eating? Would you? Is there a friend you might talk to
after reading this?
page 35
February 28, 2012
NEDA Week: Eating Disorders In Midlife | Margarita Tartakovsky
Misinformation about eating disorders abounds. One of
the most common myths is that eating disorders largely
affect young, white girls.
But EDs don’t discriminate. They affect people of any age,
race, religion size, shape and sex.
Today, I want to focus on an often neglected group:
women in middle age. Even when it’s recognized that
middle-aged women struggle with eating disorders, the
talk almost always turns to cultural pressure. While there
is increasing pressure for women to stay young and be
slim, eating disorders are more complex than the desire
for a certain silhouette.
As I said yesterday, eating disorders are a complex interplay of genetics, biology and environment.
Below, Enola Gorham, LCSW, CEDS, clinical director of adult services at the Eating Recovery Center, shares
her insight on eating disorders in middle age. She discusses why more middle-aged women are seeking
professional help for eating disorders, why EDs affect them, the unique challenges of treatment and more.
Q: I’ve read that more and more middle-aged women are seeking help for eating disorders. Why do you
think that is?
A: There has most likely always been a large group of women who have had eating disorders, but were
never diagnosed because doctors and therapists were not trained in the disorder. Recent attention to eating
disorders has resulted in most doctors and high school counselors being “on the lookout” for symptoms of
eating disorders in their younger populations. The older women, those who have had this disorder long before
it was a “looked-for” diagnosis, often just struggled with it.
Many women spent time working with their doctors trying to find a medical reason for their eating issues.
Doctors simply did not look for eating disorders in older/adult women. A doctor’s training would have him
or her look to IBS or other medical issues. Also, bulimia has only been listed as an official diagnosis since the
1980s, so it is a relatively new diagnosis. The eating symptoms of individuals who previously suffered from this
disorder likely would not have been identified as an eating disorder.
We now are seeing more older women seek treatment because the diagnostic criteria is understood by more
doctors, and doctors are increasingly looking beyond the “classic” young girl population as the only ones who
can develop eating disorders. Also, there are many women who have had eating disorders for a long time, and
“continue” to be in treatment as they enter middle age. In addition, there are those that have never had
page 36
treatment, knew they needed it, but were focused on their families, their children and so on, and did not get
treatment for themselves until something became acute.
Q: Why do eating disorders affect people in middle age?
A: We are seeing that there are some personality traits that predispose people to use management of food
to try to relieve some other issue in their lives. Perfectionist, persistent, type A and anxious women have the
traits that set them up for trying to manage food and finding that it helps them to feel better emotionally.
Because of their perfectionist, persistent traits, they will engage in food management behaviors even more and
will end up triggering a vicious cycle of trying to manage emotions with food management.
If they also have co-morbid disorders such as obsessive-compulsive disorder (OCD) or depression, they become
even more trapped in trying to apply their food management rules to make themselves feel better.
Most middle-aged women have most likely been doing some version of trying to manage uncomfortable
emotions with food for most of their lifetimes. They might get treatment at middle age because someone
recognized the disorder, they recognized the disorder in themselves and finally can spend time getting help or
their family is negatively affected and they can no longer ignore the problem.
I think it is a minority of women who “start” their eating disorder in middle age. This could happen from a
major life stressor, like trauma, which places them in a hyper vigilant, controlling/protecting stance. In this
case, they begin to use food to manage the resulting emotions. A life transition – such as kids leaving home
or parents dying – could also cause a middle-aged woman to turn to using food management, which then
becomes a process she cannot stop.
Q: What are the biggest myths about eating disorders in middle age?
A: Eating Recovery Center’s patients range in age from 10 to 81. The popular notion of an “eating disordered
patient” is: young, white and affluent. However, the truth is far from this misconception. I think the previous
notion of “young, white and affluent” had to do with after school specials, and the large number of studies on
eating disorders that were conducted on younger girls with anorexia, due to the fact that anorexia was easier
to visibly notice in younger girls and it was easiest to do ongoing work with younger girls due to concerned
parents bringing them into treatment.
Q: Do eating disorders manifest differently across age such that people in middle age may show different signs
and symptoms or their course may be different? Are there unique challenges to treating EDs in middle age?
A: Middle-aged women can be very hard to treat because, first, they are invested in the idea that their eating
disorder is actually a medical problem, and they struggle to see how this is a psychological problem.
Second, they also can be caught in the belief that eating disorders only impact young girls, so they are
fearful that the treatment will not apply to them, or that they will not fit into eating disorders treatment
environments.
Middle-aged women may have had the illness for a very long time, and it is a very ingrained coping
mechanism, so for many, it can be hard to even imagine stopping. Also, if they have been relatively functional
in life — well employed, a parent, etc. — they may struggle with why they need to do the hard work to get
well, and quickly give up and return to the illness.
Finally, the illness may have cost them a great deal in their life, and it is just too hard for them to take an
accounting of this, and easier to stay ill.
page 37
The illness itself does not tend to be different, except that as we age, we all have less of an ability to bounce
back physically, so natural aging issues can make the illness more complex and treatment needs to address
more areas of physical issues. In addition, because the illness may have impacted a woman’s life for a longer
time, they will likely have more mental and emotional “clean up” to do.
Q: What would you like readers to know about treatment?
A: Though the specific life circumstances of a young patient and an older patient may differ, treatment is
essentially the same for older women as it is for younger women. Based on the acuity of the illness, the first
priority is to ensure that patients are medically and psychiatrically safe.
At Eating Recovery Center, we then individualize nutritional, medical and psychiatric interventions, and work
with patients in individual and group therapy sessions to help them learn how to accept themselves, their
thoughts and their feelings, and live a valued life beyond their eating disorder.
Q: Anything else you’d like readers to know about EDs in middle age?
A: Regardless of age, the sooner an individual enters treatment, the better her chances are for a positive
outcome and lasting recovery. If you think a loved one may be struggling with an eating disorder, urge them to
get an assessment from a qualified professional sooner rather than later.
—
Thanks so much to Enola Gorham for speaking with me!
February 29, 2012
How do you know if you have an eating disorder? | Nancy Melear
Dr. Weiner did a live, in-studio interview about eating disorders and the associated warning signs for
National Eating Disorders Awareness Week.
See the CD at the back of this clipbook for full video.
March
2012
page 39
March 2, 2012
The Takeaway: Older Americans Rejecting Marriage; Anorexia and Aging | Elizabeth
Nolan Brown
Sociologists Wonder: Who Will Care For Single Seniors? A growing number of older men and women are
“opting out” of marriage, the New York Times reports. Since the 1990s, the divorce rate for boomers has
climbed more than 50 percent, even as it stabilized among other age groups. Meanwhile, less adults got
married in the first place. The result is a surprising number of Americans in their 50s and 60s heading into old
age sans spouse.
Most of the reasons for this shift are positive: Boomers have felt less social pressure to marry, or to stay in
marriages that aren’t working. Woman are increasingly financially independent. People are living longer.
But we need to pay attention “not only to the factors that precipitate (this shift), but also to the
consequences,” said Susan L. Brown, co-director of the National Center for Family & Marriage Research at
Bowling Green State University. An analysis conducted by Brown and colleagues found that in 2010, about a
third of adults ages 46 through 64 were divorced, separated or had never been married. This is up from 13
percent in 1970.
Because the post-boomer generations have far lower marriage rates than their elders, sociologists expect the
number of single seniors to rise sharply in coming decades—and the trend could drastically transform our
traditional portrait of aging in America. Unmarried older adults lack a partner to rely on for care, and with
family caregiving (and retirement savings) down also, governments and social services agencies will have
to shoulder an increasing responsibility for senior care. Stats show unmarried boomers are five times more
likely to live in poverty as married counterparts, and three times as likely to receive food stamps or disability
benefits.
Anorexia and Aging: This week is National Eating Disorder Awareness week, and one of the more interesting
NEDA stories I’ve seen is about eating disorders in the middle-aged. Folks tend to think about eating disorders
as a teen or young adult problem. Dr. Emmett Bishop, of Colorado’s Eating Recovery Center, said data on older
adults with eating disorders is scarce. But his center has seen an “upsurge” of older patients.
Margarita Tartakovsky at PsychCentral points out that “even when it’s recognized that middle-aged women
struggle with eating disorders, the talk almost always turns to cultural pressure. While there is increasing
pressure for women to stay young and be slim, eating disorders are more complex than the desire for a certain
silhouette.”
Friday Quick Hits:
• More than 9 million American retirees don’t have enough money to cover basic living expenses,
according to a new study.
• Many small business owners aren’t prepared for retirement: About a third have no personal or
business-sponsored retirement plan and haven’t estimated how much money they need for retirement.
page 40
• Grateful Dead 101? Florida Professor Barry Barnes believes the Grateful Dead can teach us a lot about
business and personal finance. A new book by the 68-year-old former Deadhead (“Everything I Know
About Business I Learned from the Grateful Dead”) explores the ‘innovative lessons’ he earned from
the band’s “marketing genius.”
• And the first LGBT senior center in New York City opened Thursday. “It is going to be … a beacon of
light all across this country,” said Michael Adams, executive directive of the nonprofit SAGE, which is co-
operating the center with the city Department for the Aging.
March 2, 2012
Tumblr Cracks Down on ‘Thinspiration’ Blogs | Annie Hauser
“Let me be empty and weight less and maybe I’ll find some peace tonight.” That rather disturbing mantra is
the message behind Thinspox, a hugely popular Tumblr account that posts a steady stream of images of stick-
thin women who serve as “thinspiration,” or inspiration to lose weight, for the account’s followers. These blogs
promote weight loss, often through unhealthy means, and idealize models, dancers, and women on the street
who have waif-like figures.
In response to the popularity of this blog and dozens like it, Tumblr is considering a new policy of prohibiting
blogs that “actively promote self-harm.” As part of the possible new guidelines, Tumblr enlisted the National
Eating Disorders Association to help craft language to display next to self-harm searches. The NEDA seeks to
remind Tumblr users and anyone struggling with an eating disorder that they are not lifestyle choices, but
rather “mental disorders that when left untreated, can cause serious health problems, and at their most severe
can even be life-threatening.”
Some critics believe Tumblr’s new policy limits free speech — and won’t do much curb the problem. One
critical article wrote that “pro-eating disorder websites do not cause eating disorders … if you think censoring
these websites will lead more women to recovery, consider whether people fought in wars before there was
violence on TV.”
Still, Julie Holland, MHS, CEDS, of the Eating Recovery Center in Denver, Colo., applauds Tumblr for its decision
to stand up against self-harm. “Tumblr’s policy is promoting and encouraging wellness and prevention instead
of encouraging promotion of illness and self-harm,” Holland says. “I love the statement they have chosen to
include about eating disorders as a mental disorder. This goes back to the lack of understanding among a large
portion of the population about the genetic component of eating disorders.”
In addition to Tumblr, eating disorder awareness educators are concerned about a similar “thinspiration”
subculture that’s developing on the photo-sharing platform Pinterest. Pinterest, which has only been around
since 2011, contains thousands of photos of thin women, often nude with protruding ribs, tagged as “workout
inspiration,” or “thinspiration.” The theoryBusiness Insider’s Jim Edwards espouses is that now that thinspo
material is being banned from Tumblr, this pro-ana (shorthand for pro-anorexia) community needs somewhere
to go.
page 41
March 2, 2012
Eating Disorders In Middle Age Bring Unique Challenges, Treatments | Mary Kate
Sheridan
While young women are often the faces of eating disorders,
diseases such as anorexia, bulimia and binge eating can affect
any age -- and recent data suggest the numbers are rising
among middle-aged women. The issue is in the spotlight in the
U.S. during National Eating Disorders Awareness Week, which
runs through March 3.
Post 50 women with eating disorders, known as “EDs,” may face
unique emotional and physical issues. “Women at mid-life now
have unprecedented opportunities and also unprecedented
stresses,” Merryl Bear, director of Canada’s National Eating
Disorder Information Centre, told the Toronto Star. “There’s an
increased fear of aging and societal pressures to change one’s
body to bring it closer to the societal ideal.”
From 2001 to 2010, the rate of EDs among the middle-aged increased by 42 percent, said Holly Grishkat,
Ph.D., regional assistant vice president and director of The Renfrew Center in Radnor, Pa., an eating disorder
treatment center.
An Australian study published in 2008 also revealed a rise in eating disorders in older adults, particularly with
binge eating and food restriction. The study found that in adults between 55 and 64, binge eating increased
from 1.7 percent in 1995 to 7.4 percent in 2005, and strict dieting or fasting increased from zero percent in
1995 to 9.7 percent in 2005.
While concerning, these numbers may largely reflect individuals with histories of eating problems, rather than
new cases, experts say. Many who face eating disorders in midlife have confronted them in the past. In fact, 94
percent of middle-aged women who are anorexic developed the disorder when they were younger.
“It’s rare -- not impossible, but rare -- for a woman 50 or beyond to develop an eating disorder for the first
time,” said Dr. Margo Maine, clinical psychologist and co-author of “The Body Myth: Adult Women and the
Pressure to Be Perfect.” “Most in their 50s and 60s are women who had eating disorders when they were
younger.”
That doesn’t mean middle-agers’ experiences with eating disorders are the same, however. Since EDs are
frequently associated with younger women, older adults may be ashamed to admit that they have these
disorders. As one middle-ager confided on a message board: “People always refer to bulimia as an adolescent
disease; I feel like such a failure that I’m almost 50.”
page 42
Grishkat believes shame is a significant component of eating disorders in middle age. “I think women who are
coming out with it in midlife feel like ‘I should be the role model here and not the one with the disorder,’” she
said.
Older women often remain silent during group therapy sessions with younger women, Grishkat added.
Acknowledging these struggles, Renfrew has created a program called “30-Something And Beyond,” which
is specifically for adult women who suffer from EDs. This in-patient program places women with roommates
of a similar age and in therapy groups that focus on issues more likely to affect middle-agers. (Renfrew also
provides outpatient, midlife-focused therapy groups.)
Through this program, Renfrew can focus on triggers that are specific to its middle-aged patients.
One such trigger is loss, which “tends to be a big underlying factor for eating disorders,” Grishkat said. Midlifers
may be dealing with a range of loss, from ailing and dying parents to children moving out, to divorce -- factors
that may not resonate with the younger generation.
One post 50 who has dealt with loss and an eating disorder is Mary Sponhaltz, who discussed her experience
with The Eating Disorder Center of Denver. Sponhaltz struggled with anorexia in the wake of her father’s death
from cancer. Over three years, Sponhaltz tended to her father, leaving her husband and children for long
periods.
“I was already worn thin emotionally and losing weight drastically when he was alive because I wasn’t taking
care of myself,” Sponhaltz told The Eating Disorder Center of Denver. “But once he died, the eating disorder
kicked in. It numbed me so I wouldn’t have to feel.”
Aging is another potential trigger. Physical changes in midlife may cause or reignite eating disorders. As
psychiatrist Anne E. Becker -- director of the Eating Disorders Clinical and Research Program at Massachusetts
General Hospital and president of the Academy for Eating Disorders -- recently told Harvard Women’s Health
Watch:
As our society values youth and as baby-boomers reinvent what it means to be middle-aged,
there are growing social forces that can undermine older women’s self-esteem and potentially
lead to body dissatisfaction — for example, if you think the surface of your skin or the contours
of your body aren’t supposed to match your chronological age. That, combined with health
concerns about obesity, can make people feel bad about their bodies and, in turn, could result
in eating strategies that undermine well-being.
In an Austrian study of 475 women between 60 and 70 years old, published in the International Journal
of Eating Disorders in 2006, 45 percent of the women indicated that their self-esteem depended on their
shape and weight. The same study revealed that “over 60 percent [of the women] stated ‘moderate’ or ‘low’
satisfaction with weight and shape.”
This pressure to maintain youth may stem from the culture in which post 50s grew up. Dr. Blake Woodside,
director of Toronto General Hospital’s in-patient eating disorder program, told the Toronto Star that the
increase in midlife eating disorders can be traced to the ‘60s, when ideals changed and the “thin is in” culture
materialized.
page 43
March 5, 2012
Tweens and Technology: Eating Disorders in the Internet Age | Julie Holland
Today, technology and social media are more readily available to our tweens and teens than ever before. From
smart phones to tablets to laptops, our kids can take the best – and the worst – of the Internet wherever they
go.
As parents, we must be mindful of what is available online and what our kids are accessing as it can be highly
influential on a tween’s developing mindset and self-esteem.
Finding unhealthy solace in online communities.
Eating disorders are very secretive diseases that can often initially go unnoticed until disordered eating
behaviors or other warning signs become more obvious. In the interim, many tweens struggling with eating
disorders turn to websites commonly referred to as “pro-ana” or “pro-mia” websites. These sites provide
struggling tweens with “advice” on losing weight and social support when unhealthy weight loss goals are met.
Pro-eating disorders websites can push someone on the verge of an eating disorder over a dangerous edge.
What are all those apps on your child’s smart phone?
Calorie counting and exercise applications are easily accessible—many are even free. When used wisely
Whatever the cause, eating disorders can have serious side effects, including osteoporosis, heart problems
and gastrointestinal issues. In a recent interview with Life Goes Strong, an online site for midlifers, Dr. Emmett
Bishop, MD, FAED, CEDS -- founding partner and medical director of adult services at the Eating Recovery
Center -- outlined some specific health issues that middle-agers with EDs may face:
Older individuals have much less resilience when it comes to physical damage from eating
disorders. A lot of things can go wrong with vital organs, bone density can be impacted, dental
health can suffer, and as tissues become less elastic, I’ve seen people aspirate from purging. A
whole host of medical issues can arise as people abuse their bodies over time. Eating disorders
are the deadliest mental illnesses and premature death is very common.
Older women also face somber statistics when it comes to EDs and death. Senior women comprise 78 percent
of all deaths caused by anorexia, and the average age that women die from the disease is 69.
But middle-agers with EDs shouldn’t give up. “There’s hope,” Grishkat said. “Even if you’ve had [an eating
disorder] for 30 years, our data show that the women in midlife and older tend to be more determined and
ready for recovery than a lot of the younger women.”
If you’re struggling with an eating disorder, call the National Eating Disorders (www.nationaleatingdisorders.
org) helpline at 1-800-931-2237.
To learn more about National Eating Disorders Awareness Week, click here.
page 44
and in moderation, these tools can keep you on track for maintaining a healthy weight and learning how to
healthfully manage in food and exercise. However, for someone genetically predisposed to an eating disorder,
smart phone and tablet apps can often act as an “eTrigger,” causing moderation to quickly spiral out of control
into restriction and other disordered eating or over-exercise behaviors.
Parents’ role in technology use.
Parents play an important role in monitoring their kids’ technology use. This includes maintaining an open
dialogue with their tweens and teens about what they see in the media and online, asking how they interpret
what they see and discussing what a healthy use of technology looks like. In addition, it’s important as parents
to model healthy technology use behaviors for our tweens and teens. If we’re overly absorbed in our phones,
laptops or tablets, how can we expect our children to know other ways of interacting with technology?
Technology isn’t all bad.
Technology – when used in a healthful way – can actually help to inspire eating disorders recovery. For
example, at Eating Recovery Center we use technology such as MP3 players and biofeedback video games to
help our patients learn how to manage anxiety and embrace lasting recovery.
In addition, although the Internet may have a plethora of negative images and information, there’s also plenty
of support for individuals who are in eating disorders recovery or overcoming body image issues. One of my
favorite sites is something-fishy.org. This website is dedicated to raising awareness about eating disorders and
reminding individuals with an eating disorder that they aren’t alone and can experience lasting recovery.
In fact, I think that’s a very important detail to remember: lasting eating disorders recovery is possible,
especially with early intervention. If you’re concerned about a child’s eating behaviors or curious about
offhand comments about body shape and size, visit the resources section on Eating Recovery Center’s website.
These resources can arm you with vital information about eating disorders and help you discover how to
broach the subject with your child
Comment and share below how you’re using the online space to better your body image and self-esteem!
March 12, 2012
Tumblr’s Ban on Pro-Ana and Pro-Mia Websites | Julie Holland
“Thinspiration” is a term often used by individuals who engage in disordered eating behaviors, such as
restricting, over-exercising or bingeing and purging. Using pictures of unnaturally thin males and females as
weight loss “inspiration,” these individuals strive to achieve unrealistic body ideals. Often, they engage in these
behaviors in a community setting through pro-anorexia and pro-bulimia websites, commonly referred to as
pro-ana and pro-mia websites.
Pro-ana and pro-mia websites can be incredibly damaging, because they reinforce, validate – and even applaud
– eating disordered behaviors. One online resource has become aware of the prevalence of these sites and is
taking a stand to minimize their harm.
Taking action against pro-ana and pro-mia
Late last month, Tumblr, an online forum that lets users effortlessly share anything, began removing user blogs
that promoted or glorified self-harm behaviors, such as eating disorders, self-mutilation or suicide. This action
has met with mixed reviews.
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Eating Recovery Center 2012 Clipbook

  • 2. Table of Contents January.................................................................................................. **Digital Outreach: pages 14-16 February................................................................................................. **Digital Outreach: pages 32 & 33 March..................................................................................................... **Digital Outreach: pages 50 & 51 April........................................................................................................ **Digital Outreach: n/a May.......................................................................................................... **Digital Outreach: pages 80 & 81 June........................................................................................................ **Digital Outreach: pages 91 & 92 July......................................................................................................... **Digital Outreach: pages 98, 99, 103, 104 August..................................................................................................... **Digital Outreach: pages 113 & 114 September.............................................................................................. **Digital Outreach: n/a October.................................................................................................... **Digital Outreach: page 135 & 136 November............................................................................................... **Digital Outreach: pages 150 & 151 December................................................................................................ **Digital Outreach: n/a page 4 to 19 page 21 to 37 page 39 to 51 page 53 to 68 page 70 to 81 page 83 to 93 page 95 to 105 page 107 to 117 page 119 to 128 page 130 to 142 page 144 to 153 page 155 to 171
  • 5. page 5 January 1, 2012 The Fear of Food | Lindsey Koehler
  • 6. page 6 In a previous blog, I shared the concept of the three As in the recovery process: ADMITTING you have a problem, becoming AWARE of when you are engaging in the behavior and taking ACTION to change. For most of us in recovery, taking the first step to admit we have an eating disorder is difficult enough; however, taking the additional step to share our story with someone else is an entirely different issue in itself. Whether or not you share your struggles is a personal choice. However, in my own experience, discussing the issues with others can be crucial in developing a strong support system throughout your recovery process. I would like to share some points to consider when talking to others about your eating disorder and/or disordered eating behaviors. I hope you find them helpful and meaningful. Understand your “intent” in sharing.• Be clear from the beginning why you want to share with this person and the details you’re willing to share. You can’t be certain as to an individual’s response; therefore, set realistic expectations and be prepared for any reaction. Also, be willing to ask for what you need from the individual, as he or she may not know how to support you. Consider your audience.• How you approach a family member, friend or a colleague may differ. Be thoughtful in how and where you decide to have the conversation. Make sure there is appropriate time available for you to share your thoughts and feelings. If needed, have a support person with you when you share your story. Provide educational and support materials.• It’s important that individuals are educated about eating disorders; many people don’t understand the complexities of these diseases, which can lead to saying the wrong thing. By offering support materials such as pamphlets, books or websites for the person you’re telling about your eating disorder, you can help him or her better understand what you’re going through. Location, location, location.• Be sure to find a quiet place to talk away from distractions. Distractions will only make the situation more difficult for both of you. Communicate effectively.• Prepare yourself and what you want to say, be focused and speak in a clear voice. Let the person know that what you’re saying is important and you’d like them to listen closely. Give the individual time to absorb what you’re saying.• Hearing that a friend or loved one is struggling with disordered eating behaviors or body image issues can be startling at first and a lot to take in. Give the individual a few minutes to process what you’re saying. Discuss next steps.• A common question after telling someone about your eating disorder is “What do you and/or we need to do now?” Perhaps you want the individual’s assistance in moving forward with a treatment plan; so be prepared to discuss your treatment options and plans. For some helpful treatment resources, see my previous blog, “Getting Help for Anorexia and Bulimia: Eating Disorder Resources You Can Use.” Be kind to yourself.• Give yourself praise for taking this big step. Remember, it takes courage, strength and bravery to tell others our story. My hope is that in sharing your story, you’ll continue to gain the support you need to build lasting recovery. For additional support, you can always contact the Clinical Assessment Team at Eating Recovery Center. For those of you who have shared your story with others, what were some things you did to get the support you needed? January 2, 2012 Telling Your Loved Ones “I Have an Eating Disorder” | Julie Holland
  • 7. page 7 For most people, each new year brings about a new set of resolutions for change; changes in our lives, our ambitions or ourselves. My advice: Why make the same ‘resolutions’ that typically are unsuccessful? Instead, forget a ‘resolution’ and each day make a commitment to being healthy and living happily in every part of your life. Far too often New Year’s resolutions focus on weight loss or diet in an attempt to kick start the new year and the “new” you. I think it’s far more important to focus on who you are and what you can do rather than how you look. It’s time to make a commitment to improve who you are as a person, rather than a resolution to change yourself. Here are a few recommendations for facing each day with a positive focus: Make healthier choices for your body through movement.1. Instead of taking the elevator, try taking the stairs. You’re sure to have an extra bounce in your step when you reach your office. Instead of circling endlessly in the mall parking lot searching for the perfect, close parking spot, go ahead and take that spot near the back of the lot. Focus on what your body does for you, rather than how it looks.2. Recognize the strength of your body and praise it for what it’s capable of doing for you each and every day. This year, shift the focus of exercise away from burning calories or losing weight. Instead, find an activity you enjoy – dancing, horseback riding, hiking – and experience what your body can do. Remember and use your five senses when making food choices.3. Look at your food, smell your food, touch your food and listen to what is happening during each meal. Enjoy the process of eating and move way from labeling food as “good” or “bad.” Look at how far you’ve come, not how far you have to go.4. Maybe one of your commitments for 2012 is to find a new job or buy a house, but it just isn’t happening right away. That’s OK. Focus on what you’re actively doing to meet those goals, whether it’s looking through the want ads, revising your resume or saving money each paycheck for a down payment. These small steps each day will help you meet your commitment. Just give it time and be kind to yourself. At Eating Recovery Center, we strive to help patients realize how far they’ve come with eating disorders treatment and what an amazing commitment they’ve made to their health by seeking treatment. It’s not an easy path to take, but it’s certainly not impossible. So let’s start with nixing New Year’s resolutions and instead make commitments to be healthier each and every day. What healthy commitments are you going to make starting today? And, how will you start your day differently tomorrow? I look forward to hearing your comments. January 18, 2012 Nixing New Year’s Resolutions | Julie Holland There’s no argument that childhood obesity is a serious health concern. More than one-third of children ages 10-17 are obese or overweight* and obesity rates among U.S. children grew from 14.8 percent in 2003 to 16.4 percent in 2007.** Obesity is related to more than 20 major chronic diseases, including heart disease and diabetes, and January 24, 2012 Anti-Obesity Ads: How Far is Too Far in Addressing Childhood Obesity? | Julie Holland
  • 8. page 8 children who are obese are more than twice as likely to die prematurely before the age of 55 compared to healthy-weight children.*** Education and nutritional intervention is key to combating childhood obesity rates; however, are anti-obesity ads effective in addressing the issue or are they crossing a line into body shaming? As some of my readers may already know, I struggled with eating disorders from the time I was seven years old through much of high school. From a very young age I battled with negative body image and a low self-esteem; being perceived by my peers as the “fat girl in class” was never easy. This perfect storm of factors triggered an onset of binge eating disorder, anorexia nervosa and bulimia nervosa until I was nearly 20 years old. Many obesity prevention campaigns promote balance and moderation, practices I agree with and that I think we can all support. However, a recent anti-obesity campaign in Georgia has come under fire for, according to critics, shaming and stigmatizing children who are obese. It probably goes without saying that this anti-obesity campaign hits close to home for me. Although I’ve been in recovery from my eating disorder for 30 years now, maintaining a positive body image and self-esteem is something I work on each and every day. When I see TV ads identifying overweight children as “fat” and placing a negative connotation on that label, I worry about what someone genetically predisposed to an eating disorder might think and feel. Many people – including children – are at a higher risk of developing an eating disorder, either because eating disorders run in their family or because they have a temperament that’s more susceptible to eating disorders development. For these individuals in particular, any number of events or life experiences can trigger disordered eating behaviors or a full-blown eating disorder. Having someone tell you, “you’re fat” or “you need to lose weight” can be emotionally and mentally traumatizing, especially for a child. We need to be extremely cautious in how we approach the childhood obesity epidemic so as not to stigmatize our children or make them feel less valued or loved. Because obesity – with its associated health risks – is a growing health issue, it’s certainly an issue to be addressed. However, it’s equally important that we accept body diversity and ensure that obesity prevention efforts take into account our children’s body image and self-esteem. Healthy bodies come in all shapes and sizes. If you’re concerned your son, daughter, friend or loved one may have an eating disorder, visit www. EatingRecoveryCenter.com to chat confidentially with a member of our Intake Team and get all your questions answered about eating disorders and eating disorders treatment. What do you think of the anti-obesity ads? Comment and share your thoughts below! -- *http://healthyamericans.org/report/88/ **http://healthyamericans.org/reports/obesity2010/ ***http://healthyamericans.org/reports/obesity2010/
  • 9. page 9 Women aren’t the only ones who struggle with body image issues. New research revealed that 35 percent of men would sacrifice a year of their life to achieve an ideal body weight or shape. This study, collaboratively conducted by the Centre for Appearance Research (CAR) at UWE Bristol, The Succeed Foundation and Central YMCA*, examined British men’s attitudes toward their appearances. Researchers found that more than four in five men (80.7 percent) regularly engage in conversation about one another’s bodies and that most are unhappy with their muscularity. The study, which was released in December 2011, also found that more than half (58.6 percent) of men said that “body talk” affects them personally and mostly in a negative way. Findings of this nature underscore the importance of breaking down “body ideals” and reinforcing body acceptance at any shape or size for both women and men. You’ve all heard me talk about “fat talk” on the blog and discuss how critical it is to be aware of the body-focused comments we make about ourselves. Talking about having a “fat day” or rejoicing when you fit into your “skinny day jeans” can have a profound and negative impact on your own body image as well as on the body image of those around you. The same goes for the male-focused body-related comments we make. Noting a “six pack” versus a “beer belly” or calling someone “chubby” can elevate male body image issues and cause men to strive for an unrealistic body ideal. For both women and men, it’s time for us to stop placing value judgments on the way we look and start appreciating our bodies for what they can do. Are you concerned about your own body image or does a friend seem to be preoccupied with body image issues? Visit Eating Recovery Center’s website to get your questions answered or chat confidentially with a member of our Intake Team. -- *http://www.sourcewire.com/releases/rel_display.php?relid=69377 January 30, 2012 STUDY: Body Image Issues Aren’t Just for Women Anymore | Julie Holland January 3, 2012 Eating Disorders and College Freshmen Dr. Kenneth L. Weiner was interviewed for a morning show segment about eating disorders and college freshmen as they return home for the holidays. See the CD at the back of this clipbook for full video.
  • 10. page 10 January 5, 2012 College Students Can Face Eating Disorders | Sarah Jones
  • 11. page 11 January 10, 2012 The Truth Behind Common Eating Disorder Myths | Ken Weiner A recent study revealed that 40 percent of Americans have themselves experienced or know someone who has experienced an eating disorder, such as anorexia or bulimia.* Despite rising awareness among the general population and health care professionals alike, misconceptions about these serious diseases, which have the highest mortality rate of any mental illness, remain pervasive.** Myth: Eating disorders revolve around food. Truth: Eating disorders are complex illnesses with biological, psychological and sociological underpinnings. While behaviors associated with eating disorders may begin with a fixation on calories and weight, eating disorders generally stem from issues beyond food and body size. They also signify an attempt to control something of substance in an individual’s life. The mistaken belief that eating disorders are about food compels friends and loved ones to encourage individuals to “just eat,” when in fact, the disorder from which they’re suffering is incredibly complex. Myth: Eating disorders are an illness of choice. Truth: Eating disorders are a mental illness, and no one chooses to have an eating disorder. The women, girls, men and boys suffering from eating disorders are generally wonderful people with a horrible illness. They’re often the best and the brightest and come from good families that care deeply about their well-being. On the surface, these individuals look like they have everything in the world going for them, and
  • 12. page 12 recovering from the disease is far more complicated than simply making healthy lifestyle choices. Myth: Eating disorders aren’t serious illnesses. Truth: The mortality rates associated with eating disorders are higher than any other mental illness, including depression, bipolar disorder and schizophrenia. Anorexia nervosa, which is characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight, is the most lethal eating disorder. Half of one percent of patients die every year from anorexia, and it has a mortality rate of 20 percent within 20 years, meaning that one in five people that have had anorexia for two decades will die as a result of the illness. Even for patients whose eating disorders don’t prove fatal, there are often severe medical complications associated with starvation and purging, including bone disease, cardiac complications, gastrointestinal distress, organ failure and infertility. Myth: Dysfunctional families cause eating disorders. Truth: While previous models of eating disorders treatment viewed families and dysfunctional dynamics therein as a contributing cause of these illnesses, the community has moved away from the blaming of families toward an understanding that families aren’t a cause, but rather an integral part of eating disorders recovery. While families don’t cause eating disorders, these illnesses have been shown to run in families and are as inheritable as bipolar disorder and schizophrenia. Between 40 and 50 percent of the risk of developing an eating disorder is genetic, and a woman with a mother or sister who has anorexia is 12 times more likely than the general population to develop the disease and four times more likely to develop bulimia nervosa. Those that develop an eating disorder likely had a latent genetic predisposition toward the illness and a precipitating event, such as going on a diet, a traumatic event or significant life change, triggered their anorexia, bulimia or related disorder. Myth: Eating disorders are a women’s illness. Truth: While eating disorders involve many women’s issues and females represent a large part (90 percent) of the affected population, research suggests that male eating disorders now account for at least 10 percent of all cases. Interestingly, despite significant biological, psychological and sociological differences between men and women, the etiology of eating disorders remains fairly constant between the two genders. Like in their female counterparts, eating disorders in men and boys are genetic in nature and are often supported by psychological and sociological pressures such as traditional gender roles and socially accepted ideas about masculinity. Eating disorder myths can prevent individuals, families and professionals from recognizing these illnesses and seeking appropriate treatment. Education and awareness are the strongest antidotes for misinformation, and promoting a better understanding of eating disorders among the general public and the healthcare community can support early identification, effective intervention and lasting recovery for the men, women and children suffering from eating disorders. Learn more about eating disorders and debunk eating disorders myths here. -- *http://www.nationaleatingdisorders.org/uploads/statistics_tmp.pdf **http://www.huffingtonpost.com/kenneth-l-weiner-md-faed-ceds/eating-disorders_b_872057.html
  • 13. page 13 January 12, 2011 Parents: Important Advice About Your College Student and Eating Disorders | Pamela Cytrynbaum Eating Disorders Can Be Fatal: Here’s What Parents Should Say and Do If They Think Their Child Has an Eating Disorder College students have tremendous pressures on them these days. As parents and grandparents we read, hear and worry a lot about binge drinking and drug use on college campuses. There are quieter but equally destructive – in fact, even deadly – ways college students are harming their health as well: eating disorders. In Parents: 10 Winter Break Warning Signs of Eating Disorders in Your College Students, I shared expert advice on what parents should look out for while your college students are home for the holidays. Experts stressed that parents and other family members should be “vigilant,” especially with college freshmen. Here, I’d like to share more expert advice on what to do and say if you suspect a loved one is suffering from an eating disorder — especially a college student coming home for visits. Maybe they are starving themselves with anorexia or bingeing and purging with bulimia. Or both. Whatever disordered relationship they may have with food, it means they are in crisis, in pain, and need your intervention. Elizabeth Easton, PsyD, is the clinical director of child and adolescent services at Eating Recovery Center. She offers some “dos and don’ts” for parents or other family members who become concerned about a loved one’s eating habits. As Dr. Easton explains, there are two possible scenarios as your loved one returns home from college for a visit and you suspect an eating disorder: Signs and Symptoms: Weight Loss and Depression: “Your loved one has lost a significant amount of weight, become very isolative or socially withdrawn and appears more pre-occupied with weight and/or food.” Obsession with Exercise: “Additionally, there’s a significant change in his or her exercise drive and/or compensatory behaviors (vomiting after eating, abuse of diet pills or laxatives, etc…). These behaviors often mean the person is more entrenched in the eating disorder and is relying on eating disorders behaviors to cope with stress, depression and anxiety.” Eating Little, and in Ritualized Ways: Maybe he or she is eating a small amount but is cutting it into tiny pieces, eating in some private pattern.
  • 14. page 14 If this sounds like your child: What To Do: “The first priority is your child’s physical health. Your son or daughter needs to be taken to a physician for an assessment (current weight versus ideal, any weight loss since leaving for college, current blood work and vitals). If your child refuses to go to the medical appointment or cooperate with the assessment, stress how critical it is to be healthy, especially if he or she wants to successfully return to school the next semester. In other words, if he or she wants to return to independent life back at school, he or she needs to demonstrate that he or she can manage his or her health and well-being through cooperating with the process.” Parents Stay Focused on Health: “Parents should focus on what needs to be done, rather than simply asking, “Are you OK?”. Kids can easily ‘skate’ around yes or no questions and give parents answers without details. Also, he or she may not be willing – or capable – to identify the illness and engage in the treatment process. They often need others to take the lead and help them face this issue head on.” Be Firm: “Parents need to be firm and stay involved. If you are concerned about your child’s health and potential for an eating disorder, tell your son or daughter what’s going to happen, instead of asking for permission. For example: ‘In an hour (or tomorrow or this afternoon), we’re going to see a physician and explore what’s going on with your weight and overall medical functioning. We need to make sure you’re healthy.’” Some Kids ‘Wake Up’: “Parents should also remember that some kids will ‘wake up’ when they find out there’s a medical concern. Other kids, especially those who are deeply entrenched in the eating disorder, will see it as a challenge and hear the confirmation of weight loss as a motivator to continue to use the eating disordered behaviors.” Stay Connected - Be Supportive and Tough: “Although parents should be firm, it’s important to stay involved and acknowledge the stressful and painful process your child is going through. Making threats such as he or she can’t return to school until they “get better” can be shaming for a child and won’t foster productive conversations. Instead, validate how hard and invasive the assessment and treatment process can be, while firmly insisting that you’ll be there to support them and follow through on getting them the help they need. In my next post, Dr. Easton explains what to do if your child or loved one falls into a second category of possible eating disorders. January 17, 2012 Parents’ New Year’s Resolution Weight Loss Behaviors Can Contribute to Eating Disorders in Children As millions of Americans resolve to lose weight in 2012, parents’ new diet and fitness regimens may have an unintended, negative outcome—triggering disordered eating behaviors or body image issues in their children. Because children often will mirror what they observe in their adult counterparts, Eating Recovery Center, an international center for eating disorders recovery providing comprehensive treatment for anorexia, **Digital Outreach**
  • 15. page 15 bulimia and binge eating disorder, urges parents to be mindful with their food- and body-focused words and behaviors while undertaking New Year’s resolutions. “Children and teens are very susceptible to picking up value judgments about body shape and size,” said Elizabeth Easton, PsyD, clinical director of Child and Adolescent Services at Eating Recovery Center. “If we teach them – through dieting, over-exercise behaviors and critiques of our own bodies – that there is a ‘good’ body type, then that is exactly what children will strive for at all costs if they are susceptible to an eating disorder or poor body image.” According to the National Eating Disorders Association, weight and body consciousness among children begins at very young ages, with research finding that 81 percent of 10-year-olds are afraid of being fat and 46 percent of 9- to 11-year-olds are “sometimes” or “very often” on diets. More than one-third of “normal dieters,” many of whom begin dieting at young ages, progress to pathological dieting, a condition marked by continual dieting and from which 20 to 25 percent of individuals develop eating disorders. When considered alongside a recent Thomson Reuters and National Public Radio poll, which reveals that one-third of Americans have made a New Year’s resolution to lose weight in the last five years, this research illustrates the perfect storm parents can unknowingly initiate by adopting aggressive or unhealthy weight loss regimens. Eating Recovery Center encourages parents to follow these four tips to model healthy behavior, help their children embrace healthy attitudes about their bodies and minimize the chances that children will adopt negative thoughts and behaviors related to food and body image. Do not diet.1. Instead, resolve to eat healthier, well-balanced meals. Through their own behaviors, parents can teach children how to focus on moderation without rigidly labeling foods as “good” or “bad.” Shift your perspective on exercise.2. Instead of looking at exercise as a dreaded weight loss tool, approach it as a fun activity for feeling good and improving overall health. Plan family outings and activities and children will follow their parents’ example. Be aware of comments you make about your body.3. Children are far more astute than parents may give them credit for, and they often mirror observed behaviors. Offhand comments about having a “fat day,” failing at your weight loss resolution or feeling too snug in an old pair of jeans can have a bigger effect on a developing child’s body image than many may think. Be aware of comments you make about others.4. Criticizing others for “gaining a few pounds” over the holidays or complimenting someone for resolution-driven weight loss can lead children to believe that there are “good” and “bad” body shapes and sizes. “Because eating disorders have a genetic component, children with a family history of anorexia, bulimia or binge eating disorder are particularly susceptible to negative diet- and body-focused words and actions,” explains Dr. Easton. “In these children, seemingly innocent body image comments or dieting behaviors can quickly spiral out of control.” Parents are encouraged to seek an eating disorders assessment if they notice troubling food- or body image- oriented behaviors in their children. Recovery is entirely possible with early intervention and proper eating disorder treatment from qualified professionals.
  • 16. page 16 January 17, 2012 Parents’ New Year’s Resolution Weight Loss Behaviors Can Contribute to Eating Disorders in Children **Digital Outreach**
  • 17. page 17 January 20, 2012 Status Update Could your weight loss #resolution have unintended consequences for your kids? Find out more! http://bit. ly/Amxh5b January 12, 2012 Does Your Child Have an Eating Disorder? | A.V. Flox Eating disorders affect five to ten million young and adult women and one million men in the United States. What is a parent to do when we suspect our child may be exhibiting symptoms of disordered eating? Come to think of it -- what are symptoms of disordered eating? To answer these questions, I called up Liza Feilner, a licensed professional counselor and senior therapist at the Eating Recovery Center’s Child and Adolescent Behavioral Hospital who for nine years has been working inpatient with individuals suffering from eating disorders. A lot of us don’t always have the opportunity to observe our children’s eating behaviors throughout the day, meeting up with them only at dinner time. In the following list, Feilner offers some tell-tale signs that a child may be exhibiting symptoms of an eating disorder. “Remember, you’re looking for changes to previous patters that they’ve set with their eating,” says Feilner. Symptoms of disordered eating Weight loss or weight fluctuation. These are well-known indicators, though Feilner warns that neither of these in themselves are the only determinant that somebody is struggling with an eating disorder.
  • 18. page 18 Significant changes in food behavior. “If suddenly they’re cutting out a particular food group, that may signify a change in food behavior,” warns Feilner. “For example, they may cut out fats or carbs or certain foods and begin getting more rigid with what they are willing to eat.” Limiting intake. “I already ate.” “I’m not very hungry tonight.” If your child is consistently skipping meals or otherwise trying to limit their food intake by pushing food around the plate or taking really small bites to make it seem like they are eating, watch closely for other symptoms of disordered eating. Ritualistic behavior. Eating disorders tend to turn the consumption of food into a very rigid ritual. Any peculiar eating behaviors -- such as finishing one item on the plate before moving on to another, for example -- should signal a parent to become more observant. Overindulgence. If your child is getting several helpings of something -- and this is a change from their previous behavior -- it might indicate binging. “Usually people who are binging will be drawn to what they have identified in their minds as ‘bad’ foods, so overindulging might involve desserts or carbs, of whatever they believe to be ‘worse’ for them,” says Feilner. Increased time spent in the bathroom. Any increase in the amount of time spent in the bathroom, or going to the bathroom immediately after a meal could be a sign that your child is purging. “Vomiting is a way to purge,” says Feilner. “But you also need to be aware of other forms of purging. Is there any evidence of laxative use or diuretics?” Rigidity in exercise behaviors. There is healthy working out and disordered working out. If a child is prevented from working out, does it cause them a disproportionate level of distress? “Most people would be inconvenienced if they couldn’t do their normal workout routine, but they would get on with their day,” says Feilner. “Somebody with an eating disorder has so much anxiety -- they’re using exercise to alleviate their guilt around food -- that they’ll become very agitated if they can’t exercise.” Changes is style of dress. “You see this go both ways,” says Feilner. “Some kids might start wearing more revealing clothes, showing off what they have accomplished, and other kids may start wearing really baggy clothes to hide weight loss.” Negative evaluations. You might hear your child talking more about their bodies, making comments about being fat or giving a generally negative evaluation of their appearance. Obsession with health. It’s important to mention that disordered eating doesn’t always look like a disorder. An emphasis on healthy eating can also lead to an increased preoccupation with food. “It almost is socially acceptable, because it looks like self-control or discipline, when in reality it might be making food increase in importance until their rules surrounding food and general preoccupation begin dominating their lives,” says Feilner. Increased involvement in food purchasing decisions. “Some kids will insist on going to the grocery store or going over the food labels,” says Feilner. “They want to exert some control over what is bought and consumed.” So what are some things a parent can do when they come across these behaviors? Communication, seeking support and being a good role model are key to responding to your child’s unhealthy eating behaviors:
  • 19. page 19 Response tactics Don’t take a heavy handed approach. Eating disorders are about more than food, emphasizes Feilner. “Don’t take a heavy handed approach and say, ‘you’re going to eat this.’ A more effective approach is expressing your concern,” she says. Show concern. “Don’t interpret their behavior for them,” says Feilner. “Mirror back their behavior by saying, for example, ‘I notice you’re going to the bathroom a lot after meals and I’m concerned that maybe you’re struggling and I’m wondering if something is going on. Why do you think you’re going to the bathroom so much?’ or ‘I notice that you’re losing weight and I’m worried about that.’ Express your concern in a way that invites conversation rather than says, ‘you’re doing this, therefore you have an eating disorder and you’re going to eat.’” Seek outside support. If you have evidence that your child is exhibiting disordered eating, seek outside support from a medical doctor who can assess your child; a dietician who can give some information about healthy meals and listen for some of the behaviors that can be problematic; and a therapist to discuss the underlying issues. “Ideally, you want people who already work together and can function as a team, but at the very least, seek people who are willing to communicate with each other. It’s really important to have a cohesive group of people who can support the kid and the family,” says Feilner. Watch your body judgments. Parents can impact on their children with their behaviors and attitude. Be mindful of your body attitudes, try to cut down on talk about weight and physical imperfections, and avoid assigning judgments to people based on their weight. “We see a lot of kids whose parents make negative comments about people who are overweight,” says Feilner. “Some kids internalize the fear that they may become a person who is rejected because of how they look.” Consider food attitudes. Assigning values to food, even simple labels like “good” and “bad” can inform disordered behaviors. This also extends to attitudes about people -- judging people based on their behavior with their food as “good” or “bad” can impact a child’s perception of consumption and later inform disordered eating. Beware your exercise habits. As a parent, you should model that exercise is healthy, but be careful not to show that it is connected to your ability to function. “One of the tells that exercise is becoming a problem is when a person can’t be without it for a day,” says Feilner. “If there is a disruption in a parent’s exercise routine are they distressed and upset? Showing your kids how to be flexible is important.” Careful with compliments. Limit the amount of compliments that are appearance-based. “You look thin.” “You’re very fit.” “I was that small when I was your age.” These body-focused comments are intended as compliments, but they shift an unnecessary amount of pressure on your child to maintain a physical ideal. Don’t assume. Eating disorders don’t just affect women. As mentioned above, there are at least one million men who suffer from disordered eating in the U.S. alone. Just because your child is a boy, or of normal weight, or even fit, does not mean they are immune to developing an eating disorder.
  • 22. page 22 February 1, 2012 Feeding Frenzy | Sunny Sea Gold
  • 23. page 23 One shocking recent statistic, released by the American Academy of Pediatrics in fall 2010, is that from 1999 to 2006, hospitalizations for eating disorders increased sharply - 119% - for children younger than 12 years old. The academy also noted significant increases in prevalence of eating disorders among minorities and males. I spoke to Ovidio Bermudez, MD, medical director of child and adolescent services at Denver’s Eating Recovery Center and a board member of The National Eating Disorders Association (NEDA). The 119 percent rise in hospitalizations for such young children, Dr. Bermudez said, is “likely to be a good proxy for a rise in incidence,” meaning that as incredible as it sounds, it probably accurately reflects the increase in the number of kids under 12 who are suffering from eating disorders, especially, as Dr. Bermudez points out, when you consider how carefully third-party reimbursing organizations scrutinize hospital stays, and how reluctant they are to okay them. The reasons for this scary rise in children’s hospitalizations, says Dr. Bermudez, are complex, the result of a variety of forces that have created a “perfect storm very likely related to changes in the environment and changes in people’s experience.” Here’s how Dr. Bermudez believes this “perfect storm” has taken shape: Imagine that we can divide children our society into two groups, one that is genetically protected from eating disorders (meaning they have no family history of them), and another that is “genetically vulnerable” (meaning there is a family history of such disorders). Suppose a child in the latter group grows up in a “protective environment,” let’s say where there is no dieting peer group, no obsession with fashion and popular culture, or perhaps no obsessively dieting parents. Such a child is not likely to develop an eating disorder. “If that environment is altered and becomes a ‘promotive environment,’” explains Dr. Bermudez, “even someone who is more genetically protected” might be affected. The child who is really going to be adversely affected, though, and who is most likely to develop an eating disorder is the genetically vulnerable child exposed to the promotive environment. Dr. Bermudez speculates that what we’re seeing now is a cultural shift from a “protected” environment to a “promotive” environment and notes, “in a lot of ways we’re seeing the same thing in other areas: childhood obesity, diabetes, and respiratory illnesses. My sense is that we are changing, the earth is supporting seven billion of us and that brings all kinds of added challenges, not only from a physical, and environment standpoint, but from an emotional and socio-cultural point of view.” Dr. Bermudez cited 2010 findings from the American Psychological Association’s annual Stress in America, survey, which found that the number one stressor on families is their financial situations, and that nearly half of all children reported feeling saddened or worried about family problems. He calls it “stress by proxy,” meaning that kids “are not living the financial difficulties to the extent that their parents are, “but they were picking up the stress because we don’t live in isolation.” He adds, “the world in general, is becoming a more stressful place to grow up, in. Everyone has access to mass media and there are things being promoted that aren’t healthy, about body image, fitness, about the tolerance of violence.....and we know that exposure matters.” February 7, 2012 What’s Behind the Dramatic Rise in Childhood Eating Disorders Hospitalizations? | Nancy Matsumoto
  • 24. page 24 In addition to be bombarded by potentially triggering mass media messages, kids face other challenges: “social competition, pressure to perform, to be multitalented, and engaged in so many things,” adds Dr. Bermudez. The pace of change and the level of tension in our society, he believes, are creating a culture that’s very difficult for our kids to get a stake in.” The message: “If you’re not a super go-getter, you may not make it,” and not everybody takes that message well. So what can parents do? “First of all,” says Dr. Bermudez, “alleviate stress for yourself, and for your family. Maybe you do with less: work two jobs instead of three, and take care of yourself in appropriate ways.” (The American Psychological Association Stress in America report notes that managing stress levels, eating right, and getting enough sleep and exercise are key.) Another thing: “Without kind of pushing your kid outside of the space within the bell curve, you want your kid to skew toward the side of less intensity, and fewer expectations of immediate performance.” When he speaks, Dr. Bermudez tells audiences, “I’m so grateful that a good chunk of my childhood was in Cuba, playing in the streets and flying kites...I didn’t take any lessons...now kids take everything, and if they’re not doing that, they’re out of the mix.”Instead of trying to cram in sports, arts, academic and enrichment programs all at once, Dr. Bermudez suggests rotating them “rather than all of them all the time at all costs.” Another way you can help counteract an increasingly “promotive” environment is to, as Marcia and I advise in our book, model healthy attitudes and behaviors when it comes to food, eating, shape and size, and make exercise an enjoyable and regular part of your lives. It’s National Eating Disorders Awareness Week, and this year’s theme is “Everybody Knows Somebody.” Increasingly, that “somebody” might be a woman in her 30s, 40s, 50s or beyond. Although eating disorders often appear in adolescence, or (as I wrote in my last blog post) even earlier, they are also becoming more prevalent among middle-aged and older women. Emmett R. Bishop, MD, a founding partner and medical director of adult services at the Eating Recovery Center in Denver, told me about the noticeable rise in older women seeking treatment for eating disorders at his facility. Although hard data is hard to come by, Dr. Bishop, who has been treating eating disorders for 30 years now, says, “I’ve been around long enough to see the trend, and we’re seeing considerably more” such older women. At the time of my recent conversation with Dr. Bishop, at least six of the 28 or so inpatients at the center were older women. Several were over 40, a couple patients were in their 60s and there was one 80- year-old patient. Dr. Bishop called this a patient demographic “that you would not have seen ten years ago.” Often, these patients have been in treatment before and are returning after a relapse. Usually there has been a triggering incident, which might be a stressful life event such as divorce or medical illness. Gastrointestinal illnesses that cause inadvertent weight loss can trigger a new onset of dieting, and “exacerbate a fight [the patient] is already fighting,” explains Dr. Bishop. In other cases, the eating disorder has been obvious to family members but ignored by all, until physical complications make it impossible to do so anymore. When they do start, the physical problems can be numerous. Years of under-eating leads to “deterioration of the body, which leads to everyone becoming alarmed,” says Dr. Bishop. “It’s a common theme in this group: body decline.” Even so, Dr. Bishop notes that February 27, 2012 Rise in Middle-Aged and Older Women with Eating Disorders | Nancy Matsumoto
  • 25. page 25 February 9, 2012 Eating Disorders Treatment Saves Lives: An Interview with Scarlett Ramey | Julie Holland these patients are most often coerced by their families to come in for treatment, whether because of shame or entrenched denial, or both. The pattern among patients in their 30s and 40s, however is different. Often worried about the effect of their eating disorder on their children, they are more motivated to seek treatment on their own. Dr. Bishop frequently hears the comment, “I’m concerned about what kind of example I am for my teen-aged daughter.” In many cases, the daughter is also struggling with eating issues, he notes, but there are also the instances “where I’ve had daughters come in and react in opposition. For as many who identify with their mothers, there are those who react and want their mother to ‘get her act in order,’ so to speak.” The physical symptoms that tend to affect the long-term eating disorder patient, says Dr. Bishop are gastrointestinal and bladder dysfunction. If a patient has purged for years, chronic esophageal problems demand treatment, while long-term food restriction can lead to constipation-related issues that are very difficult to treat. Dr. Bishop is puzzled as to why bladder problems are so prevalent among the long-term eating disorder patient, but says it’s been an emerging issue, “even among patients in their forties.” Another condition Dr. Bishop says is prevalent among “the chronically semi-starved individuals,” as he puts it, is poor cognition, noting, that besides lack of clear thinking, “it’s hard for them to shift gears [mentally].” Even though insurers can be reluctant to cover nutritional rehabilitation for such patients, Dr. Bishop has seen dramatic improvements in cognition with nutrition counseling and weight restoration, and an increase in motivation to get better on the patient’s part. His belief, one that clinicians often must do battle with insurers to uphold, is: “We should never give up on patients.” Only one in 10 men and women with eating disorders receive treatment.* Only 35 percent of people with eating disorders that receive treatment are doing so at a specialized facility for eating disorders.** Understanding the importance of seeking treatment is a crucial step in the recovery process. I thought it would be interesting to hear another treatment professional’s point of view on eating disorders treatment and what it means for lasting recovery. So today my colleague, Scarlett Ramey, MS, RD, CD, founder and president of Ramey Nutrition (www. rameynutrition.com), shares her thoughts on qualified eating disorders treatment and what it can mean for an individual struggling with anorexia, bulimia or binge eating disorder. Question: Why do you think eating disorders treatment is so important? Answer: Our society has a growing concern with body image. It’s becoming one of the most important determinants of self worth and identity. Eating disorders treatment helps people to understand what their true self worth is and deal with their body image issues and eating disorders behaviors. Treatment also helps to empower patients so they can see an enjoyable life without the eating disorder. Additionally, treatment raises
  • 26. page 26 awareness of eating disorders and serves as an educational tool for friends and families wanting to know more about the diseases affecting their loved one. Q: What about treatment do you believe is so valuable to the patients? A: For someone seeking inpatient or residential eating disorders treatment, I think the most beneficial part is the 24/7 care provided by a medical treatment team. A chronic eating disorders patient requires constant medical care and observation in order to break the eating disorders behaviors and move forward. There are so many “parts” to treating eating disorders, from the different types of therapies to the meal plans, but each “part” has its place—as long as the patient is present and willing. Not every therapy is right for every patient, but allowing the patients the option to express themselves through body movement or art projects creates a treatment plan and atmosphere that the patient can embrace and make the most of. For individuals seeking treatment, remember to do your treatment center research. Different centers do different “parts” of treatment really, really well. Make sure the treatment center you decide on fits your individual needs, medically and emotionally. Q: What advice do you have for individuals seeking eating disorders treatment? A: My advice to an individual needing treatment: You’re worth it. It’s no secret that treatment can be expensive, hindering it for some. For this reason, I tell all my patients that they’re worth the treatment; they’re worth living. Taking the step to treatment is scary and patients need to feel someone “in the corner” as they make those decisions. For the family of someone needing treatment, I think they want to have all the answers about eating disorders to feel supportive. These are complex, mental illnesses and families don’t need to understand them completely to support a loved one in treatment. It’s also important to note families need their own therapy too. As a family member, when your wife, husband, son or daughter is struggling with anorexia or bulimia, you’re struggling too. Many treatment centers offer family support groups; I encourage you to take advantage of these groups and deal with your own questions and concerns. Q: When do you think eating disorders treatment is most successful? A: Nobody is ever excited to go to treatment, even if you’re making the choice for yourself. So, in order to increase the chance treatment is successful, I believe a patient needs an ongoing support group that encourages them to push through with treatment. By validating a patient’s feelings and telling him or her, “you’re right, you need this treatment,” the patient feels supported and confident in his or her decision to seek treatment. Additionally, the collaborative approach to treatment with an entire team of medical professionals, from doctors to therapists to nutritionists, helps effectively address the biological, psychological and sociological parts of eating disorders. Q: Anything else you’d like to share about eating disorders treatment? A: At Ramey Nutrition, we don’t offer 24/7 care for our patients, so when those patients return home and transition out of inpatient or residential care, we strive to make that transition as seamless as possible. At treatment centers like Eating Recovery Center, a patient arrives back home with a full report on their treatment program and experience helping the “aftercare” treatment team – people like me – continue the care and treatment plan a patient has become accustomed to while in a treatment center. Thank you, Scarlett, for sharing your experiences with eating disorders treatment. It’s always great to hear another colleague’s point of view on the reasons qualified treatment is so important.
  • 27. page 27 Comment below with your own advice for individuals seeking treatment or people helping a friend or loved one make that important step towards recovery. -- *Ruth Striegel-Moore, et al., One year Use and Cost of Inpatient and Outpatient Services Among Female and Male Patients with an Eating Disorder: Evidence from a National Database of Insurance Claims, International Journal of Eating disorders 27 (2000). **Characteristics and Treatment of Patients with Chronic Eating Disorders, by Dr. Greta Noordenbox, International Journal of Eating Disorders, Volume 10:15-29, 2002. February 14, 2012 Are Models Too Thin? A Look at the Fashion Industry’s Efforts to Ensure Healthy Runway Models | Julie Holland Twenty years ago the average fashion model weighed 8 percent less than the average woman. Today she weighs 23 percent less.* As this season’s fashions were revealed at Fashion Week, which began February 9, I commend the Council of Fashion Designers of America (CFDA) for taking a stand to prevent eating disorders through its model health guidelines. Every year for the past five years, the CFDA releases model health guidelines, which designers are encouraged to follow, in order to ensure girls under the age of 16 aren’t hired to walk in the shows and address the concern that some models are unhealthily thin. While unhealthily skinny models continue to be hired by designers, these guidelines represent a small step in the direction of making a healthful change. In the CFDA’s Health Initiative, Diane Von Furstenberg, CFDA president, stresses the importance of all designers sharing the responsibility of protecting women and encouraging positive body image by emphasizing that “beauty is health.” According to the CFDA, the Health Initiative is about awareness, education and safety, not policing. Although a specific body mass index isn’t required to work, models are recommended to receive regular medical care to ensure their wellbeing. A brief overview of the CFDA Health Initiative’s guidelines: Support the well being of younger individuals by not hiring models under the age of 16 for runway• shows. Develop workshops for the fashion industry (models and their families) to raise awareness about eating• disorders including their warning signs, complications and treatment options. Provide healthy meals and snacks backstage at Fashion Week and at shoots. In addition, offer fitness• and nutrition education. Source: New York magazine’s fashion blog, The Cut** It’s my hope that guidelines such as these will spur cultural change in the fashion industry, and encourage designers to place health above size. Changing the idea of “size zero fashion” and society’s warped views of what is “healthy” and “beautiful” won’t happen overnight. But everyone – from individuals to the fashion industry – is responsible for urging that change along. Remember, it’s not what you’re body looks like; it’s what it can do for you. Embrace the unique. Are you concerned about a friend or loved ones potential disordered eating habits? Visit the Eating Recovery Center website to confidentially chat with a member of the Intake Team and have all your questions answered.
  • 28. page 28 How will you appreciate your body and embrace a change in society this Fashion Week? Comment and share below! -- *http://www.foxnews.com/entertainment/2012/01/11/new-magazine-editorial-highlights-shocking-differences-between-plus-size- and/ **http://nymag.com/daily/fashion/2012/01/cfda-releases-model-health-guidelines.html February 20, 2012 Parenting a Healthy Body Image | Julie Holland Childhood is a place for dreams, imagination and growth. It’s the time in life when we’re free to let our natural curiosities take the wheel as we bloom both physically and mentally. As parents, we play a significant role in encouraging this growth as our children go through every day, learning about the world around them. In our society, which is hyper-focused on dieting methods and unattainable beauty ideals, the role of parenting is especially important in children’s development of a realistic and healthy body image. Knowing this, parents should monitor how they speak and act around their children; it’s a key factor in ensuring that each child receives a chance to develop a healthy self-concept and body image. Here are some quick tips to jumpstart your success as a healthy body image role model: Avoid dieting.1. Dieting is an unrealistic way of thinking for children. In order to help your child develop a healthy understanding of food as nourishment, provide well-balanced, healthy meals and avoid labeling certain foods as “diet foods” or “good” or “bad” foods. Make regular exercise fun for everyone.2. We all have those days where we dread the very thought of exercise. It’s human nature! However, it’s important to remember how our own attitudes can easily rub off on our children. Try referring to exercise as a healthy activity rather than a means to lose weight. In doing this, you can lead by example and plan family trips to the park, pool or local recreation center. Remember that exercise doesn’t just occur in the gym or on the treadmill. There are many fun and exciting family activities that involve body movement. Practice positive self-talk.3. Children are notorious for mimicking observed behaviors; after all this is how they learn. Although negative “fat talk” may come as second nature every now and then, these small comments could have an intense affect on your child’s own body image down the road. Instead, aim to offer comments of confidence and positivity. Remember, you’re beautiful and so is your child. Develop a consciousness of others.4. Growing up, our parents always told us, “If you have nothing nice to say, don’t say anything at all.” Well, they were right. This idea is just as important for parents to practice as their children. Negative comments about the size and shape of others might lead our children to believe there’s a certain way the human body is supposed to look. Guide your child to define his or her own positive definition of beauty. Not only will these tips lead you to model a healthy body image for those around you, but you’ll also find the positivity improving your own health and happiness. If you’re concerned about a friend’s or loved one’s negative body image, visit Eating Recovery Center’s website to learn more about what a negative body image can do to your overall perception of self. What healthy changes or improvements will you make to your own body image behaviors to ensure a positive environment for your child? What do you already do that you are proud of? Comment and share below!
  • 29. page 29 February 27, 2012 National Eating Disorders Awareness Week: It’s Time to Heighten Our Awareness and Increase Our Understanding Because ‘Everybody Knows Somebody’ | Julie Holland More than 10 million women and 1 million men currently struggle with an eating disorder. The significant – and growing – prevalence of eating disorders in the U.S. makes eating disorders awareness extremely important, especially as we observe this year’s National Eating Disorders Awareness Week (February 26-March 3) with the theme, “Everybody Knows Somebody.” Eating disorders are the deadliest mental illnesses and they can have a damaging effect on an individual’s body image, self-esteem and mental health. During this National Eating Disorders Awareness Week, as well as for the rest of the year, I invite you to educate yourself and loved ones about eating disorders and help raise awareness of these diseases, which can alter the lives of men, women, boys and girls. Remember, eating disorders can happen to anyone, regardless of their age or gender. As eating disorders continue to grow in “nontraditional” demographics, it’s important to be aware of eating disorders warning signs and vigilant for unhealthy food- and body-focused behaviors in all of the people you love. During National Eating Disorders Awareness Week, we should all make an effort to recognize risky behaviors associated with eating disorders and learn how we can all provide support for individuals of all ages and genders who struggle with anorexia, bulimia, EDNOS or binge-eating disorder. Please join me in reducing the stigma that surrounds eating disorders by learning to recognize five passive behaviors or mindsets that may indicate that someone has an eating disorder. Although I have previously discussed a few of these on my blog, National Eating Disorders Awareness Week puts them at the forefront of our minds. Cycles of Dieting.1. Repetitive cycles of dieting can go hand-in-hand with patterns of weight fluctuation. For some, this constant change in weight may lead to the development of body image problems and can even trigger the development of an eating disorder. Family History.2. If a woman’s sister or mother has anorexia, she is 12 times more likely to develop the illness and four times more likely to develop bulimia. It’s especially crucial for these individuals to be conscious of disordered behaviors such as over-exercise and unhealthy attitudes toward food. Labeling.3. It’s important to be aware of how we label foods and food groups. Placing “good” or “bad” labels on foods because of their nutritional make-up could lead to unhealthy attitudes and patterns of consumption. Rather, we should focus on moderation. Negative Talk.4. Making negative comments about our own appearance or the appearances of those around us can contribute to the development of an eating disorder or hinder eating disorders recovery. These comments can affect ourselves and those around us, like our children and loved ones. Food Habits.5. Emotional, reward or punitive ties to food can foster an unhealthy relationship with those foods or food groups. Instead of using food to reward positive behavior, refer to it as fuel to help develop a positive mindset. Visit www.nationaleatingdisorders.org for more information about National Eating Disorders Awareness Week and learn how you can get involved across the country.
  • 30. page 30 February 9, 2012 Eating Disorders: Hope for Recovery | Susan Hickman Dr. Johnson did a recorded interview for Susan Hickman’s radio show on eating disorders, treatment and recovery. See the CD at the back of this clipbook for full audio. For additional support and resources on eating disorders recovery and a complete listing of National Eating Disorders Awareness Week events sponsored by Eating Recovery Center, visit the website at www. EatingRecoveryCenter.com. How will you help raise awareness and reduce stigma surrounding eating disorders this week? Comments and share below! February 15, 2012 Is Your Teen into the eTriggers Trend? | Julie Weingarden Dubin Tech Triggers Though not a clinical term, eTriggers is a shortened way of referring to electronic- or technology-based activities that could potentially trigger someone to engage in dieting, exercise or disordered eating behaviors, says Ovidio Bermudez, M.D., the medical director of child and adolescent services at Eating Recovery Center in Denver, Colorado. Kids and teens may use game consoles, computers, tablets and phones to study diet and exercise techniques. For example, calorie-counting smart phone or tablet apps that manage calorie intake or exercise-focused video games that measure current weight and calories burned. Healthy when used in moderation, but when taken too far, they can enable
  • 31. page 31 damaging behaviors. In addition, there’s a myriad of websites, such as pro-anorexia or pro-bulimia websites or forums, that offer harmful tips to help children and adolescents learn and practice disordered eating behaviors, Dr. Bermudez adds. It’s important to recognize that these activities do not “cause” eating disorders. Eating disorders are complex, heritable diseases that involve bio-psycho-social factors, says Dr. Bermudez. “These triggers can simply kick-start one behavior that may be taken to an extreme, and they can serve as enablers for unhealthy food- or exercise-focused behaviors that have already begun.” They want to be the best Through websites, phone apps, games and social media forums, technology can trigger or enable an eating disorder. “An important part of the mindset of individuals struggling with eating disorders is a desire to learn ‘how to do it better’ and how to compete with others,” says Dr. Bermudez. “Both of these can be cemented by accessing information related to losing weight.” Plus, they compare themselves to other people with eating disorders and motivate themselves to “do it better” by learning new ways to drop weight and bond with others around their successes or failures in eating disorders behaviors. Need to Know It’s not just kids genetically predisposed to eating disorders who have to worry about the dangers of e-Triggers. Any kid can get lured in. Parents are ultimately responsible for monitoring the appropriateness of their kids’ screen use.Keep an open dialogue with your children about healthy habits and technology. Be aware of the technology your kids have access to and the amount of time they spend using it on school days and weekends. Keep an open dialogue with your children about healthy habits and technology. February 17, 2012 Interview with Enola Gorham Enola did a live interview about eating disorders and warning signs while traveling in Nashville. See the CD at the back of this clipbook for full video.
  • 32. page 32 Four in 10 Americans have either suffered from or know someone who has suffered from an eating disorder, according to the National Eating Disorders Association. During National Eating Disorders Awareness Week (February 26-March 3), Eating Recovery Center ( www.EatingRecoveryCenter.com), an international center for eating disorders recovery, highlights eating disorders pervasive impact on Americans of all ages and genders. A classic misconception of eating disorders is that they are a teenage girls disease, when in fact, we are seeing more older women, younger children and men of all ages entering treatment, said Kenneth L. Weiner, MD, FAED, CEDS, founding partner, chief executive officer and chief medical officer of Eating Recovery Center. Genetic risk factors and environmental triggers for these diseases don’t discriminate based on age or gender. The 2012 National Eating Disorders Awareness Week theme is Everybody Knows Somebody, which is truer now more than ever, as eating disorders and body image dissatisfaction continue to experience what experts term epidemiological drift, which is marked by a conditions swift growth in incidence in new populations. Older women: Eating Recovery Center has seen a marked increase in older women seeking treatment• for eating disorders. From 2010 to 2011, admissions of women over the age of 30 increased from 27 percent of total admissions to 33 percent of total admissions. In the same timeframe, admissions of women over the age of 40 increased from 13 percent of total admissions to 15 percent of total admissions. Men: A recent British study shows that more than 80 percent of men regularly engage in conversation• about their bodies, that three in five men are unhappy with their muscularity and that more than one- third of men would trade a year of their life to achieve their ideal body weight or shape. Younger children: From 1999 to 2006, hospitalizations for eating disorders increased sharply 119• percent for children younger than 12 years of age, according to recent analysis by the Agency for Healthcare Research and Quality. Its important to be aware that eating disorders can happen to anyone—men, older women and younger children, continued Dr. Weiner. Do not discount disordered eating behaviors or concerning body image issues just because they are displayed by an individual believed to be outside of the traditional eating disorder demographic. Eating Recovery Center encourages individuals to quickly respond if they notice troubling food- or body image-oriented behaviors in their loved ones, regardless of age or gender. Eating disorders recovery is entirely possible with early intervention and proper treatment from qualified professionals. If you notice troubling behaviors in an adult friend or loved one• , find a quiet time and place for a private, respectful meeting to discuss your concerns; and ask if he or she has considered whether or February 21, 2012 Eating Recovery Center Raises Awareness of Eating Disorders in “Nontraditional” Groups During NEDAW **Digital Outreach**
  • 33. page 33 not he or she may have an eating disorder. While you continue to express your support, offer to help• your friend or loved seek treatment. If you notice troubling behaviors in your child or adolescent• , engage your child in conversation and speak to what you have noticed instead of making accusations; visit a medical provider if you are concerned about your childs physical health; and identify a mental health provider for an eating disorders assessment. For more information about National Eating Disorders Awareness Week, visit www.nationaleatingdisorders. org. Join Eating Recovery Center at these events during National Eating Disorders Awareness Week: An annual candlelight vigil honoring those who have passed away from eating disorders, hosted by The• Eating Disorder Foundation, Thursday, March 1, A Place of Our Own, 1901 E. 20th Ave., Denver, Colo. Mind and Body Fair, hosted by the University of Northern Colorados Womens Resource Center,• Monday, February 27, 10 a.m. to 1 p.m., Greeley, Colo. Eating Recovery Center Patient Art Show, February 27 to March 2, an exhibition of patient artwork,• 1830 Franklin Street, Denver, Colo. A National Eating Disorders Awareness Week informational table in the Colorado State University• Student Center, Wednesday, February 29, 8 a.m. to 5 p.m. National Eating Disorders Association Walk, hosted by The Eating Disorder Network of Central Florida,• Saturday, March 3, Orlando, Fla. February 24, 2012 What to Do If Your Friend Has an Eating Disorder | Jennipher Walters The signs are all there. Your friend is intensely afraid of being fat, she talks nonstop about how many calories are in her food and what she weighed this morning, and she’s starting to avoid situations where she’s expected to eat. While you don’t know for sure, you start to get worried that your friend might be developing — or already be suffering from — an eating disorder. It’s a tricky subject. You want your friends to be healthy and you want to be fit with them, but what happens if your best friend starts to take it too far? Do you stand up and say something? Do you risk hurting your friendship or making her angry and pushing her away? It’s worth it to speak up even if you’re not sure, says Bonnie Brennan, clinical director of Eating Recovery Center’s Adult Partial Hospitalization Program.
  • 34. page 34 “I think that it is a mistake not to address your concerns with a friend for fear of hurting his or her feelings,” Brennan says. “If a friend does not have an eating disorder and is offended by your inquiry, that emotion will usually last a very short time, even a few minutes. On the other hand, if you are correct about your friend’s eating disorder, you may be saving a life, as eating disorders have the highest mortality rate of any other mental illness.” With numbers of those suffering from eating disorders on the rise and societal pressure to be a certain size at a fever pitch, it’s estimated by the National Eating Disorders Association (NEDA) that as many as 10 million females and 1 million males in the United States are fighting a life and death battle with an eating disorder such as anorexia or bulimia, and millions more are struggling with binge eating disorder. That’s why the theme to this year’s National Eating Disorders Awareness Week — which is this week — is “Everybody Knows Somebody.” “I often have patients lament that no one ever challenged them or said anything,” Brennan says. “They will admit that they might have reacted angrily at the time but that it is more painful to think that no one cared or that others were afraid of them.” Although the signs of an eating disorder vary from person to person, Brennan says, they can include an intense fear of being fat, weight loss, avoiding situations in which expected to eat food, using the bathroom directly after a meal, excessive exercise, having conversations that are highly centered on food or calories or weight, “having to” prepare separate meals, and fear of not knowing what ingredients are included in foods (such as at a restaurant). So just how do you go about talking to a friend who might be suffering? Brennan recommends finding a neutral setting and time to meet, and then expressing your concerns and asking if anything has been particularly distressing to her lately. “When speaking with your friend, use non-judgmental language and ‘I’ statements,” she says. “It is OK to point out behaviors and emotions you have lately noticed, but avoid blaming or shaming. Be prepared to listen and don’t try to problem solve. Offer to help your friend find a professional to talk to.” If your friend acts negatively or defensively, Brennan recommends reminding her that you care for her and that you’d rather ask about the troubling behaviors than let them go unnoticed. Then, offer to talk when she’s ready and be available if she wants your help. If your friend admits that he or she is struggling, offer to help him or her find a professional, she says. “Avoid playing the food police,” she says. “Rather, ask your friend if he or she needs support if you notice that he or she eats too little or too much.’ It’s important to also understand that eating disorders are not a choice, Brennan says. They are biologically based mental illnesses, and some people are genetically hard-wired to be more at risk for an eating disorder than others. Furthermore, eating disorders in men is on the rise, so don’t rule out the possibility of an eating disorder with your male friends if the signs are there. Bottom line, one of the most important things you can do as a friend is to let your friend know he or she is loved and accepted by you, even if he or she is suffering from an eating disorder, Brennan says. And it’s always best to speak up — because it might save your friend’s life. Have you ever confronted a friend about disordered eating? Would you? Is there a friend you might talk to after reading this?
  • 35. page 35 February 28, 2012 NEDA Week: Eating Disorders In Midlife | Margarita Tartakovsky Misinformation about eating disorders abounds. One of the most common myths is that eating disorders largely affect young, white girls. But EDs don’t discriminate. They affect people of any age, race, religion size, shape and sex. Today, I want to focus on an often neglected group: women in middle age. Even when it’s recognized that middle-aged women struggle with eating disorders, the talk almost always turns to cultural pressure. While there is increasing pressure for women to stay young and be slim, eating disorders are more complex than the desire for a certain silhouette. As I said yesterday, eating disorders are a complex interplay of genetics, biology and environment. Below, Enola Gorham, LCSW, CEDS, clinical director of adult services at the Eating Recovery Center, shares her insight on eating disorders in middle age. She discusses why more middle-aged women are seeking professional help for eating disorders, why EDs affect them, the unique challenges of treatment and more. Q: I’ve read that more and more middle-aged women are seeking help for eating disorders. Why do you think that is? A: There has most likely always been a large group of women who have had eating disorders, but were never diagnosed because doctors and therapists were not trained in the disorder. Recent attention to eating disorders has resulted in most doctors and high school counselors being “on the lookout” for symptoms of eating disorders in their younger populations. The older women, those who have had this disorder long before it was a “looked-for” diagnosis, often just struggled with it. Many women spent time working with their doctors trying to find a medical reason for their eating issues. Doctors simply did not look for eating disorders in older/adult women. A doctor’s training would have him or her look to IBS or other medical issues. Also, bulimia has only been listed as an official diagnosis since the 1980s, so it is a relatively new diagnosis. The eating symptoms of individuals who previously suffered from this disorder likely would not have been identified as an eating disorder. We now are seeing more older women seek treatment because the diagnostic criteria is understood by more doctors, and doctors are increasingly looking beyond the “classic” young girl population as the only ones who can develop eating disorders. Also, there are many women who have had eating disorders for a long time, and “continue” to be in treatment as they enter middle age. In addition, there are those that have never had
  • 36. page 36 treatment, knew they needed it, but were focused on their families, their children and so on, and did not get treatment for themselves until something became acute. Q: Why do eating disorders affect people in middle age? A: We are seeing that there are some personality traits that predispose people to use management of food to try to relieve some other issue in their lives. Perfectionist, persistent, type A and anxious women have the traits that set them up for trying to manage food and finding that it helps them to feel better emotionally. Because of their perfectionist, persistent traits, they will engage in food management behaviors even more and will end up triggering a vicious cycle of trying to manage emotions with food management. If they also have co-morbid disorders such as obsessive-compulsive disorder (OCD) or depression, they become even more trapped in trying to apply their food management rules to make themselves feel better. Most middle-aged women have most likely been doing some version of trying to manage uncomfortable emotions with food for most of their lifetimes. They might get treatment at middle age because someone recognized the disorder, they recognized the disorder in themselves and finally can spend time getting help or their family is negatively affected and they can no longer ignore the problem. I think it is a minority of women who “start” their eating disorder in middle age. This could happen from a major life stressor, like trauma, which places them in a hyper vigilant, controlling/protecting stance. In this case, they begin to use food to manage the resulting emotions. A life transition – such as kids leaving home or parents dying – could also cause a middle-aged woman to turn to using food management, which then becomes a process she cannot stop. Q: What are the biggest myths about eating disorders in middle age? A: Eating Recovery Center’s patients range in age from 10 to 81. The popular notion of an “eating disordered patient” is: young, white and affluent. However, the truth is far from this misconception. I think the previous notion of “young, white and affluent” had to do with after school specials, and the large number of studies on eating disorders that were conducted on younger girls with anorexia, due to the fact that anorexia was easier to visibly notice in younger girls and it was easiest to do ongoing work with younger girls due to concerned parents bringing them into treatment. Q: Do eating disorders manifest differently across age such that people in middle age may show different signs and symptoms or their course may be different? Are there unique challenges to treating EDs in middle age? A: Middle-aged women can be very hard to treat because, first, they are invested in the idea that their eating disorder is actually a medical problem, and they struggle to see how this is a psychological problem. Second, they also can be caught in the belief that eating disorders only impact young girls, so they are fearful that the treatment will not apply to them, or that they will not fit into eating disorders treatment environments. Middle-aged women may have had the illness for a very long time, and it is a very ingrained coping mechanism, so for many, it can be hard to even imagine stopping. Also, if they have been relatively functional in life — well employed, a parent, etc. — they may struggle with why they need to do the hard work to get well, and quickly give up and return to the illness. Finally, the illness may have cost them a great deal in their life, and it is just too hard for them to take an accounting of this, and easier to stay ill.
  • 37. page 37 The illness itself does not tend to be different, except that as we age, we all have less of an ability to bounce back physically, so natural aging issues can make the illness more complex and treatment needs to address more areas of physical issues. In addition, because the illness may have impacted a woman’s life for a longer time, they will likely have more mental and emotional “clean up” to do. Q: What would you like readers to know about treatment? A: Though the specific life circumstances of a young patient and an older patient may differ, treatment is essentially the same for older women as it is for younger women. Based on the acuity of the illness, the first priority is to ensure that patients are medically and psychiatrically safe. At Eating Recovery Center, we then individualize nutritional, medical and psychiatric interventions, and work with patients in individual and group therapy sessions to help them learn how to accept themselves, their thoughts and their feelings, and live a valued life beyond their eating disorder. Q: Anything else you’d like readers to know about EDs in middle age? A: Regardless of age, the sooner an individual enters treatment, the better her chances are for a positive outcome and lasting recovery. If you think a loved one may be struggling with an eating disorder, urge them to get an assessment from a qualified professional sooner rather than later. — Thanks so much to Enola Gorham for speaking with me! February 29, 2012 How do you know if you have an eating disorder? | Nancy Melear Dr. Weiner did a live, in-studio interview about eating disorders and the associated warning signs for National Eating Disorders Awareness Week. See the CD at the back of this clipbook for full video.
  • 39. page 39 March 2, 2012 The Takeaway: Older Americans Rejecting Marriage; Anorexia and Aging | Elizabeth Nolan Brown Sociologists Wonder: Who Will Care For Single Seniors? A growing number of older men and women are “opting out” of marriage, the New York Times reports. Since the 1990s, the divorce rate for boomers has climbed more than 50 percent, even as it stabilized among other age groups. Meanwhile, less adults got married in the first place. The result is a surprising number of Americans in their 50s and 60s heading into old age sans spouse. Most of the reasons for this shift are positive: Boomers have felt less social pressure to marry, or to stay in marriages that aren’t working. Woman are increasingly financially independent. People are living longer. But we need to pay attention “not only to the factors that precipitate (this shift), but also to the consequences,” said Susan L. Brown, co-director of the National Center for Family & Marriage Research at Bowling Green State University. An analysis conducted by Brown and colleagues found that in 2010, about a third of adults ages 46 through 64 were divorced, separated or had never been married. This is up from 13 percent in 1970. Because the post-boomer generations have far lower marriage rates than their elders, sociologists expect the number of single seniors to rise sharply in coming decades—and the trend could drastically transform our traditional portrait of aging in America. Unmarried older adults lack a partner to rely on for care, and with family caregiving (and retirement savings) down also, governments and social services agencies will have to shoulder an increasing responsibility for senior care. Stats show unmarried boomers are five times more likely to live in poverty as married counterparts, and three times as likely to receive food stamps or disability benefits. Anorexia and Aging: This week is National Eating Disorder Awareness week, and one of the more interesting NEDA stories I’ve seen is about eating disorders in the middle-aged. Folks tend to think about eating disorders as a teen or young adult problem. Dr. Emmett Bishop, of Colorado’s Eating Recovery Center, said data on older adults with eating disorders is scarce. But his center has seen an “upsurge” of older patients. Margarita Tartakovsky at PsychCentral points out that “even when it’s recognized that middle-aged women struggle with eating disorders, the talk almost always turns to cultural pressure. While there is increasing pressure for women to stay young and be slim, eating disorders are more complex than the desire for a certain silhouette.” Friday Quick Hits: • More than 9 million American retirees don’t have enough money to cover basic living expenses, according to a new study. • Many small business owners aren’t prepared for retirement: About a third have no personal or business-sponsored retirement plan and haven’t estimated how much money they need for retirement.
  • 40. page 40 • Grateful Dead 101? Florida Professor Barry Barnes believes the Grateful Dead can teach us a lot about business and personal finance. A new book by the 68-year-old former Deadhead (“Everything I Know About Business I Learned from the Grateful Dead”) explores the ‘innovative lessons’ he earned from the band’s “marketing genius.” • And the first LGBT senior center in New York City opened Thursday. “It is going to be … a beacon of light all across this country,” said Michael Adams, executive directive of the nonprofit SAGE, which is co- operating the center with the city Department for the Aging. March 2, 2012 Tumblr Cracks Down on ‘Thinspiration’ Blogs | Annie Hauser “Let me be empty and weight less and maybe I’ll find some peace tonight.” That rather disturbing mantra is the message behind Thinspox, a hugely popular Tumblr account that posts a steady stream of images of stick- thin women who serve as “thinspiration,” or inspiration to lose weight, for the account’s followers. These blogs promote weight loss, often through unhealthy means, and idealize models, dancers, and women on the street who have waif-like figures. In response to the popularity of this blog and dozens like it, Tumblr is considering a new policy of prohibiting blogs that “actively promote self-harm.” As part of the possible new guidelines, Tumblr enlisted the National Eating Disorders Association to help craft language to display next to self-harm searches. The NEDA seeks to remind Tumblr users and anyone struggling with an eating disorder that they are not lifestyle choices, but rather “mental disorders that when left untreated, can cause serious health problems, and at their most severe can even be life-threatening.” Some critics believe Tumblr’s new policy limits free speech — and won’t do much curb the problem. One critical article wrote that “pro-eating disorder websites do not cause eating disorders … if you think censoring these websites will lead more women to recovery, consider whether people fought in wars before there was violence on TV.” Still, Julie Holland, MHS, CEDS, of the Eating Recovery Center in Denver, Colo., applauds Tumblr for its decision to stand up against self-harm. “Tumblr’s policy is promoting and encouraging wellness and prevention instead of encouraging promotion of illness and self-harm,” Holland says. “I love the statement they have chosen to include about eating disorders as a mental disorder. This goes back to the lack of understanding among a large portion of the population about the genetic component of eating disorders.” In addition to Tumblr, eating disorder awareness educators are concerned about a similar “thinspiration” subculture that’s developing on the photo-sharing platform Pinterest. Pinterest, which has only been around since 2011, contains thousands of photos of thin women, often nude with protruding ribs, tagged as “workout inspiration,” or “thinspiration.” The theoryBusiness Insider’s Jim Edwards espouses is that now that thinspo material is being banned from Tumblr, this pro-ana (shorthand for pro-anorexia) community needs somewhere to go.
  • 41. page 41 March 2, 2012 Eating Disorders In Middle Age Bring Unique Challenges, Treatments | Mary Kate Sheridan While young women are often the faces of eating disorders, diseases such as anorexia, bulimia and binge eating can affect any age -- and recent data suggest the numbers are rising among middle-aged women. The issue is in the spotlight in the U.S. during National Eating Disorders Awareness Week, which runs through March 3. Post 50 women with eating disorders, known as “EDs,” may face unique emotional and physical issues. “Women at mid-life now have unprecedented opportunities and also unprecedented stresses,” Merryl Bear, director of Canada’s National Eating Disorder Information Centre, told the Toronto Star. “There’s an increased fear of aging and societal pressures to change one’s body to bring it closer to the societal ideal.” From 2001 to 2010, the rate of EDs among the middle-aged increased by 42 percent, said Holly Grishkat, Ph.D., regional assistant vice president and director of The Renfrew Center in Radnor, Pa., an eating disorder treatment center. An Australian study published in 2008 also revealed a rise in eating disorders in older adults, particularly with binge eating and food restriction. The study found that in adults between 55 and 64, binge eating increased from 1.7 percent in 1995 to 7.4 percent in 2005, and strict dieting or fasting increased from zero percent in 1995 to 9.7 percent in 2005. While concerning, these numbers may largely reflect individuals with histories of eating problems, rather than new cases, experts say. Many who face eating disorders in midlife have confronted them in the past. In fact, 94 percent of middle-aged women who are anorexic developed the disorder when they were younger. “It’s rare -- not impossible, but rare -- for a woman 50 or beyond to develop an eating disorder for the first time,” said Dr. Margo Maine, clinical psychologist and co-author of “The Body Myth: Adult Women and the Pressure to Be Perfect.” “Most in their 50s and 60s are women who had eating disorders when they were younger.” That doesn’t mean middle-agers’ experiences with eating disorders are the same, however. Since EDs are frequently associated with younger women, older adults may be ashamed to admit that they have these disorders. As one middle-ager confided on a message board: “People always refer to bulimia as an adolescent disease; I feel like such a failure that I’m almost 50.”
  • 42. page 42 Grishkat believes shame is a significant component of eating disorders in middle age. “I think women who are coming out with it in midlife feel like ‘I should be the role model here and not the one with the disorder,’” she said. Older women often remain silent during group therapy sessions with younger women, Grishkat added. Acknowledging these struggles, Renfrew has created a program called “30-Something And Beyond,” which is specifically for adult women who suffer from EDs. This in-patient program places women with roommates of a similar age and in therapy groups that focus on issues more likely to affect middle-agers. (Renfrew also provides outpatient, midlife-focused therapy groups.) Through this program, Renfrew can focus on triggers that are specific to its middle-aged patients. One such trigger is loss, which “tends to be a big underlying factor for eating disorders,” Grishkat said. Midlifers may be dealing with a range of loss, from ailing and dying parents to children moving out, to divorce -- factors that may not resonate with the younger generation. One post 50 who has dealt with loss and an eating disorder is Mary Sponhaltz, who discussed her experience with The Eating Disorder Center of Denver. Sponhaltz struggled with anorexia in the wake of her father’s death from cancer. Over three years, Sponhaltz tended to her father, leaving her husband and children for long periods. “I was already worn thin emotionally and losing weight drastically when he was alive because I wasn’t taking care of myself,” Sponhaltz told The Eating Disorder Center of Denver. “But once he died, the eating disorder kicked in. It numbed me so I wouldn’t have to feel.” Aging is another potential trigger. Physical changes in midlife may cause or reignite eating disorders. As psychiatrist Anne E. Becker -- director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital and president of the Academy for Eating Disorders -- recently told Harvard Women’s Health Watch: As our society values youth and as baby-boomers reinvent what it means to be middle-aged, there are growing social forces that can undermine older women’s self-esteem and potentially lead to body dissatisfaction — for example, if you think the surface of your skin or the contours of your body aren’t supposed to match your chronological age. That, combined with health concerns about obesity, can make people feel bad about their bodies and, in turn, could result in eating strategies that undermine well-being. In an Austrian study of 475 women between 60 and 70 years old, published in the International Journal of Eating Disorders in 2006, 45 percent of the women indicated that their self-esteem depended on their shape and weight. The same study revealed that “over 60 percent [of the women] stated ‘moderate’ or ‘low’ satisfaction with weight and shape.” This pressure to maintain youth may stem from the culture in which post 50s grew up. Dr. Blake Woodside, director of Toronto General Hospital’s in-patient eating disorder program, told the Toronto Star that the increase in midlife eating disorders can be traced to the ‘60s, when ideals changed and the “thin is in” culture materialized.
  • 43. page 43 March 5, 2012 Tweens and Technology: Eating Disorders in the Internet Age | Julie Holland Today, technology and social media are more readily available to our tweens and teens than ever before. From smart phones to tablets to laptops, our kids can take the best – and the worst – of the Internet wherever they go. As parents, we must be mindful of what is available online and what our kids are accessing as it can be highly influential on a tween’s developing mindset and self-esteem. Finding unhealthy solace in online communities. Eating disorders are very secretive diseases that can often initially go unnoticed until disordered eating behaviors or other warning signs become more obvious. In the interim, many tweens struggling with eating disorders turn to websites commonly referred to as “pro-ana” or “pro-mia” websites. These sites provide struggling tweens with “advice” on losing weight and social support when unhealthy weight loss goals are met. Pro-eating disorders websites can push someone on the verge of an eating disorder over a dangerous edge. What are all those apps on your child’s smart phone? Calorie counting and exercise applications are easily accessible—many are even free. When used wisely Whatever the cause, eating disorders can have serious side effects, including osteoporosis, heart problems and gastrointestinal issues. In a recent interview with Life Goes Strong, an online site for midlifers, Dr. Emmett Bishop, MD, FAED, CEDS -- founding partner and medical director of adult services at the Eating Recovery Center -- outlined some specific health issues that middle-agers with EDs may face: Older individuals have much less resilience when it comes to physical damage from eating disorders. A lot of things can go wrong with vital organs, bone density can be impacted, dental health can suffer, and as tissues become less elastic, I’ve seen people aspirate from purging. A whole host of medical issues can arise as people abuse their bodies over time. Eating disorders are the deadliest mental illnesses and premature death is very common. Older women also face somber statistics when it comes to EDs and death. Senior women comprise 78 percent of all deaths caused by anorexia, and the average age that women die from the disease is 69. But middle-agers with EDs shouldn’t give up. “There’s hope,” Grishkat said. “Even if you’ve had [an eating disorder] for 30 years, our data show that the women in midlife and older tend to be more determined and ready for recovery than a lot of the younger women.” If you’re struggling with an eating disorder, call the National Eating Disorders (www.nationaleatingdisorders. org) helpline at 1-800-931-2237. To learn more about National Eating Disorders Awareness Week, click here.
  • 44. page 44 and in moderation, these tools can keep you on track for maintaining a healthy weight and learning how to healthfully manage in food and exercise. However, for someone genetically predisposed to an eating disorder, smart phone and tablet apps can often act as an “eTrigger,” causing moderation to quickly spiral out of control into restriction and other disordered eating or over-exercise behaviors. Parents’ role in technology use. Parents play an important role in monitoring their kids’ technology use. This includes maintaining an open dialogue with their tweens and teens about what they see in the media and online, asking how they interpret what they see and discussing what a healthy use of technology looks like. In addition, it’s important as parents to model healthy technology use behaviors for our tweens and teens. If we’re overly absorbed in our phones, laptops or tablets, how can we expect our children to know other ways of interacting with technology? Technology isn’t all bad. Technology – when used in a healthful way – can actually help to inspire eating disorders recovery. For example, at Eating Recovery Center we use technology such as MP3 players and biofeedback video games to help our patients learn how to manage anxiety and embrace lasting recovery. In addition, although the Internet may have a plethora of negative images and information, there’s also plenty of support for individuals who are in eating disorders recovery or overcoming body image issues. One of my favorite sites is something-fishy.org. This website is dedicated to raising awareness about eating disorders and reminding individuals with an eating disorder that they aren’t alone and can experience lasting recovery. In fact, I think that’s a very important detail to remember: lasting eating disorders recovery is possible, especially with early intervention. If you’re concerned about a child’s eating behaviors or curious about offhand comments about body shape and size, visit the resources section on Eating Recovery Center’s website. These resources can arm you with vital information about eating disorders and help you discover how to broach the subject with your child Comment and share below how you’re using the online space to better your body image and self-esteem! March 12, 2012 Tumblr’s Ban on Pro-Ana and Pro-Mia Websites | Julie Holland “Thinspiration” is a term often used by individuals who engage in disordered eating behaviors, such as restricting, over-exercising or bingeing and purging. Using pictures of unnaturally thin males and females as weight loss “inspiration,” these individuals strive to achieve unrealistic body ideals. Often, they engage in these behaviors in a community setting through pro-anorexia and pro-bulimia websites, commonly referred to as pro-ana and pro-mia websites. Pro-ana and pro-mia websites can be incredibly damaging, because they reinforce, validate – and even applaud – eating disordered behaviors. One online resource has become aware of the prevalence of these sites and is taking a stand to minimize their harm. Taking action against pro-ana and pro-mia Late last month, Tumblr, an online forum that lets users effortlessly share anything, began removing user blogs that promoted or glorified self-harm behaviors, such as eating disorders, self-mutilation or suicide. This action has met with mixed reviews.