Concerned Your Loved One is Struggling with an Eating Disorder? Recognizing the Warning Signs

What warning signs should friends and family look out for regarding disordered eating?

People often come to me concerned that their loved one is developing an eating disorder. They wonder if they should be concerned and want to know potential warning signs. Here are some of the symptoms I talk with them about:

Increased isolation is a big red flag. Mental illnesses, especially eating disorders, thrive in isolation. A person struggling with an eating disorder often avoids situations involving food, whether it's a family bbq, a friend’s birthday party, or an office luncheon. Negative body image, low mood, and increased anxiety are also commonly experienced and can act as barriers to connecting with loved ones and the wider community.

Symptoms vary, and eating disorders manifest differently from person to person. You may notice changes in behavior surrounding food, exercise and body. People may start to engage in odd eating patterns such as pushing food around their plate, overuse of low-calorie condiments or over-controlling how a meal is cooked (no butter, oils or fats). Someone might also spend excessive time in the bathroom, particularly after meals. 

You may notice evidence of food being hidden or hoarded, or your loved one may express guilt and distress regarding what they have consumed.

You might also notice that a loved one’s exercise schedule becomes rigid, inflexible, or extreme. For example, an adolescent may continue their regular sports practices but begin adding significant exercise outside of those sessions, becoming distressed if prevented from doing so. Additionally, someone with an eating disorder may start hiding their body under baggy clothing or become anxious when clothes shopping.

There is Hope:

Eating disorders can look a lot of different ways, but all deserve support and care. Regardless of the specific behaviors, the mental distress and impacts on one’s physical and emotional wellness are significant. Fortunately, with the proper support of eating disorder specialized therapy and dietetic support, eating disorder recovery is possible. 

My Body Is the Least Interesting Thing About Me: Navigating Unsolicited Body Comments

What do you say when someone comments on your body? Oftentimes, when people comment on your body, it comes with good intentions. They are offering what they believe is a compliment, such as, “You look great. Have you lost weight?” or “You look so healthy!”

The problem is that we don’t know how someone’s brain is going to receive these seemingly positive body comments. We never know the internal workings of someone else’s relationship with their body. Could those comments trigger their eating disorder? Could they have lost weight because of depression, grief, or chronic illness? Now, every time they see you, if you don't say “you look great,” are they going to be stuck wondering if you’ve noticed they gained weight?

And when someone comments on your body with judgment, well, that’s a whole other story (and I recommend telling them to mind their own business).

So, what can you actually say when someone comments on your body? Here are some ideas:

• “I’m trying not to focus on appearance these days.”

• “My body is the least interesting thing about me.”

• “Welp, that made me uncomfortable.”

• “I would rather you not comment on my body.”

• Quickly change the subject. 

You can either push through the discomfort and offer some education as to why their comment felt problematic, or you can simply change the subject. If the commenter is saying this to you, they probably say similar things to other people. Your feedback could be helpful for their social learning. However, you are not obligated to put your energy into educating everyone around you as to why body comments are unwelcome.

If someone constantly engages in body talk and it makes you uncomfortable, you can try being open about why this bothers you, either from a personal or societal perspective. You may also want to take space from this person, especially if you find their comments detrimental to your mental health. It certainly makes it easier to feel good, or even just neutral, about your body when you’re surrounded by people who focus conversation on topics outside of what they or others look like.

The best piece of body commentary advice I have ever heard is: “Don’t comment on anyone’s body unless it is about something they can change in two minutes.” For example, if your coworker has spinach stuck in their teeth or your friend’s shirt is on backwards, they might want to know. Otherwise, keep your thoughts about their body to yourself.

5 Tips for Improving Postpartum Body Image

Adjusting to our postpartum bodies is a challenging part of early parenthood. We live in a society drenched in “bounce-back” culture, making it hard to accept and love the changes that happen to our body during and after pregnancy. Here are five tips for improving your body image postpartum:

Photo of author one month postpartum.

1. Wear comfortable clothing. 

   This means wearing clothes that are your current size (not your wishful pre-pregnancy size) and also feel comfortable in a sensory way. 

   C-section scars, new stretchmarks, and lactating breasts can all feel sensitive, especially when a piece of clothing exacerbates any of that discomfort. Opt for soft, loose, stretchy, and breathable clothing. 

   If finances are a barrier to purchasing new items that feel good for your postpartum body, consider shopping at local thrift stores, joining a “Buy Nothing” group on Facebook, or asking other recently postpartum friends if they are looking to give away any of their maternity or postpartum clothing. 

2. Take a break from the mirror. 

   Sometimes looking at yourself in the mirror causes too much havoc for your brain, especially if you are prone to critical body checking.  It is okay to take a break from looking at yourself in the mirror - cover it up, take it down, or only use mirrors that are high or small enough to reflect your body from the shoulders up. 

3. Consider gradual exposure.

   Other times, it is beneficial to allow yourself to habituate to your new body. Habituation is a process of adjusting to a new stimulus. Initially, the new stimulus (our postpartum body, in this case) can cause an anxious or fear-based reaction, but the more we expose ourselves to the stimulus, the quicker that anxiety-based reaction dissipates. 

   Challenging yourself to observe, not judge, your body is key to this practice. The idea is to get used to and accept your new body without getting lost in self-criticism. This means allowing yourself to describe your body as it is now, rather than comparing it to how it used to look. Make sure to observe your body from several angles so that you don’t jump-scare when you see it from the side or the back because you’ve only been observing it from the front. 

4. Practice Appreciation

   I know, it’s easier said than done, but we have to admit that our postpartum bodies have just performed incredible, intense, amazing acts. Our bodies created, carried, and delivered a human being - is there anything more impressive than that? Can we at least allow space to appreciate our body for what it has been through and brought to us? 

5. Understand that your body, much like your brain, is forever changed. 

   Again, you just created and delivered a human being into this world. Your body had to change, and that is okay.  Just like your brain has forever shifted to adjust to becoming a parent, your body has also shifted. Plus, many of these bodily shifts make sense. Our belly-pooch can be a great place to support a baby while breastfeeding and it can make us that much softer and cuddlier for our little ones to hug. 

So as you adjust to your new post-pregnancy body, understand that you will feel a mix of emotions. Feelings of frustration and grief are valid and so are feelings of awe and gratitude.

Three Steps to Reducing Your Body Checking Behaviors

Body checking is a safety-seeking behavior driven by anxiety and worry about one’s appearance. Body checking manifests in many different ways: lifting up your shirt to see your stomach in the mirror; pinching, poking or measuring your body; tugging your shirt away from your belly; obsessing about how you look as you walk past every store window. The intention of body checking is driven by a hope that if we “check” the body and feel content with it, our anxiety will decrease and we will feel “safe” in terms of our body image.

Even though the urge behind body checking is driven by a hope to reduce anxiety, it often does the opposite by acting as a trigger for body-oriented or disordered eating thoughts. When we body check, we are giving our brain a signal to think more about how we look, and unfortunately those thoughts are typically not positive. Body checking becomes particularly problematic when it becomes compulsive and consuming of our brain space and time.

How to reduce your body checking:

1. Bring awareness to your body checking behaviors. Start to notice when you are body checking, how you are body checking, and what triggers your urge to body check.

2. Work on actively resisting the urge to body check - this might mean:

   • challenging yourself not to look at your reflection in store windows

   • covering your mirror until the urges feel more manageable

   • writing a self-affirmation on your mirror that reminds you that your body is worthy and good

   • wearing a fidget ring or bracelet and directing your anxious energy towards them when feeling the urge to body check

   The less we give in to the urge to body check, the less we will eventually want to body check.

3. Notice when your urges to body check reduce and acknowledge your success. Allow yourself to appreciate what it feels like to have less of your brain space taken up by body image thoughts.

Movement for All Bodies

Movement can be joyful. Movement can be challenging. Movement can feel wonderful, and movement can feel triggering - especially when we don’t feel like our bodies belong. 

We know, in no uncertain terms, that moving our bodies improves both our physical and mental health. Unfortunately, the majority of the fitness industry doesn’t make every body feel welcome. Not dissimilar to the fashion industry, fitness is missing out on a major population of people who would be eager to engage if there were services that fit their needs. This includes people who live in larger bodies, who have differing levels of ability, who are recovering from eating disorders or disordered relationships with exercise, or who otherwise don’t feel welcome due to their race, religion, gender, sexual orientation or financial background.  

Luckily, there is a small (growing?) corner of the fitness community that does in fact try to make all bodies and abilities feel welcome.  I often get requests for ideas on where to look if fitness feels intimidating or unwelcoming. I have compiled a list of options that I am familiar with for anyone interested in exploring movement in a flexible way - not a punishing, “I have to change my body” kind of way.

All resources below have online options for engaging in fitness. Budget-friendly tip: most of these instructors either have free content on their websites and social media and/or offer free trials of their programs. I will try to continue to update the list as I learn of more resources.

Yoga: 

The Underbelly Yoga & Wellness with Jessamyn Stanley: “Vison: To create and foster a community for everyone, including those who have ever felt overlooked, underserved and left out by the wellness industry. To empower you to show up and take up space. Define and achieve wellness in a way that makes sense for you.” https://theunderbelly.com/ 

Full Being Yoga with Dana Falsetti: “Dana Falsetti is a white, fat, non-binary, disabled person, a speaker, writer, and the founder of Fullbeing. At 22 they started traveling and teaching yoga workshops in person and online with the intention of reaching those who felt othered because of how their bodies are treated and seen.”   https://fullbeingyoga.com/dana-falsetti-classes/

More to Love Yoga with Rachel Estapa: “Rachel Estapa, founder and CEO of More to Love, is passionate about empowering people to love and appreciate their bodies. Her own path to body acceptance began many years ago. After yo-yo dieting throughout her teenage years and into adulthood, Rachel took stock of her life and realized she wasn’t happy. Even when she reached her “goal weight,” she felt something was missing. That’s when she decided she would stop trying to change her body and instead she would focus on loving the body she has.” https://www.moretoloveyoga.com/

Pilates and Strength Building: 

The Be.come Project with Bethany C. Meyers: “the be.come project is a subscription-based fitness platform built on the idea of bringing inclusivity, approachability and body-neutrality to the fitness world.” https://thebecomeproject.com/  

Hybrid Calisthenics with Hampton Liu: “... the true revelation may be that physical exercise itself has applications beyond building strength, gaining muscle, and losing fat. Because these goals are so popular, there is a seemingly endless supply of products and educational content to help people achieve them. However, there are applications beyond this. Hybrid Calisthenics is the initiative to help people better their lives and achieve unconventional goals.” https://www.instagram.com/hybrid.calisthenics/?hl=en

Kara Duval Pilates: “I love to celebrate my body for what it can do opposed to what I think it should. You will quickly find that my teaching philosophy is the complete embodiment of this.”  https://www.karaduvalpilates.com/  *Bonus: Kara is open about her own journey of recovery from disordered eating and body image after years spent dancing ballet. 

Dance & Aerobics: 

The Fitness Marshall: “Hailed as the modern day Richard Simmons meets Britney Spears, The Fitness Marshall is the internet's favorite fitness pop star delivering non-stop, easy to follow dances to his 5 million followers across social media. Caleb along with his two Backup Booties welcome and celebrate every age, size, ability, color, and gender expression. No matter where you are in your journey, you have a place with them on the dance floor.” https://thefitnessmarshall.org/ 

Curves with Moves by Jessie Diaz-Herrera: “Diaz-Herrera now teaches in NYC and structures her classes to suit all body types and dance levels. Not your typical dance class, she ensures that the environment is judgment free, incorporating body positive talk and affirmations during the sessions to make her students feel comfortable at any dance level. Her mission is not to just teach dance but to empower her students to learn how to love their bodies through dance.” https://www.instagram.com/curveswithmoves/?hl=en

Personal Training & Pole Dancing with Roz the Diva: “Come as you are. I'm a dark skin, semi-bald, overweight, outspoken woman who runs around NYC half naked. I'm also a proud ally of the LGBTQ+ community; I'm already a fan of your religion; your disabilities don't scare me; the only race I see is pizza. Unless you're a total douche bag, we're already BFFs.” https://www.rozthediva.com/ 

Why I Have a Problem with the New Weight Loss App for Kids

Weight Watchers rebranded last year to “WW”, which was smart branding on their part because old school diets such as Jenny Craig or Nutrisystem are no longer as popular as they once were. Now, we are sold the idea that we can be better, more moral people not by “dieting” but by “eating clean” or “eating whole”, but we fail to see that these “lifestyles” are another version of a diet repackaged and tied up with a new, more green bow. 

What better way to attract us millennials, the lovers of environmentalism, yoga, & self-care, than by convincing us that drinking a green juice or eating an avocado toast, will bring us closer to enlightenment (or at least the “yoga body” that makes people think we look enlightened). And through this all, some company somewhere is making a lot of money. The diet industry was projected to be worth $70 billion in 2018 and that amount is only projected to keep rising with time. 

Speaking of companies looking to make money off our country’s obsession with weight loss, WW has created a new weight loss app for children, called Kurbo.

While I hate that adults have to struggle with diet culture, thinking about young kids being exposed to a weight loss app like Kurbo makes me very, very sad. 

As a therapist who specializes in eating disorders, I can tell you that I have been receiving more and more requests to see kids, ages 12 and under, who are struggling with eating disorders of their own. I have had the experience of visiting a treatment center and seeing a child, that could not have been more than 10 years old, sitting in the audience of my presentation. 

If you’re unfamiliar with eating disorder treatment, when a person  has an eating disorder that is appropriate for a residential or inpatient level of care, that means that person has to live at the facility 24/7. For a child, this means that they have to spend the night, every night, away from their parents, their siblings, their family pet, their favorite books and blanket and live instead with the other patients and staff at the treatment center. Of course, parents and families can visit, but when I think about how scared I was to even go to summer camp as a kid, I can only imagine how terrifying it must be for a young child to have to go to treatment. 

Do you know where most eating disorders start? They start with a diet. Not all dieters develop eating disorders, but for the people that might be genetically predisposed or predisposed via their environment, a simple diet can trigger the thought process that develops into an eating disorder. So why would we sign our children up for a weight loss app that introduces them to the thoughts and behaviors associated with eating disorders? Why would we pay $69 a month for our children to have online coaching to learn what foods are “good” and “bad”, or in Kurbo’s case “yellow”, “red” and “green”? 

I do not expect diet culture to go away any time soon. We can bet that our children will hear about which foods are “good” or “bad” even if we refrain from using that language in our own households. If we want our children to learn to have a healthy relationship with food, why not encourage them to learn instead about tuning into their bodies. We can help them figure out what types of foods make their bodies feel good, that give them energy to play and study and all that good stuff that comes with childhood. And most importantly, why not teach our children that they are loved regardless of what they look like and help them build the self-confidence they need to live in this image-focused world? I do not want another company to profit off our children feeling bad about themselves. 

To learn more about the controversy surrounding the Kurbo app, check out this article from Refinery29:https://www.refinery29.com/en-us/2019/08/240564/ww-weight-watchers-kids-diet-program-kurbo-controversy

To learn more about what to do if you are afraid your child is going to be fat, see this blog by eating disorder expert, Beth Mayer, LICSW: https://more-love.org/2017/02/24/for-parents-who-are-afraid-that-their-kid-is-going-to-be-fat-an-interview-with-beth-mayer/

4 Tips for Making it Through the Holidays Binge-Free

For many, Halloween means dressing up in a silly costume, taking the kids in your life trick-or-treating, and marathon watching Stranger Things and for most, Halloween involves in some way, shape, or form a big bowl of candy.

For people struggling with Binge Eating Disorder (BED), Halloween can mark the start of a 2-month long holiday obstacle course with a finish line of January 2nd: navigating an alternate path past the CVS candy aisle, trudging through family and work holiday get-togethers, hurdling over Thanksgiving, Christmas, & New Years with a final face-off against the January 1st“New Year, New you!” weight-loss ads.

This obstacle course takes a heck of a lot of endurance especially if all the while you’re trying to steadily hold your progress in BED recovery like your own Olympic torch – never to be dropped, never to be extinguished, and held high with pride. Don’t be surprised if your metaphorical arm gets tired…It’s not easy to run with a fiery torch in your hand!

All jokes aside, here are some tips for maintaining your progress in BED recovery through the holiday season (You CAN do this!):

• Meet yourself where you’re at: You might be at a place in your recovery where you can attend all of the holiday functions and benefit from exposing yourself to former binge-foods while remaining binge-free. You may also be at a point in your recovery where being surrounded by holiday delicacies is not manageable for you. Be honest with yourself: do you need to avoid the candy aisle? Do you need to set a limit for how long you can stay at your work’s Christmas lunch? Either way – It’s OKAY!

• Practice Self-Compassion: Yes, every time I say “Self-Compassion” in my BED support group, I hear a resounding group sigh. I get it! Self-Compassion is NOT easy, but is the cure to shame and self-judgement. If you slip-up and have a binge (or 2 or 3 or 10), instead of beating yourself up, talk to yourself as if you were a dear friend: “It’s okay. Don’t worry about it. This isn’t worth beating yourself up over. You are a good person. The food you eat has nothing to do with your self-worth. You are worthy, and valuable, and gosh darn-it people like you!” Remember, you are SO much more than your eating disorder.

• HALT: Are you Hungry? Angry? Lonely? Tired? If it’s the holidays, you can probably say yes to all of these questions. Make sure you take a moment to “HALT” when feeling vulnerable to a binge:

  • Hungry? Eat a nutrient-dense snack like a fruit/veggie/or protein. If you’re still hungry, eat another. Wait 10 minutes, and ask yourself if you’re “belly hungry” again (Thank you to the group member who taught me that helpful phrase).

  • Angry? Turn the music up loud in your car and sing at the top of your lungs. Punch a pillow. Do 15 jumping jacks. Yell! Dance like crazy to “Monster Mash”. Release your anger in a way that does not involve pushing your anger down with food.

  • Lonely? Reach out for support. Text a friend. Facetime a family member. Call your therapist. Pet your dog. It’s a lot easier to successfully make it to the end of the holiday season with someone by your side to cheer you on.

  • Tired? REST! Yes, there are presents to wrap, greeting cards to send, and financial reports due by the end of the year, but you will not be able to complete these tasks and maintain your recovery unless you are taking time to rest. Your body and mind can only handle so much without time to reenergize.

• Do Self-Care: When you’re taking care of yourself and feeling good, you are less vulnerable to bingeing or utilizing other self-harming behaviors. Make time and space for YOU this holiday season. Eat regularly throughout the day. Buy yourself a Christmas gift that brings you joy. Take yourself to a gentle yoga class. Make yourself a cup of warm apple cider. Nap by the fire. Walk through the fallen leaves. You deserve it.

And finally, remember that “normal” eating is flexible eating. You are not a good person for eating brussel sprouts, and you are not a bad person for eating pumpkin pie. All foods fit. It is normal to occasionally overeat, and if you do overeat, it does not mean that you need to punish yourself with restriction the next day. Eat breakfast like you normally would and continue holding your eating disorder recovery torch high.

This blog was originally published at https://www.medainc.org/4-tips-for-making-it-through-the-holidays-binge-free/ and is republished here with permission.