Tuesday, May 17, 2016

Why Is Everyone a Nutrition Expert?

If you're recovering from an eating disorder, sometimes scrolling through social media can be a recipe for disaster.

I've noticed recently that my Facebook feed is filled with women advertising (on groups I've joined) their multi-level marketing businesses. They're selling shakes, body wraps, and beach body programs, touting their own success and before-and-after pictures as proof.

When I joined a group of local vegetarians, it wasn't long before the posts devolved from restaurant recommendations and meetup opportunities to members' advertisements for boot camps and diet shakes. Why must we conflate a lifestyle choice with a drive to lose weight?

Health and nutrition coaches abound. Pilates instructors are offering pre- and post-natal nutrition coaching. Personal trainers are serving up meal plans and chefs are counseling people on the "psychology of eating."

For those in recovery, the barrage of weight-loss/thin-ideal material is triggering and hard to ignore. For the general population, this practice turns out potentially dangerous misinformation. The fact that nutritional counseling is largely unregulated creates a bunch of pseudo-experts advising on a topic that can have significant negative consequences. Diets don't cause eating disorders, but they can trigger someone who is susceptible. I've had a number of patients through the years report that their symptoms began - or intensified - when they sought out the services of a personal trainer who prescribed them a rigid meal plan.

We need to leave nutrition to the experts, the registered dietitians who have the education, training, and certification to stand behind their recommendations. Even within this group, there can be great variability regarding an understanding of disordered eating, the emotional connection to food, and sensitivity to weight stigma.

Let's educate the public to seek out properly trained individuals on matters of physical and mental health. Nutrition is a science, and while it might be a hobby for some, imposing this hobby on others can have often harmful effects.

Tuesday, May 03, 2016

Fitness at Every Size

Did you hear about The University of Washington's advice for prospective cheerleaders? The infographic, published last week by the university, suggested that coeds show up for tryouts with "curled or straight hair," false eyelashes, and bare midriffs - and created quite a stir in the body image community.

It's clear that the university - and likely not the only one but maybe one of the only to advertise - was looking for a female prototype to populate its squad. Might women of color have a shot? Would women of diverse body types or varying degrees of femininity have any chance of nailing an audition? Unlikely.

While we might take aim at any one of the stereotypically confining pointers they recommend, the one that jumps out most to me is the hint, "Be physically fit, with an athletic physique." What might happen, as I'm sure will be the case, if a woman shows up for tryouts who is physically fit but who doesn't have the "athletic physique" that the squad requires? Might she have a shot to dazzle the captains with her fitness and skill? Doubtful.

What exactly is an "athletic physique," anyway? One word connotes function, the other form. In reality, athleticism has no look. It's possible to be perfectly athletic without sporting the "athletic physique" most of us are brainwashed to prefer.

The Health at Every Size® movement proposes that healthy behaviors be considered independent of body size. I'd add a special emphasis on fitness, as indices of fitness (e.g., strength, endurance, flexibility) can be accomplished regardless of shape or size. A thin body is not, by definition, fit. 

So, might the cheer captains at the University of Washington take note of a truly athletic woman, who can tumble and jump but who has a bulky midriff? Fat chance.

But, there's a lesson in this for all of us.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Tuesday, April 26, 2016

News Bites

1) Have you heard about the ANGI? Here's their latest:
The Anorexia Nervosa Genetics Initiative (ANGI) will be coming to a close in the following months and we need your help! We are still recruiting individuals with a history of anorexia and individuals without a history of an eating disorder to participate. But hurry, the deadline to participate is June 30, 2016. All that is required is a brief online questionnaire and a blood sample. To make it easier for you, we’ll even send the phlebotomist to wherever you are, nationwide!  
Participants will receive a $25 Amazon gift card to say thanks. We can’t do this important research without you! 
To find out if you are eligible to participate, visit this link and fill out the survey: https://unc.az1.qualtrics.com/SE/?SID=SV_b7KDMDd8SuM1o 
For more information call 1-855-746-2547, email ANGI@unc.edu or visit www.unceatingdisorders.org/angi.
2)  Would you have any interest in an Intervention-style show on eating/body image issues? Here's a blurb from production:
A new documentary style TV program about people with body image issues: We are looking to conduct a 30 minute Skype/FaceTime interview with someone who is currently battling anorexia. The project is in the development stages so the interview would never air/broadcast but will hopefully help us help others. If interested please email us (@jessicamelz@gmail.com) directly. All information will be kept strictly confidential. Thanks so much.
3)  Check out my latest interview on Refinery29 on the snarkiness/gossip around friends with eating disorders.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Tuesday, February 23, 2016

Kick the Scale Interview

Remember my interview with Erin Konheim Mandras?

Well, she also interviewed me! You can check out our conversation here.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Tuesday, February 09, 2016

How Weight Information Can Increase Overeating/Binge Eating - Four Pathways

Recently, I found myself explaining to someone’s mother how encouraging her daughter to weigh herself was exacerbating her eating disorder symptoms (binge eating, in this case). As I did so, it occurred to me that there are four pathways to this relationship. They might seem intuitive, but it helped to spell out the matrix of consequences for this family.

If someone (let’s call her Veronica) steps on the scale and sees a number that’s higher than she anticipated, she might experience distress. For many who struggle with binge eating disorder, food is the most convenient and effective coping mechanism. So, the urge to binge can increase.

If she weighs herself and sees a number that’s higher than predicted, she could also have an urge to restrict her intake in an attempt to suppress her weight. As it typically does, restricted intake will likely result in future binge episodes.

Now, if Veronica steps on the scale and sees a number that “passes the test,” or one that is lower than expected, she could similarly restrict her intake as a way to continue this weight-loss trend. Again, binge eating is a likely consequence.

And if she weighs herself and sees a number that’s equally satisfying, it’s possible she might choose to celebrate by overeating or might feel that she is entitled to eat past fullness as a reward for her success.

Many will endorse one or more of these possibilities as potential outcomes of weighing themselves in early recovery. While some professionals believe that access to weight information in eating disorder treatment is always contraindicated, I think that there are certain benefits to learning this information.

Often, those who struggle with binge eating eat sporadically and infrequently – and avoid certain foods – setting themselves up for future binges. When encouraged to eat more intuitively, they might have fears about excessive weight gain. Witnessing weight trends can provide evidence that a more regular meal plan, which reduces the frequency of binge episodes over time, will not result in significant weight gain. Here, weight information serves as an evidence-based cognitive challenge. But, patients in early recovery might still be triggered by weight information, and it’s important to determine where individuals are in their recovery and to provide space to process and learn from concerns that arise as the result of weight information.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Friday, December 18, 2015

Happy Holidays/NEDA Article/Another Award

Guess what? This blog one another award! I'm in great company - be sure to check out the rest of the winners.

Also, I have a new article up for the National Eating Disorder Association (NEDA).

Recovery is possible.

Happy holidays.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com

Wednesday, December 02, 2015

Interviews in Recovery - A Conversation with Erin Mandras

Recently, I had the opportunity to e-meet Erin Konheim Mandras, ex-athlete/coach and mom of two, who recovered from anorexia. We decided to interview each other for different perspectives on eating disorder recovery. Below is my interview with Erin - enjoy!

SR: What connection, if any, do you see between your athletic participation and the development of your eating disorder?

EM: I believe that my participation in athletics and soccer significantly contributed to the development of my eating disorder. The competitive component, along with pressures to perform and succeed, are all elements that can lead to an unanticipated disorder, such as anorexia. Also, athletes want to be as physically fit as possible, and with a personality that tends to take things to the extreme, exercise can go too far. 

SR: How did you get motivated to recover? 

EM: I became motivated to recover from my eating disorder far before I actually made any changes. Parts of me wanted to get better and feel better at my lowest point, but the act of changing my diet was too scary, and I just didn't know where to start. My psychiatrist and parents offered me an incentive to gain weight­­ which ultimately became my excuse to start turning my behaviors around. Mostly, I did not enjoy the way I felt and how obsessed I had become with food. 

SR: How did you recover? What helped? 

EM: I, first, acknowledged I had a problem. I just needed to be surrounded by a lot of support, therapy, and medication to slowly alter my thoughts and behaviors about food, my diet, and my body image. Then, my parents, with the support of my psychiatrist, offered me an incentive to gain weight. I had a goal and an excuse to start getting better. Once I began slowly introducing food back in my diet, my body wasn't able to comfortably handle and digest it. So I began added foods that I had already been eating, but in larger quantities. Then, I wanted to get rid of anything that was associated with my eating disorder; that brought me back to the feeling of weakness, obsession, and frailty. This included clothing, shoes, food stored in my apartment, soccer equipment, and more. This helped establish a clean slate involving different and new behaviors. With the combination of all of the support I had while having an eating disorder, the will to want to get better, and an incentive to help get me on the right track, I was able to recover. 

SR: What was the most challenging thing about recovery?

EM: The most challenging part of recovery was seeing the number on the scale go up. I knew it was for my best interest and to regain health, but I couldn't bear seeing it increase. I feared it would go up quickly and uncontrollably, so with this fear in mind, increasing my food consumption was also terrifying. What should professionals know about recovery from a patient’s perspective? Professionals should understand that an individual experiencing such a disorder is a person possessing certain qualities; competitiveness, drive, and motivation. Therefore, if you are able to turn "the truck around and re­route it" by using an incentive (something that individual would have a desire to achieve), then that may be a good start. At the same time, a person with an eating disorder needs to be able to acknowledge there is a problem, and a solution; it will just take time, patience, and the same qualities used to get oneself that low, to get healthy again. 

SR: What message do you have for those who are currently struggling with an eating disorder? 

EM: I empathize with those who are currently struggling with the disorder. Though they may believe they are healthy, fine, and highly functioning, it is no way to live life. It consumes your mind, heart, and ability to give your most to yourself, your loved ones, and the world. Even if you are succeeding in your career, family, and social life, think how much more you would have to offer if your life didn't revolve around the pure focus of food, calories, and scale. Life is too short. If you have a problem, seek help. You cannot do it alone. You need all the support you can get. You can do it! 

SR: Any favorite resources (e.g., websites, books) for those in recovery? 

EM: There weren't as many accessible resources twelve years ago as there are now. I wish I had blogs, like yours and mine, readily available while battling and struggling from my eating disorder. If anything, I would have been reassured that I wasn't alone. That is why I will continue writing, speaking, and connecting with those experiencing similar challenges I faced, and continue to face in regards to food, eating disorders, and body image. I urge people to use my blog as a resource, and to feel free to contact me anytime with questions or concerns. I can relate to many people on many different levels!

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com