Stories: Part III

Posted with permission. . .

I remember using food to comfort myself from the time I was a small child. I had (have?) father issues, I could go on and on here but I won't. When I was 19 my step dad was diagnosed with terminal brain cancer. I had been working out and making healthy dietary changes, but over time as my life seemed to spin more and more OUT of my control, I tightened the reigns on my eating and exercise. Very textbook, though I had no idea what was happening at the time. I thought I was simply "being healthy". At 5'5" I dropped from 145 pounds (a healthy weight for my height!) to 88 pounds and 5.5% bodyfat. I remember the day my weight read under 100 pounds. I couldn't believe it, it was very surreal, almost like a dream (nightmare?). But I didn't know what to do; I still wasn't satisfied with my body, I couldn't stop working out or carefully measuring my food, planning all my meals, counting calories... I was TRAPPED. I lost a handful of "friends", the love of my life... I shut out the real world so that I could maintain this strict, regimented lifestyle. This lasted for about 4 years. What a sad, dark, black hole in my life.

After about a year of nutritional therapy, when I was 23, I began to gain weight. I don't know how else to put it... when I say that something just CLICKED, like a switch being shut off, I mean it. Something finally gave and like THAT I was bingeing, something AWFUL. I couldn't focus in college, all I thought about was hitting up the vending machine for junk that I hadn't let myself have in literally years. My stomach was always horribly distended and bloated... the skin on my belly, hips and thighs was always SORE from stretching at such a rapid pace... in a matter of months, maybe 9 or 10 months, I gained over 100 pounds. I finally topped out at 205 pounds. I could not stop eating and with each bite I hated myself more and more. Again, I was stuck in a cycle that I didn't know how to stop.

I finally got a grip (somewhat) and am back to 145 pounds, but I stay here with rigid "dieting" throughout the week (6 small meals of veggies, protein and fruit each day) and inevitably bingeing my brains out on the weekend. I always say oh, I won't binge this weekend. I'm doing so well! It is the worst feeling ever to not be able to have just one cookie without it sending me into a total downward spiral of carb coma madness. It's shameful. It's not healthy. I'm always striving for something better, always telling myself that life REALLY starts once I'm a size 6 or 4 (I'm currently an 8/10)... I'll pursue my dreams/take that class/decorate the house/BE HAPPY once I reach a certain size or my body fat drops past a certain level. IT IS INSANE. And I ask you, why? WHY? Why does this make sense to me, why have I WASTED 27 years trying to fit that mold? FOR WHAT? I am the only one that really cares. I have a wonderful family, a loving husband, an amazing 2-year old boy, a great job... life is good. But it would always be BETTER if I could lose 10 or 15 pounds.

So yesterday I came across your blogs (editor's note: mine and Margaux's, Size Ate). I read through them during every minute of my free time. I'm missing out on life. Why not eat what I want? Go have lunch with my coworkers, order something that sounds delicious, eat slowly, enjoy everything the meal has to offer, leave feeling satisfied but not stuffed, and without that pesky internal calorie counter that just won't quit. I have an established exercise regime that I enjoy... I LOVE working out, love to move my body... but within reason. It's food that is my issue. And it has got to stop. I have got to stop obsessing. Every day I thank GOD for not giving me a baby girl. She'd be a total mess from the start. And my boy deserves better than a mom who looks at life as something that happens between unenjoyable protein and carb balanced mini-meals. How fucking sick is that?

There's so much more to it all than I've said here. Just know that I am going to FIGHT to get my life back. It's scary, I haven't listened to my internal hunger signals in YEARS... or ever? I know it won't be easy, but given that my other option is to STAY IN THE HELL I AM IN NOW, I'll take my chances and give it my all. I have nothing to lose! (Well, I could make a joke here but I won't. Sheesh.)

I'm finally getting to the point where I truly believe that it really isn't about food at all. Friends and family were (are?) aware, and lots of the questions I asked myself in my email to you were prompted by things that were said on your site. Let me tell you, years of therapy and two Geneen Roth books later I was STILL struggling, and your site is what FINALLY crossed me over to the other side. I just ate a bowl of raisin bran with soy milk. I love raisin bran. I haven't LET myself eat cereal in YEARS (but I sure have binged on it!). When I'm done I will move on with my day, ready to face whatever is thrown at me. And guess what? I didn't gain 100 pounds from letting myself have a bowl. Who knew? Freedom = an allowed, calmly eaten bowl of rasin bran.

No Escape

In 13 short days, I'll be working as a psychologist on the "psyching team" at the New York City marathon, helping runners relax, cope with pre-race jitters, etc. Just a couple hours after that, I'll cross the starting line myself, setting out to run my second 26.2.

I've been doing most of my training indoors (at the gym), in the name of injury prevention. What's interesting to me, and why I bring up running in the first place, is the assortment of comments I've received. Of course, no one knows I'm a psychologist; no one knows about my blog. Here are a couple of my exchanges:

1) During one long(er) run, I wore yoga pants, in the name of comfort. Boy, was I wrong. Yoga pants are made for yoga, not for running, silly! My comfortable yoga pants kept falling down, and I spent the majority of my run pulling them up, like a bridesmaid tugging at her strapless dress. At one point, I announced this to my treadmill neighbor (who is often my treadmill neighbor, and with whom I've become friendly over time). "My pants keep falling down," I complained.

"That's a good thing!" she congratulated me.

Why is that a good thing? My pants keep falling down!

2) A couple of weeks ago, I did my longest training run (again indoors). In the elevator down to the locker room (because, yes, I take the elevator at the gym, particularly after running 20 miles), a guy pointed to my sweaty head and asked, "Did you just work out?" (There's a pool at the gym, so he seemed to be wondering if the soakage was sweat or chlorinated water from a swim).

"Yeah, I just ran 20 miles," I replied proudly.

"Wow!" he exclaimed. And then a moment later: "If you keep that up, you'll lose lots of weight."

Thanks, buddy.

In Light of Our Recent Animal Ethics Discussion. . .

Thoughts about the intended message here?

Just Like Glitter

Newsflash: Mariah Carey's lost some weight. Again. This comes after she gained some weight. Again.

In an OK magazine article titled, "Mariah: How I Got Thin," we learn that Mariah has last almost 30 pounds in the last seven months. Her secret? No, no, it's not her forkful diet again. This time, Mariah's lost the weight by reportedly "eating a plain diet of soup and fish, following a strict workout plan and--most importantly--by not stressing about how her body looks."

Does that sentence even make sense? The article is full of contradictions like this--if you're not stressing about how your body looks, then why are you eating what she reports is her own words as a "bleak diet" and stating, "'I still feel like I have a ways to go, but it is what it is. . . . It does feel good when you get into a nice size three and you're like, "It feels big in here." We should all embrace who are are physically.'" Mixed messages much? And, what's a size three, anyway?

Her trainer, Patricia, says that Mariah's workouts depend on her daily intake: "'If she's serious about the food, then she doesn't have to work out that much.'" Besides sounding like an entry to exercise bulimia, isn't this statement just flat out wrong? Shouldn't a personal trainer be promoting exercise across the board?

Mariah says of Patricia: "'I love her. But sometimes, she can be very strict. If I want a little snack, I know if Patricia's in the kitchen, she's going to give me something really bleak to eat, so I don't even bother going downstairs. I just send somebody else to get something for me and sneak it up!'" Sneaking food when deprived--another pathway to an eating disorder.

"'I like flavor in my life. I don't just want chicken stock and zucchini and carrots and call it a day. Patricia will also give me fish and chicken." Well, thank goodness for that. My concern, as you can see, is that the "every woman" who reads this type of article doesn't even stop to realize how flat-out wrong it is--how the messages contained within promote (clearly) yo-yo dieting and (with a little more subtlety) eating disordered thoughts, feelings, and behaviors. And then there's Dr. Jackowski. . .

In the article, "body image expert," Dr. Edward Jackowski, comments on one of Mariah's shots: "'Her upper body and stomach look good in this photo. She can carry more weight because she's got the wide shoulders and boobs to support it.'" Um, why is a doctor using the word, "boobs"? (Plus, what's a body image expert? Wasn't that akin to my new title? ; ))

Dr. Jackowski, who earned his Doctorate in Behavioral Management from the International University for Graduate Studies, is well-known for classifying us into four body types (it's not just apples and pears, anymore, ladies). Think you're a professional? A wife? A mother? A functional member of society? Uh-uh. You're a spoon. Or an hourglass, a ruler, or cone. Now, carry on, as your intended shape. Me? Looks like I require a trip to the ice cream shoppe. ; )

Joy Nash, At it Again

Thanks to an anonymous reader who shared Ms. Nash's most recent gem. . .

Title Me This

I know it's not true. But, if you've read my intro, you know that I really don't think we all have eating disorders, but some sort of disordered eating or body image concern. Not everyone. Maybe not you. But most of us. And that was the original point.

Plus, as I've mentioned before, the title was meant to be provocative. It's also kinda catchy, I think. It's the kind of title I'd pick up at Barnes & Noble because, apparently, I DO judge a book by it's cover.

But, some of your feedback has led me to believe it's not the best title. It could be off-putting, it reflects poorly on women, etc. A publisher I had hoped to work with originally said she loved the title. When she met with the rest of her staff, they ended up rejecting the project. One of the reasons she offered? The title. They felt that most women would not be willing to pick up the book, be seen with it, etc.

Recently, I've thought about: "EWHAED. . . or Something Like it." What are your thoughts? (on this or other possible titles)

Without using this title, how can I capture my premise, attract an audience, and still incite debate and contemplation?

Any other ideas?

A Relative Plus Size

As you can clearly see from the photo above, America's Next Top Model has again included a plus-sized model in its cast for cycle 9.

Which one is she, you ask? C'mon. . . It's Sarah!




Here's Sarah during her rock-climbing shoot. Tyra? Are you there? The only thing plus-sized about this woman are her heels!



Kinda makes you just want to throw your hands up and surrender. . . But then, along comes Dove, with its latest marketing campaign:




I
love
Dove.

Mirror, Mirror

Often, women with body image issues will use the mirror the way they use the scale, for frequent, instantaneous feedback on the value of their self-worth. Stomach look flat enough? Check. Hips look too wide? Devastation.

A number of writers in the eating disorders field encourage mirror exercises, in which you expose yourself to your reflection (first clothed, then, for the more advance, naked) as a way to address negative body image. Jane Hirschmann and Carol Munter, of Overcoming Overeating and When Women Stop Hating Their Bodies (see sidebar) call the exercise "mirror work" and suggest you stand in front of the mirror and make non-judgmental statements about your body. "My arms look big." Judgment. "Here, the angle of my legs increases." Non-judgment. The goal is to engage only in non-judgmental statements about your body. If you can't, slowly back away from the mirror. . . and try again another time.

Thomas Cash, in the The Body Image Workbook writes about "mirror desensitization." The term "desensitization" is borrowed from behavioral psychology. Usually used with phobias, psychologists will encourage patients to expose themselves to their phobic stimuli, with the idea that with time and exposure, anxiety will fade. Afraid of spiders? Hang out with one for an hour. Scared of elevators/heights/subways/crowds/rats? Come to New York!

With mirror desensitization, the idea is create a "Ladder of Body Areas," in which you rank a number of your body parts on a satisfaction hierarchy--the part or parts of your body that you're most satisfied with go on the bottom, while those you detest the most go up top. Once you've done this, you're ready to face the mirror.

Stand in front of your mirror and begin by looking at a particular body part that doesn't cause you much distress to view--maybe even a part of your body you like. Breathe. Relax. Think pleasant thoughts. Then, according to Cash, go to a body part that causes a bit more discomfort for you. Look at the body part for a full minute. Shut your eyes and relax. Cash encourage readers, systematically, to work their way up their "Ladder of Body Areas" until they reach the top (i.e., the part of your body you find most difficult to view). Does this happen immediately? Of course not. Mirror desensitization will usually take multiple sessions--do a couple of body parts at at time. If you can't relax, breathe, and avoid judgment, stay at that particular rung until you can.

Hard work? Potentially. Impossible? Not at all. The goal is to work your way toward what I call "mirror indifference." You can look or not; it doesn't matter. You don't feel the need to pause at every mirror you see. Your reflection says nothing about who you are, and a mirror, is, after all, just a piece of broken glass.

*Yes, the picture of the broken mirror above is mine; no, I didn't do it purposely. ; )

Summer Love

I gotta say, lately, I've been digging Justin Timberlake. Not in a rob-the-cradle, rock-your-body, kinda way, but more because he likes his women sexy. Recently, he's been choosing leading ladies with flesh. With curves. With a little bit of meat on their still-thin frames.

Have you seen his HBO special? (Sadly,) I was struck by his choice of back-up dancers. In my sporadic viewing of the show, I didn't see one skin-on-bones dancer. Granted, the ladies' pelvic-gyrating, crotch-bearing poses weren't necessarily an advertisement for feminism per se, but at least their bodies were as solid as their performance.

Scarlett Johansson? Jessica Biel? His romantic choices reflect the same attraction to a healthy female physique. JT, single-handedly bringing sexy back. . .

Come Here Often?

Sunday, after brunch with the girls, we headed out for a stroll downtown, when we happened across a cute boutique. The outdoor sales rack lured us in, and soon enough, I headed toward the back of the store with my clothing possibilities in tow.

The salesman called out, "Everyone decent?" before he drew back the curtains.

You know what that means, right?

Communal dressing room!

I entered and found a couple of women inside. I tried on several items and found a dress I adore. But, that's not the point of this post. The point of this post is that there was a woman in her early 20s directly across the room, which put her about three feet away from me. She wore a long sweater with a pair of skinny jeans and she called to her friend outside, "The jeans aren't working."

I happened to like the jeans. Now, I'm not one to work when I'm not working. But, there was something about seeing her in clear view--this wasn't just something overheard in the next fitting room stall--I could see the girl! And, so I made a conscious decision to be Stacey, not Dr. Stacey, when I said, simply, "They look nice."

"Yeah, but I have runner's thighs," she said.

"Uh-huh."

"And this makes them look worse."

She looked at me inquistively, expecting some sort of reaction in return.

Uh-oh. What do I do? Stacey. . . Dr. Stacey. . . Stacey. . . Dr. Stacey. I went witht the Dr., because, you see, the thing is, we're one in the same. We have the same principles, the same voice, and the same difficulty in keeping our mouth shut when it comes to women and our bodies.

"Well, I'm actually a psychologist, and quite interested in body image, so I'm not going to agree with you on that one." We laughed and exchanged names. (I feel the need to say that I said the above statement with a smile, because I don't want to come off sounding like the psychology police. . . even though, apparently, I am.)

"Hey," she yelled out to her friend. "There's a body image consultant in here!"

"Well, I'm not a body image consultant [whatever that is], but I am a psychologist, and I do a lot of work with eating disorders and body image." At one point, my friend wandered in, also a psychologist. "Now there are two of us," I told my new communal dressing room friend (NCDRF) with a sinister smile.

Her friend joined us shortly. NCDRF said to her, "See, don't they look awful?" But the thing was, she looked at me, when asking the question. "Terrible, I said snidely, "You should probably start starving yourself tomorrow." (And yet again, I feel the need to reinforce the fact that I was joking--I was amplifying her irrationality to make a point--but that's the Dr. talking. No, I don't really think anyone should start starving herself tomorrow. . . including you.)

We commented on the psychology of the communal dressing room experience. "I probably should just have a seat and set up shop," I joked.

"Yeah, do you have a card?" she asked with a smile. I couldn't tell if she was joking or not. "No, I'm kinda serious here--do you have a card? It's probably something I should look into."

I handed her my card. "Well, now that you've seen me naked, I imagine it would make things much more comfortable."

Again, we laughed and eventually parted ways, agreeing that this qualified as one of the best ever fitting room stories.

It's Not Me; It's You

In Life Without Ed, writer and eating-disorder sufferer, Jenni Schaefer, crafts a declaration of independence from her disorder, which she cleverly anthropomorphizes to be, just, "Ed." In it, she declares:

Jenni, therefore, solemnly publishes and declares that she is free and independent; that she is absolved from all allegiance to Ed, that all connection between Ed and her ought to be totally dissolved, and that as a free and independent woman she has the full power to eat, live in peace, and to do all other acts and things which independent people do.

Our version? The break-up letter? Ever broken up with someone via letter, email, or text? Now's your chance (and trust me, you'll need more room than a post-it note provides). You'll need to explain why you're ending this (potentially) seemingly good relationship. Your task: write a letter to your scale, your mirror, your calorie-counting conscience, the part of you that mentally and physically abuses YOU, that causes YOU to restrict or binge, that causes YOU to hate your body, which is also part of YOU, and that has likely been doing this for years, obscuring the real YOU, and preventing YOU from being as independent, happy, and fulfilled as YOU deserve to be.

Dump him. He wasn't that good of a kisser, anyway.

You Better Shape Up

September's issue of Shape magazine beckons us with the following headline: "The #1 Weight-Loss Secret--Do This & You Will Drop Pounds."

A quick visit to page 232 of the monthly reveals the treasured secret, which likely enticed thousands of readers.

But, I'm not going to share, because you really should by the magazine.

Just kidding. I'm not going to share, because to do so would be to support and promote our societal obsession with weight loss, which clearly doesn't fall under my mission statement.

Alright, fine, I'll tell you, but only because I laughed out loud when I opened to 232. Here, a two-page spread reveals--"The secret to Weight Loss? Calories" followed by the statement, "The truth is, all diets boil down to a simple formula--eating fewer calories than you burn."

This is it, ladies, groundbreaking journalism at its finest. Make sure you pick up your copy today.

An Interview with Leslie Goldman

Last week, I had the opportunity to interview Leslie Goldman, author of Locker Room Diaries: The Naked Truth about Women, Body Image, and Re-Imagining the "Perfect" Body (see sidebar). Leslie's 31, a professional journalist, and holds a Master's in Public Health--she also writes a blog at iVillage called, The Weighting Game. As I mentioned earlier, I had read and enjoyed LR Diaries and found it incredibly serendipitous that Leslie had found and read my blog and was contacting me to discuss collaborating. At Leslie's suggestion, we decided to do a cross-interview to post on our respective sites.

As Leslie's in Chicago, our interview occurred via phone. Immediately, I was struck by her interpersonal ease, her warmth, sincerity, and sense of humor. If she were in New York, I'd love to have her as a friend.

At the end, I picked her brain about the publishing world--this is a woman who, at very young age, has published numerous magazine articles, and who (especially admirable and inspiring to me), managed to publish a book. My interview with her appears below. For the questions she posed to me, check out her blog today.

You mention in the prologue to your book that you struggled with anorexia. How did you recover? Is there still a pull toward eating-disordered thoughts, feelings, and behaviors?

I had an eating disorder in college—it was a very kind of cliché ED: I was the straight-A, perfectionist, eager-to-please young woman who goes off to college and freaks out and develops and eating disorder to cope with it, to cope with this new dis-order in her world. I lost a significant amount of weight; not so much that the fashion world would be appalled, but enough that I looked horrible. In terms of recovery, I got better physically within my freshman year, gaining most of the weight back. . . but it wasn’t until, I’d say, my junior year that I started looking deeper and realizing it wasn’t just about food—that it was so much more.

I do view eating disorders kind of like alcoholism—it’s a coping mechanism—you can get through it and live a healthy life, but it’s always there, it’s always something that you have to think about, like "I can’t go back there." I’m not going to say that I don’t think about food or working out or my body today, but I know I can’t and won't go back to what I was like—I have too full of a life to let that happen.

Why do you think The Scale has such an influence on women?

I think that that number is something tangible for women to grab onto, and kind of identify with, and measure themselves against. . . I actually just wrote about this today on my blog—I remember when I was writing my book, I interviewed a woman who said, "At 114, I feel skinny and beautiful; at 118, I feel fat." And this is a smart, educated lawyer. But this isn’t about being smart. So many of us are smart, educated—it’s about the weight-obsessed world we live in. . . and you read about the celebrities, and you think, "That’s what I need to do to be successful." There are so many women who get on the scale, and that number rules their day. It can make or break their day. You can see women get on the scale, and if they’re unhappy, they’ll slump. They’ll take off their flip flops or towel to try to lose that extra quarter pound.

Were women in the locker room generally approachable?

I found that women were approachable when I explained what I was doing and when I explained that I had had an eating disorder. When I revealed my past struggles, it made me more approachable. But some chapters were more difficult that others. The chapter on obesity was very difficult—I found a lot of my sources through blogs or friends of friends. You can tell when a woman’s open: There was a woman sitting on the ground, breastfeeding her daughter, I could tell that she was at peace with her body by the dreamy smile on her face and she just seemed like on open soul.

A lot of my research took the form of observation—I did a lot of looking and listening. I did worry when the book came out that people would think I was spying on them. But that was not the case. I wasn’t judging them. I was doing it more from an anthropological standpoint. If I did talk to women, I always got their permission.

How much female-female competition did you encounter?

It’s everywhere, and not just in the locker room. If you just watch, you’ll see women using glances, looking each other up and down. You can just see the thought bubble over their head, "Thank God she has a big butt," or, "Oh, she has cellulite, too" or "I wish my boobs were like hers." There’s already enough competition and self-loathing. I think women should be joining together and supporting each other. Another example was women watching each other get on the scale—one woman would get on and other women would wring their necks, trying to see.

Are you comfortable naked in the locker room?

Yes (laughs). I walk around, usually with a towel around my waist. I certainly don’t rush, rush, rush when the towel drops to get my underwear on. I will say one of the really interesting things I learned while writing the book on the chapter on ethnicity. Some of the women who worked in the locker room were raised in a culture that was much more modest. One woman said she couldn’t believe that women were walking around naked, bending over. I did start covering up, in some ways, as a matter of respect, but there are parts of me (my arms, my stomach) that I’m particularly happy with and proud of and I so I don't mind walking around topless or in a bra.

How do you think your book would have been different if you were a male journalist hanging out in the men’s locker room?

(laughs) I probably would have gotten in my share of fights - I don’t think most men would take to a man with a pad and a pen. But, from what I hear from men, their locker room is much different. They take much greater offense to men walking around naked. The younger men are always complaining about the older men walking around naked. I don’t think men have the same pressures women have. . . . I think men must look at each other to see what’s normal.

We both attended weight-loss support group meetings for research purposes. What was your experience like? How did you leave there feeling?

So, I attended a Weight Watchers group, and I was a bit troubled by what happened. I had a similar experience to you—many people were a normal weight—maybe they got there by attending the meetings. But I felt there was a lot of sadness. When the moderator would ask people to share, one man mentioned he had had gravy on his chicken, and I was sitting behind him and it was like he was going to cry, so I wanted to cry. The whole thing seemed cult-like, but so many people have had wonderful experiences with it, and I really can’t be one to judge. Maybe for him, it was very freeing to talk about his "dietary slip ups." And then of course, there’s the whole weigh-in aspect where they weigh you in behind the curtain. And, I have a problem getting on the scale and tying your self-worth to a number. For some people, the number can be motivating.

Did you get weighed at the meeting?

No. I was a first time visitor. No one pressured me or anything like that.

You speak of differences in body image based on culture. How do you think socio-economic status factors into the mix?

I do think that it has to do with socio-economic status. I think that regardless of your racial or ethnic background, the more money you have, the more access to things you have (health club memberships, fat free foods, fashion magazine subscriptions), things that pave the way toward exercising or eating [problems]. I do think also that different cultures appreciate different body types in different ways. But that’s not to say that Black women don’t get eating disorders or Indian women don’t get eating disorders, because they do.

How would you recommend mothers introduce their daughters to the locker room?

You know, I see mothers and daughters all the time in the locker room, and I see things that are positive moves, and I see things that make me cringe. I think, first of all, don’t introduce the scale into the equation. Just pretend it’s not even there. . . . I think it’s great when women are showering to talk [to their kids] about what they did at school that day or what they did at camp ("I heard you were great in archery").

Do not point out flaws in your own body. Make a concerted effort not to grimace at your body as you look in the mirror, or as you tweeze your eye brows. Allow them to explore, "Do you want to dry you hair?" "Do you want to comb it?" "Do you want to try getting dressed all by yourself?" Or, if they’re at the appropriate age, "Do you want to try to open the lock this time?" "Do you remember the combination?" Don’t focus on looking at yourself in the mirror. Make it a time when the two of you can have mother-daughter time and not a body-bashing session.

What’s your take on dieting?

I don’t even know if I can answer that. It’s so different for so many people. If you’re trying to lose some weight, dieting can be a helpful tool. I’m trying to think of a way to put it succinctly—I think dieting can be a useful tool if you’re working with a doctor or a nutritionist, but I think it can become an obsession for many people. But, I think there’s no reason to live your life on a perpetual diet, to live your life obsessed with every single calorie. There’s a fine balance. . . .

Some of my readers pointed out that your blog does not always champion health at every size. Any comments on this?

It’s so interesting, because people on my blog will say basically that I am too much on the pro-size acceptance front. I’ll be blogging about dancers in their 200s [weight], or just recently I blogged about the triathlete who weighs 300 pounds. . . or getting upset at my gym because they were playing a song that was derogatory toward heavy people. Readers sometimes will think, [these people are] overweight, why are you advocating it? I posted a quote by [the actress] Mo’Nique about being happy at any size on [another blog], and I got blasted. I also get a lot of comments about my own weight—"Well, you’re thin, why should I listen to you?" It’s like, why should my weight have anything to do with what I say? Or, they forget that I have had an eating disorder, have had my own struggles, am not immune to their comments. I’m just at a comfortable weight for me.

Is there a follow-up to Locker Room Diaries in the works?

Right now, I’m focusing on full-time magazine writing. I would love to write another book, but nothing has hit me in the same way that Locker Room Diaries did. That idea struck me right in the gym. It was so obvious. Every time I was at the gym, I could not escape hearing women talk about their bodies. I know that my next book will be focused on women, maybe not about body image, but it’ll be women-centered for sure.

Toxic

By now, you must certainly have heard about Britney Spears' recent performance at the MTV VMA's. And, I'm sure you've heard how horrifically overweight she appeared.

If not, see for yourself:



As you can tell, Britney, whose abdomen has raised more concern than the number of our troops remaining in Iraq, is clearly a candidate for gastric bypass surgery.

Call her a has been.

Call her a fashion disaster.

Call her an alcohol or substance abuser.

Call her a potentially (I'm being careful here) unfit mother.

But, please, please, don't call her fat.

How Not to Win Friends

The scene: sitting at a restaurant bar with a colleague I just met discussing a project we'll be working on together. The US Open plays on the television above us. . . .

The colleague: a sixty-something-year-old male, who does not specialize (to my awareness) in eating disorders

The dialogue: I mention, at some point, my interest in eating disorders and the book I'm currently writing. Conversation shifts and then returns to the book. He's curious what underlies the problem. "So, why do you think EWHAED?", he asks. I go through my typical spiel, the whole cultural piece, our societal obsession with thinness, how women are valued most for their looks and even more so for their bodies, yada, yada, yada. . . .

He draws my attention to the television screen, where Serena Williams sports one of her usual flashy get-ups. "Now, she's not thin," he says.

"Well, I might not call her skinny, but she's solid. She's pure muscle, and she's certainly thinner than the average American woman."

"She is?" he asks, seemingly surprised.

I provide him some stats on the average American woman (AAW), which last I checked (and this could be slightly different now) has the AAW coming in at 144 pounds.

"144?", he exclaims. "That's fat!"

"See, you're the problem."

Questions, Please. . .

Next week, Leslie Goldman, author of the Locker Room Diaries: The Naked Truth About Women, Body Image, and Re-Imagining the "Perfect" Body (see sidebar) and the iVillage blog, The Weighting Game, and I will cross-interview each other via phone.

I'd like to gather some questions from you, from those who have read her book (or blog), or others who might have related questions from the self-proclaimed "women's health writer" who focuses on diet and body image. So, if you have any questions for Leslie, let me know. . . either include here as a comment or email me directly.

Size Happy

Margaux Laskey, of Size Ate, posted yesterday about a recent weight gain. For those of you unfamiliar with her, check out this post, which features clips and commentary from her one-woman show.

You can read her thoroughly insightful and enlightening post here.

The upshot?

She's gained some weight.

She's happy.

And she's one of the best writing bloggers I know.

Miss Antisocial Personality Disorder

Teeshirtsrock.com has the above item in stock for just under $25. Now, my questions for you (some rhetorical, some not) are:

1) Who would buy this shirt?
2) Whom would you buy it for?/Who would wear it?
3) Why don't they have its Miss Bulimic counterpart?
4) Any shirts on other mental or physical illnesses? (Miss Schizophrenia? Miss Female Orgasmic Disorder? Miss Diabetes? Miss Cancer?

Just checking. . .

Small Bites

Thanks to one of my readers for forwarding me this, Gawker's tongue-in-cheek commentary on the recent obesity-as-virus news item.

Also, I checked out Gawker this morning for an interesting bit on fried Oreos. I must confess--until a few months ago, I never knew there was such a thing. They fry Oreos? Wow.

And yes, that is a picture of yours truly back in the day. I hope no one is offended by the bagel. ; )

A Matter of Fabric

(Another post brought to you by little m). . .

MOD*EL – noun (adjective, verb, -eled, -eling.)

n.

Conventional fashion wisdom is that “models are selected based on how well fabric drapes on their bodies.”

And, as we know, all sorts of things can be extrapolated from that. Like, therefore, that’s the only way to be beautiful. Like the only way to look good in your clothes is to look like that.

But maybe – just maybe - conventional fashion wisdom is not the whole truth.

The smaller the body, the less fabric it’s generally going to take to construct a garment for it. The less fabric used, the lower the production cost. Cheaper production costs, all other things being equal, lead to bigger profits, which are generally deemed to be better in business.

So maybe designers are praised and rewarded when they use less fabric.

Being the granddaughter of a seamstress, I learned early that it’s easier to cut in a straight line than on a curve. So the more curves to the body, the more difficult the garment is to make.

So maybe designers are lazy. :D

We’ve read so much about the fashion models that have starved themselves and used drugs in order to work, that if we link to all the articles describing the phenomenae, Dr. S’s server may go on strike from the overload.*

So maybe FASHION models should NOT be ROLE models.

What do you all think?

*Editor's note: See mamavision for a great primer on modeling and our bodies. . .

Oops . . The Response

Since some have expressed concern about my health (related to my recent weight gain), I figured I'd shoot you a quick update from my hospital bed.

Sorry, I'm feeling feisty. ; )

My health is fine--thanks for your concern. I'll directly address some of the comments to "Oops" in this post.

BUT....12 pounds is not a small amount of weight to gain in six months. The reasons ARE important. Because if you continue to do the same thing you're doing to gain that weight, then eventually, one should be concerned about what health effects it would have. If, on the other hand, the reasons you might have gained that weight are temporary in nature, then you are right to not be concerned at all.

At what point do you begin to worry? What about a woman who is over 180 pounds (at 5'4'')gaining that kind of weight in six months? Would you also tell her to go on about her day like no big deal? Isn't it much healthier to take a realistic attitude and admit that some healthy changes need to be made, while not freaking about it?

The reasons are important, as you suggest, but they were not important to my telling of this story.

In my mind, you begin to worry about the health consequences of gaining weight when there are health consequences of gaining weight. This does not include a doctor telling you you should lose weight for your health. As some others have noted, there are plenty of skinny, unhealthy people, and plenty of fat, healthy people.

In case anyone's curious (since it seems some of you are), my blood pressure is typically about 90/60. It's low. It's low enough that I have a history of passing out (especially when dehydrated). Romantic swooning aside, a 12-pound weight gain is only going to help me out when it comes to blood pressure concerns.

So when i read ur comment, please forgive me but i felt like here is another person missing the point.
I feel like we all act like extra weight automatically means a health problem. And may i venture a guess that most people (maybe not u but most) would not show ANY concern over a 12 pound weight LOSS, they wouldnt worry if the very fact that weight was fluctuating is a sign something is wrong, but when the weight goes up they do.

That's exactly right. I encourage you all to read "The Diet Myth" and "Rethinking Thin" (scroll down the side bar for info). There's a lot of propaganda out there on the relationship between health and weight. Research shows that being underweight is associated with more health consequences than being overweight.

And, how come no one assumed I'm a recovering anorexic who should be congratulated on gaining 12 pounds?

I am just wondering, and wish maybe Dr. Stacy would chime in. How much "fluctuation" in weight is too much? And by "too much" I mean either a health risk (say for an "average 5'5" woman), or a "slippery slope" that if not nipped in the bud, WILL lead to an unhealthy gain. How many of us would really not care about a 12 lb. gain? I'd not only be very disappointed but by that time would be having knee pain, back pain, difficulty participating in my usual physical activities, and tight pants. Are those worth worrying about?

I have absolutely no idea, first because I'm not a medical doctor, and second, because even if I were, I'd have to assume that this issue could only be addressed on a case by case basis.

But it CAN amount to something- stress on your joints, increased blood pressure... 12 lbs is not "nothing". 3 lbs is nothing.

Well, I'm not sure we'll ever be able to define "nothing," except on an individual basis. In my case, 12 pounds is physically "nothing." I'm 5'6", so perhaps that helps, but I can still exercise, engage in daily activities, etc. to the same extent before I gained the weight. My body, like many others, tends to cycle with weight related to a host of reasons (which are important to me, but not necessarily for this discussion).

So, my BP is fine, but about my joints? I think they're ok, too. I run quite a bit, and I'd venture to guess that the damage I've done by pounding the pavement (long-distance running) is far more deleterious than that created by these extra 12 pounds. I haven't notice any variation in orthopaedic symptoms related to my weight.

12 pounds, though, in my case, and in many others, COULD be tremendously damaging psychologically, and that was the point of this post.

NONE of you actually asked "Dr. stacy, how is your blood pressure? And how do your joints feel?"
You assume based on her weight gain.
Furthermore, I doubt you'd ask this of yourself or anyone else as long as they are skinny.

Forgive me if I sound snappish, I don't mean to disrespect your opinions and if you have info to back that up that you want to share by all means do.
I just am sick of everyone crying out "health" to excuse our obsession with being thin.
If you care about someone's health, ASK THEM HOW THEY FEEL, don't analyze their weight or YOUR perception of their lifestyle, dietary and excercise choices.

Thank you for asking. The "health" argument will persist as long as we need something to justify our intense hatred of fat in others and ourselves.

As an athlete, gaining 12 lbs. would severely hinder my ability to train pain-free. If I saw I gained 12 lbs. in six months I wouldn't freak out - but I would certainly begin to restructure my food intake and activity levels.

I mean, if you gained 12lbs. in the past 6 months, that means you could potentially gain 24 in one year...48 in two years...100 in four years...

True, I guess it's possible that I'll gain 100 pounds in four years, but I'm going with history on this one. I've gained weight and lost weight (just about this amount) several times. There's the allure in trying to lose it again (as many of you might feel), but I'm not actively encouraging either weight gains or losses at this point in my life--the more we cycle, the worse it is for our HEALTH.

And, let's say I did want to lose the weight. Should I diet? We all know that 95-98% (depending on which research you read) of all diets fail. Dieters lose weight, gain it back, and then some. If I'm to being to restrict my food (I already exercise enough), I might lose some weight, but I won't be eating intuitively and the likelihood is that that'll backfire, and I actually could see that 100 pounds you mentioned.

I had no idea those were the lyrics in that song. Good lord, what crap. I'm embarrassed that I ever bobbed my head to such nonsense.

I actually made those up, but now that I know that my writing is virtually indistinguishable from Britney Spears's (or at least enough that I could fool one of my good friends), I'm more encouraged about the eventual publication of this book. ; )

Oops. . . I Did it Again

I stepped on the scale
Let go of the rail
I wanted to see
The damage to me
Oh, weigh me, weigh me. . . Oops. . . I did it again. . .
(a la Britney, circa 2000)*

I think the last time I knew my weight was about six months ago (dr's visit). And now, a couple of seasons later, I felt a sudden curiosity one day at the gym. I knew I'd gained--the fact that I haven't been fitting into about 1/3 of my wardrobe could have told me that. But, I wanted to know. . . THE NUMBER.

And, here it was, staring me right back in the face.

12 pounds.

I really thought it would have been about 8. But, it was 12.

12 pounds, I've gained in just about six months. The why's are unimportant here (and I'm sure I could speculate forever), but, what's more important, for our purpose, is what I did. My options? You must all know them quite well. . . .

Freak out.

Begin restricting that afternoon, or at least enroll in or plan for a full-fledged diet that Monday.

Commit to a more intensive exercise plan.

Hate myself.

Get back on the scale and try again (maybe taking off my adorning towel, because we all know how much a dry towel can weigh).

Do nothing.

I kinda handed you this one. I did nothing. I went about my shower, getting dressed, and returned to work. My exercise and eating habits didn't change a bit, and I really wasn't distressed at all. Would I like to have seen less of a weight-gain, or not one at all? Sure. I'd be lying if I said I didn't, especially because some of my favorite wardrobe items have been neglected as of late. But, I've bought some new stuff, bringing the mountain to Mohammed, and I'm really not sweating the 12 pounds at all. Because in the scope of what I do and who I am and the world I live in, 12 pounds of extra flesh amount to absolutely nothing.

*Sorry, it's just that she's been in the news so much lately, and the tune sort of lent itself to the material. . . .

A Word from a Reader*

Hello Dr. Stacey,

I just wanted to write you as I just finished reading your entire blog. It really spoke to me. I have experienced problems with eating for years now, since the age of nine when a family member poked my belly and made fun of my tiny fat rolls. Though it could be blamed on normal changes that happen when a girl goes through puberty, ever since then I have felt uncomfortable in my skin, and I'm 27 now.

I have taken diet pills, been on countless diets, and even flirted with anorexia a time or two. Unfortunately, though I have lost weight in the past, I always return to my comfort of compulsively overeating, and I go back into what I don't want to be. I currently weigh the most I ever have, and I am so tired. I am tired of feeling 'less than' because of my own insecurities tied to a physical characteristic. I am tired of feeling worried for my health and sanity because I don't know how to treat myself with respect. I am tired of hiding this part of myself from others who don't know me well. It's exhausting, and not respectful As a student of psychology (almost finished with my bachelor's degree), I have done a lot of introspection regarding myself and my eating issues. I am ready to finish what I have started, and I want to love myself for the awesome person I am. The only problem is, I don't even know where to begin. I have read quite a few books regarding the subject of compulsive overeating, including all the ones written by Geneen Roth. I have identified with what she has written, but I still don't know how to take what she is offering and run with it.

I hope that you are able to continue your book-writing aspirations. I think you will make a wonderful author, and have a lot to offer the ED community. Like I said, I got so much out of your blog, I read the entire thing in one go. Thank you for writing it and for allowing others to share their experiences with you. Thank you for reading what I have written here - it means a lot to know that I have shared this with someone who is attempting to help. It is hard to find people who understand what I go through on a daily basis, hence this long, rambling e-mail.

Thank you again.

*I post this with permission from the writer, with the idea that others might identify with her story.

Book Review--Rethinking Thin

(It's on my sidebar as an EWHAED rec).

Just last week, I finished New York Times writer Gina Kolata's new book, Rethinking Thin. Kolata's served as a science journalist for The Times for almost 30 years, and has published a handful of books, including Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It and Ultimate Fitness: The Quest for Truth about Health and Exercise.

In Rethinking Thin, Kolata sets out on a similar quest for truth, this time concerning the diet industry and our societal obsession with (and relentless pursuit of) being thin. In the fashion of Paul Campos's The Diet Myth and Laura Fraser's Losing It, Kolata tackles head on the diet world, the concept of the obesity "epidemic," and the idea that dietary control may result in sustained weight-loss. A University of Pennsylvania study comparing two popular diets (low calorie vs. low carb) sets the backdrop for Kolata's historical account of how we've gained weight, lost it, and then, inexorably, gained it back.

You know the "willpower" argument--the mantra we hear almost daily that encourages us to keep trying harder to lose the weight? As Kolata writes, "Who could miss the drumbeat of messages from scientists and weight loss experts, the incessant hectoring year in and year out, assuring fat people that everything is possible for those who really, really try." Well, Kolata debunks that myth with support from the science of weight, highlighting the genetic influences associated with body type. She confronts the notion that fat people are to blame for their size, instead offering a literary montage of research studies suggesting we really don't have much control over what we weigh. It's a never-ending battle against our genes, and quite frequently, concerning our expectations, they simply just don't fit.

Kolata's account is cultural at times, referring to images of the Gibson girl, socio-political at others, documenting the negative correlation between obesity and socio-economic status, and even meticulously scientific, discussing hormones and chemicals, like neuropeptide Y and oxyntomodulin, suspected to relate to hunger and weight.

It's also sentimental--we follow the journey of four dieters in the university study, empathizing with their loftiest weight-loss hopes and dreams. Even Kolata, the objective science journalist gets drawn in by the diet allure, as she cheer leads the fateful four:

I wanted it so much that I began to suspend disbelief. I knew, I knew, the science and the overwhelmingly convincing evidence that most obese people will not be able to diet, get thin, and stay at a new low weight. But. . . I allowed myself to think that maybe, just maybe these people would make it. Maybe they would fulfill their dreams.

A whole science of obesity and weight loss seems be similarly hopeful, forever searching for the weight-loss holy grail. Kolata writes:

I'd often wondered how obesity researchers can keep doing study after study, advertising for subjects. . ., starting them off again and again on a path whose outcome they must know for sure. Could it be that the researchers too fall for the dieter's delusion?

Or, as Kolata notes, and as others have documented before her, can an entire industry rest on the possibility of autonomic weight control, be invested in studies and products that propagate this myth?

And, the assumption that fat is bad is similarly endowed with individual, institutional, and corporate backing. As Kolata points out, a lot of people have a lot to lose if we're to continue to show that being fat is not consistent with the dire health consequences the media and diet industry would like us to believe. In fact, publication of opposing studies is often displaced by those (which, incidentally, are often not as statistically sound as their counterparts) that champion the idea that if you are fat, you will die. Kolata states:

I'd like to think also that as the population gets fatter, there might be a rethinking of the risks of a few extra pounds. When health data have not supported the alarmist cries of a medical disaster in the making, could society perhaps let up on the beleaguered fat people.

Could we? We're so invested in some of these beliefs, challenging them would require a vigilant shift in focus, an active rebellion against the status quo, and a voracious curiosity and search for the truth behind the scenes. Kolata writes: "If nothing else, I believe that that research by scientists who have open minds about obesity and its causes and consequences is starting to open doors." With help from Kolata's exposé, we may eventually arrive at a place where the "age-old assumption that the perfect diet will somehow emerge" is as much a scientific blunder as the thought that the world was flat or the idealistic misconception that physical exercise should be effortless.

Thankfully, Kolata gives us a running start.

Shameless Self-Promotion

And now, a little bit more about me. . .

Who's the Hottest?

I'm sitting here with three of my favorite trade weeklies: In Touch, Us, OK magazines. Each has a feature where two celebrities are pitted against each other in similar frocks, titled, "Who Wore it Better?" Us actually compares three stars, modifying the superlative a bit to, "Who Wore it Best?"

See, the thing with these little contests is that I always get it wrong. I cover the winner (based on staff selection or reader polls), and I try to guess who, in fact, they chose. I study the images carefully--since, we're talking about clothing, I look at how the garment is tailored, shoe and accessory selection, fit, and even at the way the item falls on the celebrity's figure.

But, I almost always get it wrong.

Let me give you an example of why I think this is. Us Weekly's version (this is the July 2nd issue), compares three stars: Sofia Vergara, America Ferrara, and Tiffani Thiessen. Who do you think received the fewest number of votes?

Enough said.

OK's (July 16th) issue weighs Naomi Campbell against Beyonce. Again, guess who won?

My hunch is that it's really not so much about the clothing here, but about the celebrity's figure. I'd have to pour over the magazines' archives for this research project, but I'm guessing that the celebrity with the better body wins, regardless of her hem line, the clutch she carries, or the height of her heels. See, I think Beyonce has a rocking body, but a lot of people don't.

Usually, in my anecdotal research, it's the thinner celebrity, but not those we judge to cross the line. So, in In Touch's version, Eva Mendes actually triumphs over Bai Ling. Admittedly, I'm relieved when stars like Nicole and Paris and Victoria are not victorious.

I really wish we weren't putting these stars' bodies up for such scrutiny and competition. The guise of whose stylist assembled the better ensemble is simply too thinly veiled.

Music and Lyrics

During graduate school, some classmates and I were hanging out in the psychology graduate student lounge (a happening place, as you can imagine), and the subject of music came up--specifically, were we "lyrics" or "music" people? In other words, when you like a song, do you like it primarily because of its words or its beat? All of my classmates, given my attraction to the written word, figured I'd be a "lyrics" girl. Not so. So much of what attracts me to music is the beat, and often, I'm not even sure what the actual message is. Which bring me to the point of this post. . .

Recently, I was introduced to songster Mickey Avalon, and I've taken a liking to his work. (Right now you're probably think that I'm a 16-year-old boy--I assure you I am not). A couple of downloads later, I finally listened to the lyrics of one of the songs, "So Rich, So Pretty" (yes, I should have known) and was shocked to hear (and then look up) the lyrics below.

I liked the song. Now, I'm kinda mixed. Erase it from the play list?

Mickey Avalon - So Rich, So Pretty

I like a girl with caked up makeup.
In the sunshine, smoking cigarettes to pass the time.
Who wakes up to a bottle of wine
On the nightstand, bites and scratches the blinds.

But i ain't found one quite right yet.
So I step with pep to the park or supermarket it.
Her apartment best be messy.
And Lisa don't mind when i call her Leslie.

She's gotta dress with class.
In Jean Paul Gautier and an Hermes bag.
And 4 inch tips made of ostrich.
Sharp enough to slit your wrists, her lips spread gossip.
Won't say sorry when she offends.
She comes over to my place in her old man's Benz.
In gold and silver and jewels of all colors.
And she doesn't take them off when we're tearing up the covers.

Come on get it 'fore I change my mind.
Come on kid don't waste my time.
So rich, so pretty
The best piece of ass in this whole damn city.
So rich, so pretty.

I like a girl who eats and brings it up.
A sassy little frassy with bulimia.
Her best friend's a plastic surgeon.
and when her Beemers in the shop she rolls the Benz.
Manis and Pedis on Sundays and Wednesdays
Money from mommy, lovely in Versace.
Costly sprees it's on at Barneys.
And i love to watch her go thru 50 G's calmly.

She gets naughty with her pilate's body.
And thinks it's really funny when her nose goes bloody.
Cuz the blows so yummy and it keeps her tummy empty
And makes her act more friendly.
Dance the night away.
And she won't say nothing when she makes a man stray.

Come on get it 'fore I change my mind.
Come on kid don't waste my time.
So rich, so pretty
The best piece of ass in this whole damn city.

I've had you come before Mickey.
Go get my purse Mickey
Lock the door Mickey
You're just a midnight snack
Shhh
Don't talk back.
You're just a boy Mickey.
You're just a toy Mickey.
You're just a boy Mickey.

Come on get it 'fore I change my mind.
Come on kid don't waste my time.
So rich, so pretty
The best piece of ass in this whole damn city.
So rich, so pretty.
So rich, so pretty.
The best piece of ass in this whole damn city.

The Mutual Admiration Society

A couple of days ago, I received an email from Leslie Goldman, author of The Locker Room Diaries (check out my side bar for the Amazon link). Goldman was writing to compliment me on this site and my writing and to suggest that we somehow collaborate in the future. Wait--the woman, whose book rests proudly among my other e.d. reads, was contacting me, saying she liked MY writing?

Nice!

So, stay tuned for some type of LRD/EWHAED venture. In the meantime, check out Goldman's iVillage blog. Her writing's funny, poignant, and EWHAED approved!

You'll Never Have to Exercise Again

Well, at least that's what the headlines will soon lead you to believe. . .

Salk Institute scientists recently created an "exercise pill," activating a gene that results in cellular fat burning. Mice who were given the formula failed to gain weight, via chemical activation of PPAR-d, a fat-burning gene, even when fed a high fat diet.

Of course, our interest in mice only extends to how research might apply to us; researchers are suggesting these findings might warrant new ways of addressing human metabolic concerns.

So, exercise no more? Even if the pill is to be proven safe and effective with humans, the only demonstrated benefit (at least with mice) is increased cellular fat burning. That leaves a whole host of physiological and psychological benefits of exercise untouched.

Back to the treadmill it is. . .

We Pause for this Important Message

Today, I'm tired of writing about eating disorders, (aren't you sick of reading about them?), so I'll focus on another issue, our nation's health care system, my diatribe inspired and fueled by my recent viewing of Sicko, Michael Moore's new flick. If you have any interest in health care, check it out--if nothing else, Moore's acerbic wit is sure to entertain. I actually found myself laughing out loud at a scene in which a woman, who had been in an accident, reported that the payment for her emergency transportation to the hospital was denied because she had failed to have the ambulance ride pre-authorized. It's funny. But it's not.

As both a patient and a provider, I've struggled with managed care. I've found myself wondering what universal health care would look like in the States, why we can't seem to get it right. Applying for Medicaid, which is supposed to insure even the most economically disadvantaged, isn't the easiest process to navigate. And, once you have Medicaid coverage, you don't get much besides the card. Most providers, at least in mental health, don't even accept Medicaid, and at horrendous reimbursement rates, that make a mockery of their advanced degrees, why would they?

Several years ago, I did a brief stint at a city hospital, where most of the patients were covered by Medicaid. My stint was brief because on my first day on the job, I was assigned 103 patients--any idea what a typical therapist's case load is like? Not 103 patients.

The objective was to meet with 10 patients a day, for 30 minutes each. Now, in the managed care and private pay worlds, patients are entitled to a bit more time. Not these folks. And, the frequency of therapy? Because of my 40-hour work week and various administrative demands, I was instructed to see each patient once every three to four weeks. Not the most ethical or medically sound care, given that many of the patients had major mood and/or psychotic disorders. Each patient in my case load required volumes of paperwork--I took to, and I'm embarrassed to say this, completing the paperwork in session, because it was the only way to get it done. For many, I was their third or fourth therapist in the last few months, due to incredibly high turnover rates.

In addition to the clinical overload, the work environment was, to put it mildly, sub-par. It took way too long to get my office up and running. My phone didn't work--not even a dial tone. So, I went downstairs to the telecom department, which was conveniently located next to the morgue, and spoke to Ms. Telecom about the problem. "My phone doesn't work. No dial tone, " I said. She handed me a slip of paper. "Here, call this number."

My computer, as luck would have it, didn't work, either. I went to I.T. They also gave me a number to call. Or, if I'd rather, they mentioned, I could log on to their trouble-shooting site. Every exchange, every moment at this hosptial, felt just like this.

Pretty soon into my stay, knowing that I would leave shortly, I visited the H.R. department to inquire about health insurance coverage. "I'm curious how long you have to work here in order for you to qualify for COBRA?", I asked. And, the director of benefits, housed in the hospital's H.R. department responded, "What's COBRA?" He also engaged me in a casual conversation regarding his recent vacation and his concern that there had been some Arab travelers aboard his flight. "You should be suspicious of the Arabs," he said. I quickly thought, "You should be suspicious of those who tell you to be suspicious of the Arabs."

So, who would work at facility with dysfunctional technology (and office clerks), dusty, likely asbestos-rich walls, and racist, incompetent H.R. staff? Let me tell you about my colleagues, each caricatures of a sort: One of the psychiatrists seemed to have some trouble reading social cues. Whenever he spoke to me, he never made eye contact, and I was always left wondering if he was talking to me or himself. One day, he said something to me in passing in the hallway. I had thought we were done, so I continued walking, but he kept talking, unfazed by my departure.

A social worker down the hall wore a white coat to work each day, as if he were an M.D. I asked him about it once, and he reported that many social workers wear white coats. No they don't. That's great, I thought to myself, there's a therapist with a delusional disorder working down the hall.

And our fearless leader? The clinic director, a psychiatrist, stood up at a staff meeting one day and stated how difficult it was for him to be the most intelligent person in the room. I'm not kidding. He's also the person who told me my first week, "If you and I get along, you should have no problems here," who referred to our clerical staff as "stupid" (yes, to their faces!), and encouraged his providers to commit Medicaid fraud. According to information gleaned after my departure, a thick enough H.R. file eventually resulted in the discipline of said psychiatrist. He was only kept on board with the provision that he must always have a third person present for his one-on-one conversations. He was castrated, but still allowed to screw.

Clinical care was substandard, morale was atrocious, and the building was falling apart. Can you see why I left? But, the thing is, this is the care that countless of Americans get. They wait hours and hours for appointments (one patient arrived for his scheduled 11 a.m. appointment at 8:30 am. because he was so accustomed to having to wait) to see providers who are overworked, mistreated, and not provided with the appropriate resources and administrative support they need to do their jobs. . . who then leave, despite their best intentions to make the world, or at least Manhattan, a better place, after just three whirlwind months. I wonder how, if we were to insure every American (and without extraordinary tax hikes), this scenario could be different, where folks who needed medical care could actually get it and not just instigate a paperwork trail that made it look as if they did.

(Apologies for the non-eating-disorder rant. Regularly scheduled programming will resume next week.)

Day at the Beach

Thesuperficial.com recently posted a bit on Kelly Clarkson's six-month battle with bulimia in high school. Accompanying the text was a newer photo of Clarkson, snapped at the beach.

As of this writing, 249 comments poured in, and I had the chance to scroll through some of the them. I sometimes forget, writing a body-friendly blog, about the angry, hateful voices that surround us. True, the domain name should have warned me, but some of these (original writing preserved) were still quite alarming:

"Beached whale!!!"

"From the looks of that picture, she should think about starting up again."

"She looks like a very thin and unattractive woman that was stretched fat. There is no shape to her such as an hourglass figure and she definitely is fat. It is quite remarkable that she is so tubby yet not at all curvaceous. That body does nothing for a man. Sex with her would be a fitting punishment for minor crimes."

"I think this pic was snapped just as she started to hurl. Way to go Kelly! There is a thin you trapped somewhere in there."

"Wow! Kelly Clarkson bullimic? yeah right! if she was ever skinny, then i was a girl in my previous life. which i still am...only i have no boobs, an extremely large penis and...well, Long Story Short, im a guy. but in other words...i'd still do her. with a bag over her head of course."

One commented. . .

"She is NOT FAT at all. I dont see cellulite, rolls or a belly. she's just not super skinny. Part of the reason people become bulimic is because of comments like this."

. . . but was quickly rebuffed:

"I don't think so, celia. the reason people become bulimic is because they take extreme pleasure in overpowering and torturing people, namely, themselves."

Inaccurate.
Hurtful.
Angry.
Violent.
Misogynistic.

It's a dangerous world out there.

Or, as one commenter noted:

"Wow. Do most of you peeps have lives of your own? I'd love to see how you measure up against an incredibly normal-looking human being having fun at the beach. I love this website, but man, so many of the commenters have really fucked up views of what is good/beautiful/acceptable/normal. You're all so brainwashed to think that women who are so Hollywood thin are normal. They ain't. Kelly looks incredibly normal and healthy there. If she wants more in the boobage area, there are nice padded bras to wear. When you're having fun at the beach, who gives a fuck? And who should, frankly?"

Well put.

Is the Tortoise Catching Up?

Yesterday, out and about in New York, I happened across not one, but two body positive t-shirts. The first, by the designer Joie, stated boldy across a woman's chest, "Diets Stink." The other, pictured above, reads, "If the definition of beautiful gets any thinner no one will fit." Cleverly, the word "fit" falls just outside the box. This shirt and others can be purchased at New Moon, an EWHAED-endorsed, grass-roots, advocacy organization that publishes an advertisement-free magazine for "girls and their dreams." Another t-shirt in their catalog? "I Can Be My Dream." I kinda like that one, too.

Big Girls

23-year-old, Lebanese-born Mica Penniman (aka Mika) hands us this latest pearl in the size acceptance movement. A celebration of the (larger) female form, catchy lyrics, a campy beat--check it!

Alli

Back in February, the FDA approved Alli, an over-the-counter version of the weight-loss drug, Xenical. Alli, which cleverly sounds like a comrade in war or a girlfriend you'd meet for brunch (depending on how you pronounce it, though the correct pronunciation is the first), hit store shelves last week to an uproar, as expected.

The $50-something Alli starter pack sold out in hours in many pharmacies, in a furor typically reserved for a life-saving remedy. The Los Angeles Times interviewed Santa Monica pharmacist, Roe Love, who equated the Alli sellout with the post-9/11 anthrax-induced Cipro dash, reporting that the bulk of Alli purchasers at her store have been women, adding, "And they're not fat."

Love's store is in Santa Monica. Did we really think they would be?

If you haven't heard, Alli, which results in weight loss due to blocked fat absorption, comes with some minor side effects, of the gastro-intestinal sort. The manufacturer's (GlaxoSmithKline) website euphemistically refers to these as "treatment effects": 1) gas with oily spotting
2) loose stools 3) more frequent stools that may be hard to control.

Not terrible, but the site goes on to say: "You may feel an urgent need to go to the bathroom. Until you have a sense of any treatment effects, it's probably a smart idea to wear dark pants, and bring a change of clothes with you to work." That bad, huh? And, manufacturers warn that the product won't work without the adoption of a low-fat, low-calorie diet and commitment to an exercise plan. Seems like what we've been told for years. . . without the need to change our oily, loose-stooled pants.

Mortality

Last week's cover of In Touch Weekly featured photos of Nicole Richie and Angelina Jolie, tagged: "Scary Skinny! Alarming new photos of Nicole and Angelina spark more fears for their health."

But, are we really worried about their health? Sure, they look unhealthy, and perhaps we pontificate about the consequences of their being too thin, but are we really concerned about their lives? What needs to happen in order for there to be bona fide concern, in order for us to stop trying to look like them? Richie and Jolie are just the latest faces of celebrity emaciation. Their predecessors (Kate Bosworth, Keira Knightley, Kate Moss, etc.) either gained weight or somehow escaped the too-thin radar. For now.

Somehow, we've learned that the consequences of being too thin aren't that serious. Somehow, we've ignored the passing of South American models. And, somehow, we've denied the fact that anorexia has hightest mortality rate of all mental illnesses.

This weekend's New York Times featured an article on cocaine, New York's party favor du jour. The substance, as common at bars, parties, and clubs as vodka tonics, has proliferated recently, in part, because of a recent absence of publicized drug-induced casualties. As Herbert Kleber, of the New York State Psychiatric Institute, is quoted as saying, "'Drug use tends to be cyclic. . . . As some of my colleagues said, John Belushi had to die before people believed that these drugs were really dangerous.'"

Is that what it will take in order for us to wake up to the dangers of anorexia? Do we need, at least on American soil, a star to lose her life? Do we really need another Karen Carpenter?

Drug of Choice

This weekend's New York Times "Style" section featured an article tracing the cupcake craze, the proliferation of bake shops across the country specializing in the fourth-grade birthday party signature treat, cupcakes. The article suggests our interest in cupcakes represents a return to comfort food (others find a similar path toward mac and cheese) and discusses how far from comfort, a la our diet culture, we've strayed. Lesley Balla, blogging food writer comments on the advent of cupcake stores in L.A.: "Do we really need another bakery? Probably not. But Angelenos have been starving for sugar and carbs for so long that the bakeries seem like a breath of fresh air."

Balla's wise words capture the principle of psychological reactance, defined in the APA Dictionary of Psychology :

. . . a motivational state characterized by distress, anxiety, resistance, and the desire to restore that freedom. According to this model, when people feel coerced or forced into a certain behavior, they will react against the coercion, often by demonstrating and increased preference for the behavior that is restrained, and may perform the opposite behavior to that desired.

The beauty of reactance theory is that it, despite its psychobabble, succinctly captures why diets fail (or at least the psychological reasons they fail). The more we're told we can't have, the more we want. Proponents of reactance theory might even argue for legalization of marijuana, gambling, and prostitution.

And so, since Atkins/South Beach/other diet of the moment has expressly forbidden sugar and, gasp, white flour, we begin to crave these ingredients to such an extent that we find ourselves secretly bingeing on them, or patiently, but urgently, lined up outside a cupcake bakery, waiting for our fix.

When I first visited Magnolia Bakery (a cupcake shop with its own wikipedia entry) in New York City*, I wasn't yet living here, but a friend thought I'd enjoy the experience. On a cold winter day, a line wrapped around the West Village block, and we were ushered in in two's and three's, allowed to box our own cupcakes, but warned of the cupcake limit (12). My friend apyly commented, "There's really no difference between this and a crack house." It's just a different drug of choice.

*for the record, now a permanent New York City resident, I prefer Crumbs, which offers 1) more flavors 2) a moister cake portion 3) frosting that isn't too sweet 4) an indoor line

What Size Is that Number?

(from little m. . . or "big m," as I like to call her and now feel incredibly righteous in doing so after reading this post) ; )

Irene is a family friend, surrogate mom crossed with fairy godmom.

When I was 10 or 11, with what I felt was a cereal box for a figure, no one in my family wanted to take me shopping for school clothes because they could gamble and win on the odds I would come home howling, in tears, with nothing to wear.

Somehow Irene could take me out and we would find something that not only would my family not die of shame to see me in, but that I actually liked! and could wear to school without fear of violating a public decency law.

Irene is like Donna Karan or Elena Miro, or Chanel (I don’t mean the designs, awesome though they are. I mean the people themselves)--she will be hip to death forever.

She recently ordered this amazing leather coat in a size she no longer wears (her closets are full of suits in that size, and they haven’t fit in years).

So she had to go to all the trouble of dragging it to the post office, sending it back, and ordering it in the size she is now – which of course both fit and looked SMASHING.

I’ve done it. You know you’ve done it.

In the age of the vanity size--and as savvy and sharp as we are about other things in our lives--WHY do we still cling to the number? Why don’t we just cut the size tag number out and get on with the business of looking--and being--fabulous?

Spinning Biel

Jessica Biel graces the front page of the June issue of Elle magazine and, in between the covers, comments on her body : "This is the thinnest and the least muscular I’ve been in a long time."

Perhaps Biel intended neutrality with her words, having no emotional reaction to her body, but that's not how the gossips took it--one magazine interpreted her statement as a dissatisfaction with her current appearance, another recognized it as praise for the status quo. It's interesting the spin they spin, leaving me to propose:

Maybe
her body
just is.

If we could gain and lose weight with the same emotional valence; if we could buy a larger (or smalller) size with no more reaction than the one we bought before; if we could make observations about our bodies with no judgment, disdain, or critique; then, to paraphrase Biel, we'd be the healthiest and the least troubled we've "been in a long time."

We Say It So Often It's a Book Title

Another installment in the littlem series. . .


*does variation on Peanuts happy dance*

Would you believe there is a book called “Honey, Does This Make My Butt Look Big?” by a therapist named Lydia Hanich?

What I love is, as the Editorial Reviews blurb on the book says, that it helps couples to deal with issues such as “appearance, weight, food, exercise, sexuality, and eating disorders.”

That pretty much covers the spectrum, doesn’t it?

Because the thoughts in our own heads aren’t always the only problem. Sometimes our beloved S.O.'s say and do stuff, based on their own conditioning, that can be, absolutely, say it with me – "part of the problem."

What I also love is that it offers not only various scenarios, responses, and WHY they might or might not be the "right" or "wrong" thing to say when asked a question like that.

I think that really works for folks (seems like they’re generally men – it really does feel like we’re speaking two different languages some days, doesn’t it?) who want to assuage the distress that a significant other might be feeling over body image, but can’t answer without feeling – this time paraphrasing the author herself in the blurb on the back of the book -- just like that "animal caught in the headlights." Ha!

What I don’t love quite as much is that, as universal an issue as this seems to be, it took me two years to find this book – because, as you’ve probably figured out by now, I believe there are elements in our society that work directly against our being able to deal with these problems. But that’s a different subject for a different post.

Today is a happy post day. Woo-hoo!!!

I have politely demanded that all my local bookstores order it immediately, but if you just can’t wait, you can order it here from Amazon.

A Tongue of Weight

Hunger, in our world, is portrayed as a demon that must be slain. We are encouraged to “reduce,” “curb,” and “control” our hunger, without ever considering that it might serve a biological (and psychological) function. An advertisement for Slim-Fast Optima Shakes suggests the product “Controls hunger for up to four hours,” a substantial duration in our crusade. Imagine other products designed to help us gain control over physiological processes: an oxygenated air freshener that helps you avoid breathing for up to a minute, a specially formulated beverage that allows you to delay urination. Why aren’t these products on the market? True, there may be some interest in gaining control over other biological processes, but we would never think we could. We purchase products such as Slim-Fast because we learn from a very young age the falsehood that hunger is controllable and that we need an ally to help us wage the war against our hunger.

In keeping with our fight against hunger, bellicose metaphors abound. We join the ranks of the war on fat as we attempt to combat cravings, to fight the “battle of the bulge,” we enroll in boot camp classes and kick off a diet as if we’re being stationed overseas. Sorry, friends, I won’t be able to join you for pizza this week—I’m being shipped out on Monday. We soldier on, sticking to a diet or fitness regime as if it’s a plan of attack, avoiding the enemy shrapnel of a whiff of cinnamon sugar from a local bakery, the trace of buttered popcorn at the local Cineplex. The helpless frustration here, the irony, is that the enemy camp is forever expanding, a cease fire too distant to imagine, and the only casualties ourselves.

Chasing Slim

Part of the assumption underlying the idea that every woman has an eating disorder is that our culture reflects (and inspires) this truth, making it strikingly easy to derive these posts.

The latest candidate? A book, which I happened across this week, by fashion designer, Cynthia Rowley, entitled Slim. The subtitle, "A Fantasy Memoir," reflects the work's fictional component, which functions side by side with Rowley's life account. However, what struck me was the title as a whole, as it appears on the cover (Slim: A Fantasy Memoir), the idea, which doesn't meet much challenge, that "Slim" is a bona fide fantasy--that those who realize this goal indulge in the good life, while those who don't spend the better part of their lives chasing the ideal. To Rowley, the word "fantasy" might connote her fabled climb from small-town, Illinois youth to major player in the fashion world. To most women, slim is enough of a fantasy on its own.

Thin Is a Moving Target

Editor's note: The post below comes courtesy of little m (you may recognize the name from her periodic comments). lm has graciously agreed to guest post for me from time to time. Let us know what you think. . .

Lots of you all might have seen in the comments here that I’ve mused that my personal physique is such that whether I’m “too thin” or “too fat” depends on where I am in the country. What that finally told me – after much mulling – is that THIN and FAT are COMPARATIVE CONSTRUCTS, not absolutes, and that they depend a great deal on WHAT people think and WHY they think that.

In our culture, we have been conditioned to believe that, especially for women, THIN IS BETTER NO MATTER WHAT.

Another absolute. And it has potentially deadly consequences when taken to the extremes – as Dr. Stacey is showing us.

So one of the things I started to do when confronted with “THIN IS BETTER NO MATTER WHAT” is to shout back – if only in my head –

“WHY?” and

“WHO SAYS?”

Those questions and others like them -- critically deconstructing messages that their creators hope we’ll absorb without thinking about them -- work for me in counteracting that never-ending assault. It’s an assault that sets the concept up based on imagery so manufactured that the people used to manufacture the standard don’t even meet it.

Dr. Stacey thought it would be cool for me to share them, and other related stuff, for readers to create their own files of coping skills – since we all deal with this same issue, but it manifests in different ways in our lives.

This will probably be one of my most serious posts. Principally because I believe so much in what Dr. S is doing and want to show her and her subject material proper respect.

Additionally (and with her approval) because I believe that when a disempowering, unhealthy, tyrannical standard has its grip on your life and lifestyle, that poking relentless fun at it helps put it in its place.

Humor is a power tool.

There may be a lot of things that I say that are not going to help everybody.

For example, these days a lot of eating disorders start when girls are pre-teens and teenagers.

I’m neither one anymore, so even though I remember what it felt like to have being thinner matter more than anything – more than energy to make good grades, more than some adult telling me it wasn’t healthy not to eat all day (what did they know, anyway?), MORE THAN ANYTHING – I’m not actually in that space anymore. So those of you still in that space might feel like I don’t have much to say to you.

On a different level, a lot of the questions I ask (like “WHO SAYS?”) depend on challenging outside norms, on challenging the status quo. And for a lot of reasons, a lot of people don’t feel like they can do that. Or that they’re not ready to do it yet.

All I would say is, if you find something here that you think will help you deal, then use it. And then come back and tell us about it.

So to begin:

The “WHO SAYS?” position in my own head got a big boost when I read an article that helped me crystallize that thought that maybe – just maybe – something OTHER THAN my body size was the REAL problem.

So I love this article very much.

Thoughts?

Calling a Spade a Spade

Recently, at Bloomingdale's, I came across a relatively new brand of denim, called "Rich and Skinny" jeans. That's right, that's the brand name. Ever heard of them? Well, maybe not under this exact name, but, truth is, you've been hearing about these jeans for years. So many clothing lines these days cater to the "Rich and Skinny" crowd--this happens to be the only one that takes responsibility.

Rich and Skinny jeans are typically offered in waist sizes 24-31, and the price tag (roughly $200 a pop) suggests that in order to wear them, as their name suggests, you better be both.

One Little Pig

By now, you've probably heard about Alec Baldwin's telephone rant to his 11-year-old (or 12, as Baldwin mistakenly notes) daughter, Ireland.

What I find most disturbing about this leaked voice mail message, after his threats to "straighten [her] ass out" upon their next meeting, is his reference to Ireland as a "thoughtless little pig." True, he modifies "pig" with "little," but being labeled a pig is the last thing an adolescent girl needs to hear. Especially when your mom happens to be Kim Bassinger. . .

The New No-Diet-No-Exercise Weight-Loss Plan

Last night's ten o'clock news beckoned with a diet trick sure to inspire--a weight-loss method that requires no exercise or food restriction.

Following several stories and commercial breaks, the plan was unveiled: chew gum. As the reporter informed us, chewing gum during the afternoon results in 36 fewer calories consumed per day.

36. So, in about 100 days, if you're to chew gum every day, you may (if you're the norm) lose about a pound. How, I wonder, did this make the news?

Scales of Measurement

I’ve never owned a scale. It seems that weighing becomes highly ritualistic, and as others have written in the past, a way to determine one’s worth and mood for the rest of the day. That’s probably why I’ve opted out. But, recently, I’ve been thinking about how, even if we shun the scale, we may compensate by using other self-worth metrics related to body image, namely frequent mirror checks and/or an over-reliance on the fit of our clothes.

“Oh, I don’t weigh myself; I just go by how my clothes fit.” Sound familiar? What exactly does “go by” mean? Why must we rate ourselves at all? Weighing. Mirror-glancing. Checking the fit of our clothes. The self-esteem trifecta.

So, I’m curious: How often do you weigh yourself? How about checking yourself in the mirror or the fit of your clothing? What types of thoughts and feelings precipitate these behaviors? How do you feel after each behavior? And, finally, what would it be like to stop?