Stories: Part IV

Printed with permission. . .

It does seem true that in our culture it's rare for there to be an uncomplicated relationship with food. We are sooooo fortunate to have plenty, why do we confound it? Perhaps it's a transmutation of guilt--for having and wasting obscene amounts when so much of the world is desperately hungry.

I've been on a project to transcribe all of my old diaries into my computer. Currently I'm on #33, which makes it at least the 25th diary (with a long, long way to go) where I'm dealing with the issue of food, eating, body image, and the western cultural imperative to be thin.

I've studied this and suffered over it for years and I don't feel any closer to understanding the imperative. I know that growing up it was implicit--'diet' was an ubiquitous verb. As a child if I went home from school with a friend my mother would ask when I got home if my friend's mother was 'heavy'. That was the euphemism.

drstaceyny writes under her profile on her blog: My contention is that every woman has an eating disorder-- not necessarily anorexia or bulimia per se, but a fixation on food/ weight/shape that is unhealthy, unwanted, and undying.

And, if I might add, wearying.

Like I said, for years I took on the subject, mainly from the point of view of why I felt so susceptible to it and the ways it jabbed me internally. Why could I not dismiss the perfection hysteria for what it is? Especially since I knew it wasn't rational, I knew it was cruel.

My current working theory is that there is a sort of anxiety-fueled need-to-win dynamic that drives it. I got a clear example of this dynamic when watching a comedy television program about a family. The father volunteered to take on coaching his son's dispirited soccer team. Obviously determined that he was going to be a nurturing coach he admonished the coach of the opposing team who was harshly screaming at his kids: "Hey! Come on, lay off, they're just kids! This is supposed to be fun!" To which the opposing coach responded by sneering to his team: "Hear that? That's LOSER talk!" Similarly, to consider swimming upstream from the main by shrugging off a cultural ideal of beauty was undermined by the idea that I was indulging in sour grapes: loser talk.

This issue has been present for most of my life, in varying degrees of intensity and urgency.

I put it in a bottom drawer for the past 3 years. Shortly after returning to Portland I was very low, very depressed. I met a physician who was confident in her ability to help me manage this medicinally.

The first antidepressant I tried was Remeron. I was shocked 3 months later at my GYN checkup when I weighed more than I had ever weighed not-pregnant. The dr. said confidently: "Everyone gains weight on Remeron. I'll often prescribe it to new mothers, stressed, underweight, and not sleeping." Well, this wasn't a time I was prepared to face down the whole weight issue and I asked my primary dr. if I could switch to something like Wellbutrin, which I'd heard had a side effect of weight loss.

The way the weight-loss side effect worked for me is that the experience of hunger was detached from my emotions. I might still feel hunger, but I didn't experience it as suffering. The eating motivator was thus less potent and I lost weight. So for the past 3 or so years I've weighed approximately my high school weight.

The thing is, the drug didn't have that much effect on my mood. Not really noticeably, anyway. Perhaps there was a subtle change to my background mood base and the alteration was so gradual that I didn't notice it. Last year when I started seeing Sharon, my counselor, I told her that I was taking antidepressants. She suggested that at some point I might want to wean off of them and "see who I was without the drugs." But I really felt I wasn't any different with or without the drugs; I felt like I knew 'who I was'. Time, situational change, and a year with both boys full time in school eased the depression symptoms; the medication didn't seem to have much effect beyond the hunger effect and a mild (not unpleasant) buzz.

It was really only the weight effect that motivated me to keep taking them.

I pushed to the back of my mind the awareness that a day of reckoning was coming where I'd face some questions:

1) What does it mean to be thin?
2) Is it important to be thin?
3) Why?
4) Is it still important to be thin when I'm 49/50/51?
5) Why?
6) What does it mean that it's important to be thin?
7) Is it legitimate to use anti-depressants as a diet pill?
8) Is it dishonest to be slender by these means?
9) To whom do I owe 'honesty' about this? If me alone, why should I feel uneasy about (dis)honesty? If someone else--no that just seems absurd. Should I carry a sign that says, "I'm slender because I take Wellbutrin"? Still, I'm dogged by the feeling of misrepresenting myself. (Then comes the 'puritan question'-- if I don't have a metabolism that makes me 'naturally', 'authentically' thin is the only way I can legitimately be thin is if I suffer to do it--either through eating less than I want or exercising mightily? Why should those means be more legitimate than an antidepressant with a convenient side effect? Who says?)

Of course this opens up a whole other can of worms, too. I can see when I read my journals that there was a lot of fevered energy that I now recognize as biological--the drive for a mate. I didn't know it then but it's plain now. A successfully sexually appealing identity once seemed very necessary.

What is the basis of sexual appeal when one is beyond childbearing age? Again, the question, is it important, is it worth an effort, is it even possible? A certain number of pounds hung on my frame now looks very different than it did when I was 20, 30.

And it's not as if I'm interested in entering the world of trying to attract a sexual partner. I have friends my age who are single, friends who are divorced, Out Looking. After 16 years of marriage there is no appeal in that for me. When I get dispatches from that field I have trouble relating personally--it seems like something that belongs to another age and another time. My friends seem very engaged: I just can't relate.

I suppose having two young children makes a mate search additionally irrelevant. It's rare that children from one man, particularly boys, have a successful relationship with a man-not-their-father who is close to their mother.

I started tapering down the antidepressants in January. It's been several weeks now since taking my last. My mood continues to be stable, but I didn't expect to experience any differences on that front. What I'm nervous about is whether or not I'll be having to confront the old demons about appearance and weight. And whether I'll finally be able to make some peace with them.

But She Got Much Back

A loyal reader forwarded me this website, a clothing company called "Little in the Middle," specializing in clothing for normal women. Specifically, the company caters to those of us "pears," who have smaller waists and larger hips and thighs.

I certainly appreciate the brand's philosophy--no more jeans gaping at the back! But, I'm staring to wonder is "Little in the Middle" as detrimental a phrase as "Big in the Bottom" when it comes to body and size acceptance?

Sex and Weight

Yesterday, I was interviewed by an online magazine on the topic of overweight* women and dating. Specifically, the interviewer asked questions about why thinness is glorified in women, how overweight women struggle in general and particularly with regard to dating. She wondered if overweight women might miss out on sexual opportunities and how these women might become more comfortable with sex. And then a bomb dropped: "What do you think about the idea that overweight women are easy?" (as in
sexually promiscuous. . . as in, in order to compensate for their weight)

Is this true? And, even if it's a stereotype, since most stereotypes are based on a glimmer of truth, why do you think this is?

*her word, not mine

The Stomach Bug

I got it. Yep, the stomach bug. You know the kind when you eventually resign to taking up residence on the bathroom floor? That's the one. And, in the week-plus of recovery since (accompanied with little appetite and the requisite weight loss), I've been thinking about what the stomach bug means with regard to e.d.'s.

Would you secretly welcome the stomach bug in order to lose weight? Take the EWHAED's first poll (on the right) to let us know. . . .

I've Got Mail

I love getting letters from my readers, especially when they look a little something like this (posted with persmission):

Hi Dr. Stacey,

You may think this is a little compulsive, and, sure, it represents the extreme end of things, but I have neither of the following things:
- a mirror in my bedroom
- a scale in my house

Consequently, I'm extremely happy, and whether or not I feel comfortable in my body has to do with just that - whether or not I feel comfortable in my own body.

Do we even need a scale to measure weight? There are an enormous number of things around us that do the weight-measuring for us, without the numbers. Everything from our own clothing sizes to other people's comments on any ups or downs in our weight serve to remind us of just where we fall on the spectrum. A scale seems, well, superfluous.

So then, why don't I have a mirror in my room? It's also superfluous. If I want to pluck my eyebrows or put on makeup, I'll go into the bathroom. That decision involves taking an active part in my self image - that is, seeing myself when I want to see myself, using the mirror for an activity with its own purpose rather as a tool to open myself up to the opportunity to self-criticize endlessly. What role could a mirror in the bedroom serve that a mirror in the bathroom could not? Looking to see if I have something in my teeth, washing my face, even trying on new earrings . . these are all things that could happen in the bathroom, with purposeful intent.

The radical part in me thinks we should abolish scales - except in doctor's offices and laboratories. I think it's extremely weird that they developed as a part of our hygiene habits. Shouldn't what we do in the bathroom be about taking care of our bodies instead of encouraging terrible self image? Bathing, toilet, brushing our teeth, combing our hair - this all makes sense. But the scale? Everyone should do themselves a favor and lose it.

Can't wait for your book to come out!

Morning Show Request

Wanna be on TV?

From Michelle Niger of FOX:

Hello, I’m a producer with “The Morning Show with Mike and Juliet.” We’re a nationally syndicated live morning television show based out of NYC. On Thursday, April 24th, we’re doing a segment about a study from the International Journal of Eating Disorders that says that eating disorders are contagious. The study says, “A study of U.S. high school students provides additional evidence that eating disorders may be contagious….researchers found that binging, fasting, diet pill use and other eating disorder symptoms clustered within counties, particularly among female students…”

I’m looking for a personal story from someone who has or has had an eating disorder, specifically someone that was shared with or learned their eating disorder from other women in high school or college. We will cover all travel accommodations to NYC. Please call me asap as this is time sensitive 212.301.5371

Line 'Em Up!

In an US Magazine April piece, entitled, "Hollywood Hunger-O-Meter," "stars weight in on how much, and often they indulge their appetites." The celebrities are arranged on a "hunger meter," with markings from "Feed Me!" to "I Watch What I Eat" to "Not Counting Calories." "Feed me" celebs include Molly Sims ("I just fasted for four days. . . . I'm back on food. Today I had kale, squash, quinoa, and lemon water," while the other end of the spectrum sports Sarah Jessica Parker ("I eat everything") and Michelle Trachtenberg ("I'm in New York for a month, so all I'm going to do is eat pizza!")

Other notables? Julianne Moore ("I still battle with my deeply boring diet of. . . yogurt and cereal and granola bars. . . I'm hungry all the time") to Kate Walsh ("I was afraid of becoming huge. . . I remember [just] eating a mixing bowl. . . of whipped cream with Equal in it") to Ali Larter ("I'm such a hedonist with food. . . . I'm not one of those girls who likes moderation").

Did you see this article? What types of thoughts/feelings emerge when hearing about it? Do non-celebrities model their diets after these women? What does it say about our world that this is the dimension on which we're rating our stars?

What the Buck?

I just arrived back from one of my local Starbucks stores (yes, that's plural in NYC) and need to know--does your Starbucks location post the caloric content of its food items? I've never noticed this before!

There, beneath each pastry name on the little pastry card was written the number of calories it contained. I have to admit, I was quite surprised to learn the caloric content of my beloved Rice Krispie Treat (aka Starbucks' generic "Crispy Marshmallow Square"). I know that this information is posted on-line, but I'm not the kind of person to look.

Yet, here it was, staring me in the face. What do you think about the in-store postings? Yay or nay?

Florida Manatees

Have you heard about the Florida Marlins baseball team's new acquisition? The Marlins have put together a plus-sized, male cheerleading squad they call, "The Manatees."


From the Marlins' official site, calling for participants: "The Florida Marlins are looking for big bellies with the biggest jiggle, big feet with the best dance moves and enthusiasm that will rock Marlins fans out of their seats."

A recent Today Show piece dedicated to the Manatees showed one cheerleader, who lifted his shirt to reveal his belly, and said, "Why have a six-pack when you can have a keg?"

It's funny, right? A Miami Herald.com article declared: "Manatees cheerleaders put the giggle in jiggle." According to press releases, the fans seem to appreciate the comic interludes the Manatees provide. And female attention follows suit. . . One fan, captured on Today, cozied up to the squad, and squealed, "They're so cute!"

Does this represent a step toward fat acceptance (in men), or just another way to mock the fat? Would female "sea cows" inspire the same attention and praise?

Stephanie Kuleba

About two weeks ago, South Florida teen, Stephanie Kuleba, died during breast augmentation surgery. The 18-year-old captain of her high school cheerleading squad, an accomplished student who had already been accepted at University of Florida pre-med, died due to complications from the anesthesia used during her procedure.

In case you didn't know, Kuleba wasn't simply aiming for bigger breasts--according to reports, one of her breasts was larger than the other, and one of her nipples was inverted, causing her distress throughout the years.

I'm curious about your thoughts about this story. Obviously, Kuleba's death is tragic and highlights the dangers of surgery in any case. Elective procedures, especially, are called into question, when medical necessity won't provide justification. But, should Kuleba have lived in shame of what she felt was a malformation? Should a psychologist have been involved? What does this say about women's body image (especially teens') and the perfection our culture demands?

I'm being interviewed by a local news station at 11:30 am to address these questions, so if you happen to see this post before, I'd love to read your comments!

Calling All Orthorexia Commenters!

So, remember the orthorexia post I wrote, in which I mentioned I was contacted by several media outlets? One of them was ABC--they're working on a piece on orthorexia for 20/20. My ABC contact read the post (and your helpful comments) and is particularly interested in speaking to:

1) Anna
2) Emily
3) Fauve
4) Rachel

If you happen to be one of these people, please shoot me an email at drstaceyny(at)aol.com if you'd like to get in contact w/ABC. He reassures me that all communications will remain confidential until agreed upon otherwise.

Thanks!

Intuitive Eating with Restrictions

Editor's note: I received this message last week from a reader I'll call Karen. I responded to her directly but would appreciate my readers' input. Please comment if you have any suggestions or recommendations for Karen.

Hi, Dr. Stacey - I was introduced to your blog through a link on Disordered Times. I love the blog for a lot of reasons - but one of them is just knowing that I'm not alone in my struggles with eating and how I feel about it and even how to do it.

I'd be very interested on your opinion, if you ever have cause to give it, on how folks like me, who have a medical condition that requires an "abnormal" relationship with food, can work to be at peace.

I'm currently really ambivalent about calorie restriction, food logging, dieting in any way - the fatosphere has given me the confidence to say, hey, why should this take up so much of my time and energy, but the social reality of having lost some weight, and the impact of years of negative thinking about my body and all of that argue against giving up the diet I'm currently on. (I'm not supposed to call it a diet - but I think anytime you're restricting or changing your food intake based on some external, artificial measurement, it's a diet, and call a spade a spade!)

But, even if I do manage to kick the diet habit - I still have to write down and be conscious of every goldanged thing I put in my mouth, because I have Type 1 diabetes, and I have to play my own pancreas here, and if I don't know how many carbohydrates something has in it, I can't take my insulin appropriately, and my blood sugar will be screwed up. (It gets screwed up enough even when I do know, or think I know!)

I think for me, it might never be possible to have a comfortable relationship with food for that reason. I know a lot of us feel the same. I'm currently looking for ways to make my peace with that and to find a healthy way to be a food logger and carb counter (if not carb-restrictor). But I wonder - is it even possible? And, if it isn't, if disordered eating is always going to be a part of our lives, why isn't it part of a standard treatment plan for diabetics? I meet with a nutritionist - a very weight-nonjudgmental one, I must say - but no one ever talked to me about how this could affect my life and my psyche. I engaged in "diabulimia" off and on for years and years - I still battle it often - to control my weight and never knew I wasn't the only one until just recently. I'd love for there to be some kind of plan for diabetics to work with therapists or social workers on the impact of how their relationship with food and eating will be impacted.

Sorry this is a bit rambling. Just wanted to say thanks for the blog, and mention something that might be of interest on a slow blog day. :)

File Under: He Won't Notice Those Extra Few Pounds

A coworker of mine is pregnant. She recently approached me in a hushed tone, "I have news!" she said.

"I know," I replied with a smile. "I've been waiting for you to tell me!"

She says she started showing early because of bloat. I think she's growing the next Yao Ming. She's three months in (though looks about five), and I've been suspicious half this time. But, did I say anything? Of course not. . . I wouldn't want to be wrong and (the horror) imply she looked fat. Moreover, I'm sensitive to pregnant women not wanting to share their news until they're ready.

A funny thing happened yesterday when this coworker informed our entire team. A 50-something male colleague seemed shocked. "You didn't know?" I asked, in disbelief. When he shook his head, I laughed and said, "But she's out to here!" (gesturing)

"I think it's a male thing. We just don't notice these things."

"At what point do you think you would notice? When she showed up at work one day with a 12-year-old kid?"

'Round Here

The EWHAED newsroom (and by newsroom, I mean me, at my computer) has been pretty active lately. Take a look:

From Rachel, over at the f-word:

I'm conducting an anonymous survey of bloggers who blog about eating disorders or eating disorder recovery in partnership with a clinical psychologist for joint research and publication purposes. I know your site attracts readers who have struggled with eating disorders, some of whom also maintain blogs. I'm hoping our survey generates lots of responses so that our findings are well-rounded, inclusive and convincing. Would you mind mentioning this survey on your blog to your readers?

More information and a survey link can be found here.

Also, Leslie, at The Weighting Game informs me she'll be on The Today Show this Wednesday during the 10am hour to discuss the question: "Would you rather be permanently 40 pounds overweight and smart, or skinny and dumb?" This is Leslie's second (recent) visit to Today--recently, she spoke about Spring Break and ED's.

Please support these valued members of the EWHAED community!

Treading Lightly

While I was at the spa, I took a class called, "Tread Sweat," a group exercise class on the treadmills, consisting of speed and incline intervals. While I don't really do any treadmill walking, I decided to walk the class (rather than run) because it was early in the morning, and I thought I'd use it as a warm-up, a segue into more difficult cardio classes.

Boy, was I off.

See, I'm not the most efficient walker in town. I tend to bounce (to the point when when I'm in physical therapy, other therapists take pause with their patients to watch me walk). I'm a bouncing curiosity. When you spend so much time and energy going up and down, there's less of both to propel forward. It's basic biomechanics. So, I'm slow. I'm a (pretty) fast runner, but a really slow walker.

So, here I was on the treadmill, warming up, trying to take the class at my own pace, when the instructor approached me and said, "Pick up the speed!" I told her I'm not really a walker and was using the class to warm-up. She walked away. Phew.

Take two: she approached me again and said (and, to clarify, this all occurred over the microphone): "C'mon, you can pick up the pace!" Having done so since her last visit, I replied, "I'm doing a couple of other classes today. I'm fine." The coast was clear for now.

But, then she came back again, looked at my heartrate (broadcast on the treadmill) and said AGAIN, "Let's pick up the speed!" And, that's when I decided to pick up the (verbal) pace: "That's the third time you've asked me. I'm taking other classes today. Can you not ask me to speed up again?" Thankfully, she didn't return.

It's frustrating this go-all-out mentality, particularly in a population that might not be so accustomed to exercising. She didn't know who I was or what (if any) medical conditions I have, nor how to motivate me to perform. She didn't know that I am confident in my level of cardiovascular conditioning. She didn't know that I have a fitness background, and that I know it's not good instruction to approach someone three times (she had singled me out for some reason, perhaps because my heartrate was lower than it "should" have been) when she's clearly walking to the beat of her own drum.

I had to assert myself. But, how many people would do the same? How many others would feel that they couldn't keep up, that they weren't doing it right, that they really were out of shape, that they should be ashamed for this? How many others would leave the class feeling dejected, like they had failed the task?

Fat Camp

Last week, I went to Fat Camp. I didn't know I was at Fat Camp (I thought I was at a spa) until I overheard a woman dining next to meet at lunch say to her companions, "I think of this place as Fat Camp." I gotta hand it to her--she was right.

I'd been to said spa* before and enjoyed the array of exercise options, the spa treatments, the healthy living lectures, and the great rooms, replete with old library collections, roaring fires, and comfy sofas on which to nap or curl up with a good book. My problem was with the food (we'll get to that later), though I will say now that I came prepared with stores of my own.

At FC, the staff encourages a lot of exercise--you finish one cardio class and they're already asking you which class you're taking next. Most people end up doing 3-4 classes a day, if not more. It reminded me of The Biggest Loser, where uber-exercise is combined with a restricted diet--not a good prognosis for long-term success. The classes are fun and varied--I tried spinning and cardio aqua, kickboxing, rebounding, and striptease aerobics. Speaking of previous posts, there were a couple of 14-year-old girls who attended striptease. I know this because I approached one of them and asked, "How old are you?" and she said, "14." The class was fun, and everyone's inner Carmen Electra shone. For the record, no men attended, nor did FC offer a male equivalent.

Now, the food. . . Fat Camp food is actually pretty good, with lots of selections and healthy eating options. They find a way to create unprocessed, balanced meals, heavy in protein, fiber, and complex carbs, and low in fat, sodium, and anything else unnecessary in larger quantities. Still, the food, for the most part, tastes good.

My gripe? The portion sizes. The food is really, really. . . small. If I were there long-term, I'd think that they were slowly starving me to death. Now, the difference between this and real Fat Camp is that you're allowed to ask for seconds, or even thirds (and, you're allowed to bring food into your room, without having it confiscated as contraband). I learned the first time around that often I'd need to order two entrees, along with appetizers and sides. Because when you're exercising as they encourage, you need some extra fuel. . . unless, of course, you're trying to lose weight. . . which wouldn't be hard to do. . . though, you and I both know what would happen when you went back home.

Fat Camp also offers desserts--low calorie, low fat treats that provide that post-meal, sweet-tooth zing. Day one, I ordered a brownie:



Can you see the size of this? I said to my server, "Can I get three more?" I figured that four of these equalled. . . an actual brownie.

On my last day, I sat down to lunch before heading out on the road. The restaurant menu, displayed on a stand outside, beckoned, "Italian-Style Grilled Cheese." Yum!

Here was my grilled cheese (accompanied by a salad):



If you can't tell by the photo, the "Italian-Style Grilled Cheese" would be more aptly described as two tiny slices of Italian bread, served bruschetta style. Each one was easily consumed in two bites. They were small, and I had just played too hard for food that was small.

So, I left wondering, for people who attend these spas, looking for long-term weight-loss success, is this a set-up for disaster? The first time I attended, I hit Carvel in the airport before even getting to my gate. Even if guests return home with their Fat Camp cookbooks in tow, is exercising three hours a day really sustainable? Are they sacrificing long-term success for short-term results?

*I'll try to write about the couple of lectures I attended in forthcoming posts.

More Leg Room?

An advertisement for Continental Airlines' new jets, spotted at a bus stop in New York:

"Do our new planes make us look fat?"

Smart marketing, or another bone to pick?

Inside Beauty

Magali Amadei and Claire Mysko are the founders of Inside Beauty, an educational and outreach program designed to promote health in the fashion and beauty industries. According to their website:

Magali Amadei has appeared on the covers and pages of virtually every fashion magazine in the world. But at the height of her career she was depressed, lonely, and bulimic. She took a break to take care of herself and became the first top model to tell her story on behalf of an eating disorders organization.

Claire Mysko is a writer and an expert on girls' and women's issues. Throughout her teens she starved herself and binged and purged while devouring the picture-perfect fantasies in the pages of magazines. She got help and went on to be the director of the American Anorexia Bulimia Association.

Working together, Amadei and Mysko have developed efforts to target the unhealthy standards and expectations in the modeling world. They have asked those in fashion and beauty to support 5 resolutions designed to transform the current state of affairs.

Just two more women, doing their part. Check out their campaign. . . .

Orthorexia

A couple of media outlets have contacted me recently to talk about orthorexia, and I'd like you all to weigh in. The term "orthorexia" was coined by Steven Bratman, a physician specializing in alternative medicine, in 1997. Orthorexia is understood to be an unhealthy fixation with eating healthy foods (often accompanied by a righteous, holier-than-thou attitude), to the point where either important nutrients are often omitted (like fat) and/or the person becomes emaciated because quality foods are not available enough. This isn't just healthy eating.

Bratman asks the following questions in order to diagnose orthorexia:

Do you wish that occasionally you could just eat, and not think about whether it’s good for you? Has your diet made you socially isolated? Is it impossible to imagine going through a whole day without paying attention to your diet, and just living and loving? Does it sound beyond your ability to eat a meal prepared with love by your mother – one single meal – and not try to control what she serves you? Do you have trouble remembering that love, and joy, and play and creativity are more important than food? Have you gotten your weight so low that people think you may have anorexia?

If you recognize yourself in these questions, you might have orthorexia.

As opposed to anorexia, the goal of orthorexia is not weight management/loss, but health, and therefore, the emphasis is not on the quantity of food consumed, but the quality. As with any psychiatric diagnosis, orthorexia is understood to impair daily functioning, to impact work/school, family, and friends because of the time and effort devoted to meal planning and consumption.

But, orthorexia is not a psychiatric diagnosis. There is a dearth of research on orthorexia, particularly quality, peer-reviewed research. Many folks in the e.d. community don't see orthorexia as significantly different from anorexia (or from an anxiety disorder, such as obsessive-compulsive disorder). I'm able to describe the condition as the lay community has described it, and I realize that some people may meet the criteria proposed above, but I, too, am not sure that it differs enough from anorexia or OCD (w/food behavior being the obsession and compulsion used to manage anxiety) in order to warrant a freestanding diagnosis. I think some folks struggling with bona fide e.d.'s may play the "health card" in order to avoid suspicion. In this way, they may present with orthorexia when the main motivation is weight control, therefore indicating anorexia.

Do you struggle with orthorexia or know anyone who does? Can you say that it is significantly different from these other disorders? Please help!

Book Report

You may have noticed a new edition to the EWHAED book club (quick, look over on the right!) It's Abby Ellin's Teenage Waistland, a part-memoir, part-reference look at how parents can best help their overweight (and, here, I mean this in the most literal sense--over the "ideal" weight our society has agreed upon, as some of the adolescents Ellin describes, including, herself, are not really fat) teens. In Teenage Waistland, Ellin tackles difficult questions, such as: 1) What should you say/not say about your child's body? 2) How can you respond to your overweight teen who is bullied at school? 3) Should you send your teen to "fat camp?" 4) How about diets? 5) Is losing weight simply a matter of willpower? 6) Why don't heavy teens want to be thinner? 7) What should you do with your overweight teen who eats well and exercises but can't seem to lose any weight?

As for the answers to these questions, you'll have to read the book. And trust me, it'll be a treat--not just because it's chock full of helpful information and case studies, but because Ellin reflects on her personal experiences in a sensitive, yet light-hearted way and because she uses careful and poignant language to make her point and to convey the deep-seated relationship between emotions and our weight. There are plenty of books out there on how to help your children lose weight and/or gain acceptance of their bodies. Ellin, having personally climbed through the fat-camp and diet-fad ranks, can effectively tell us how.

The "Big" One

Several weeks back, I attended a Broadway show with a friend. In between numbers, I whispered to my friend something about one of the cast.

"Which one?", she asked.

"The big one," I replied.

My friend looked at me curiously. "I'm surprised you said that," she said, all-too-familiar with my work.

The show went on, as did our hushed dialogue.

"Why?" I asked, "I didn't mean it negatively. I was just trying to identify her." And, I was, in a sea of tiny, ballerina-bodied cast mates, simply targeting the feature most quick to differentiate. I also could have said, "The one with the long, black hair" or referred to her as the part she was playing, but this was honestly the first thing that came to mind, and when you're talking during a Broadway show, sometimes brevity is key.

For the record, the "big" one was probably as Size 12. She just stood out. And, to me, there's nothing wrong with referring to someone as "big," or "fat," or "large." (I actually much prefer these to "obese" or "overweight.") They're simply descriptors. . . just like long, black hair.

So, was I wrong? Should I have found another feature by which to identify her, or was I (un)consciously working to destigmatize big?

Living & Eating

Master chef Julia Child once said: "Life itself is the proper binge."

I came across the quote recently on a birthday greeting card, and immediately, the wheels started turning--first, IS life really a binge? (Certainly, this is an individual question). And, if it isn't, is this reflected in our eating? If we feel that we're not getting enough out of life, do we compensate by bingeing on food?

Geneen Roth is famous for saying, "We eat the way we live." I wonder, though, do we sometimes eat the way we DON'T?

Baby Weight

A while back, a pregnant friend informed me that her ob-gyn had issued some pretty strict guidelines about her pregnancy weight. I was surprised to hear some of her doctor's recommendations and asked this friend if I might interview her for my book/blog; we agreed to talk once she had delivered. Said friend is now the proud mother of a healthy, adorable baby girl, has returned to work (as a psychologist), but still found time to answer the questions below:

1) What foods were you advised to eat, to avoid? Did she propose a daily caloric intake?

She said to avoid fruit (eat it only once or twice a week), avoid the "bread basket" and refined flour. . . . It sounded to me like she was recommending a low carb diet. I was told not to eat any more than I was eating before I got pregnant since I looked "normal" and "thin" (pre-pregnancy). She said that the fetus does not need much in terms of calories.

I told her that I was eating fruit, bread, etc. She said "okay" but encouraged me not to eat more than I was already eating or change my eating habits (except to avoid high mercury fish, more than one serving of caffeine per day, avoid alcohol, etc.).

Another patient that I met in the waiting room (our doctor told her that she was gaining too much weight) said that our doctor told her to eat the following: eggs for breakfast and maybe some yogurt and then salad with protein for lunch and dinner (fruit as a dessert/treat 1-2 times per week). She was told to avoid bagels since they are high in carbohydrates/calories.

2) What did your doctor suggest would be a healthy weight-gain during your pregnancy? What were her concerns about you gaining more?

She said that she recommended to her patients not to gain more than 20-25pounds despite the standard medical recommendation being 25-35 pounds because you don't need more than 20-25 pounds. . . . She explained that any more is "just weight you have to lose."

3) Do you think the above information was correct? How do you think the advice would have differed in a non-NYC population?

Most doctors (even in NYC) suggest gaining 25 to 35, but there is definitely more emphasis on weight gain here. I don't think her advice was very helpful. The way she encouraged her patients to eat (avoid fruit when it is so rich in vitamins, etc.) did not seem helpful. A plan-based diet rich in whole grains (e.g., whole wheat bread) and fruits, etc. is a part of a healthy diet during pregnancy (and always). She is encouraging eating behaviors that are not consistent with nutrition research or standard advice given to pregnant women (especially for someone that may have struggled with an eating disorder). Then again, doctors don't get much nutrition training in medical school.

The average weight gain during pregnancy is supposedly 25-35 pounds (that is what most doctors recommend to their patients). Most people I know gained at least that, often 40 or 50 pounds. To be honest, I don't think you have total control over it. My girlfriends have varied so much! And it did not totally have to do with how much or what they were eating. With respect to weight gain during pregnancy...I think some of it genetic, depends on body type, weight before pregnancy, etc. You can stay active (exercising in moderation) and avoid binge eating, eat healthy, etc. to prevent excessive weight gain but at a certain point you only have so much control.

I felt that her advice was extremely troubling! There seemed to be more emphasis on weight gain than eating healthily. I understand gestational diabetes is a problem and some people see pregnancy as a break from watching their weight (e.g., eating a lot of sweets or high fat foods, etc.) and end up gaining a large amounts of weight...HOWEVER, women already have enough to worry about during pregnancy (the baby, health, body changes, etc.).

I think the advice should should be on health NOT weight gain. It should be to eat as healthily as possible and to eat sweets, etc. in moderation...and to stay active (doing exercises adapted for pregnancy) to promote a healthy baby (first priority) and healthy pregnancy and postpartum recovery. Weight monitoring should be emphasized to make sure the baby and mother are healthy...not as pressure to keep your weight gain low so that you look good afterwards. Patients should be informed that there is a great deal of individual variation, so they should just try their best to eat a healthy diet and exercise in moderation (to feel well and prepare for late pregnancy when it harder to get around & labor & recovery).

4) Did you follow your doctor's guidelines? Did you, at any point, think about switching doctors?

I was quite ambivalent about staying with her. I felt self-conscious and the major goal of each check-up was to check my weight gain (even during visits when she did not bring it up, I found myself bring it up and seeking her approval). I think that if I had gained more than her recommended amount, I would have changed. I seriously thought about it during my second trimester (when I gained the most weight, at the point I had gained 15 pounds) and she suggested that if I wanted to "follow" her recommendation of 20-25 pounds instead of the average 25-35 (30ish), I should slow the weight gain down. She asked me if I was exercising as "vigorously" as before, what types of foods I was eating, etc. She said not to "stress" too much since I was "thin" to begin with if I ended up gaining around 30. She said that if I had been overwieght to begin with, she would have been "upset" that I had already gained 15 pounds.

I did not gain much during the third trimester and she complimented me on it several times, telling me that she was "really happy" with my weight gain. The reality is that everyone's weight gain occurs at a different rate (some people gain more in the middle, others at the end). I don't think it was due to me doing anything to slow my weight gain down.

I ended up gaining 22 pounds. However, I did not really follow her diet advice. I think it was just genetic (similar to my mother during her pregnancies). I ate a decent amount of fruit and bread products, chocolate, etc! I was just mindful of eating everything in moderation (not restricting), trying to eat as healthily as I could) and staying active.

5) What did your doctor have to say about you losing the baby weight post-delivery?

Not much, thank god. But if I had gained more weight, I am sure she would have! If there's anything else, please let me know! Thanks so much, Stacey

Thanks, G, for sharing your story. . .

Raising an E.D.-Free Little Girl

An old college friend and I recently caught up at another friend's celebration. She expressed interest in my life (and I hers) and then, around midnight, she asked, "So, how do I raise my daughter so that she doesn't develop an eating disorder?" One of my occupational hazards--being asked to provide meaningful psychological commentary in a social situation, second only to the "Are you analyzing me?" concern. . .

And, here, to the best of my recollection, appears my short, adlib list, dedicated to my old friend's adorable toddler, but applicable to all of our little girls:

1) Throw out your scale.
2) Talk about foods with regard to how they can nourish her body, rather than their effects on her weight.
3) Encourage physical activity for the sake of health, rather than weight control.
4) Don't judge your body in front of her--don't say negative things about your body or even glance in the mirror in a critical way.
5) Focus on all of her strengths outside of her body, but make it a point to tell her how beautiful she is.

Any others you'd like to add?

Penn & Teller Weigh In

This weekend, a friend alerted me to the latest season of the Showtime series, Penn & Teller. According to the show's site, in Season 5's premiere, "Obesity":

Penn & Teller reveal truths about the Obesity epidemic. A visit to an Obesity conference exposes the uncomfortably cozy relationships between the medical establishment, the diet companies and the weight loss industry. An advocacy group for overweight people tells us about the hardships and discrimination brought about by their weight. Plus, the first-ever Penn & Teller 'Fat Guy Olympics.'

Penn, a la Paul Campos, introduces the topic quite bluntly: "The obesity epidemic is bullshit." He and Teller (I'm never quite sure how Teller earns his keep, though he does jump on a treadmill at some point during this episode), debunk the obesity myth by visiting "The Annual Meeting of the Obesity Society" in 2006, sponsored by, as they point out, the drug companies that make diet pills, where a bunch of (usually) thin researchers suggest that curbing obesity is simply a matter of controlling diet and exercise. P & T note that if the equation were that simple, none of these researchers would have a job!

P & T actually interview Paul Campos, Professor of Law at the University of Colorado, and author of The Diet Myth. Campos weighs in on the "obesity epidemic," suggesting our nation's collective weight is a sign of economic development instead, and offering three of myths that support the "science" of obesity:

1) Weight is a good proxy for health. (Campos suggests, in fact, that we really don't know anything about a person's health, judging by her weight.)
2) Going from fat to thin can improve your health.
3) We know how to produce long-term weight loss in populations.

P & T go on to tackle the BMI, battling the notion that one need be a certain height and weight (not one's natural weight, of course) in order to be considered healthy. The 6'6", 310-pound Penn suggests, in jest, that, according to the BMI charts, he should weigh 124 pounds and be 5'4". The next thing we know, he's lying prostrate on a table, as a man with a chain saw prepares to remove his lower legs. Comedy aside, the point is well-taken: Asking a man of his size to lose large amounts of weight may be as preposterous as asking him to shrink in height.

P & T interview a Professor Oliver, who suggests that we're wired to be obese (and promiscuous, to boot). Penn then challenges the all-too-common "willpower" argument: "If you have the willpower to overcome several million years of evolution, cool. More for the rest of us."

The show also interviews Glenn Gaesser, Ph.D., author of Big Fat Lies: The Truth about Your Weight and Your Health. Gaesser suggests the diet industry is notorious for "blaming the victim," suggesting that dieters fail, not the diets themselves (if you just would have stuck with it, you know?). Gaesser goes on to warn, as many of us realize, about the dangers of yo-yo dieting and suggests that fat people who exercise regularly are healthier and have a lower mortality rate than thin people who don't.

As Penn concludes: "Is our knee-jerk 'horror of obesity' out of whack with reality? Fuck, yeah!"

Sorority Girls

In the New York Times bestseller, Pledged, Alexandra Robbins goes undercover among a group of sorority members in order to expose the inner workings of female Greek groups. What's interesting, though not surprising, is the incidence, condonation, and even camaraderie, of eating disorders in sororities.

Robbins covers everything from "Pig Runs" (when newly selected sorority members, termed "pigs," would sprint to the houses that chose them) to gym attendance: "Gymming had become a popular gerund [in sororities], as in, 'I need to go gymming if I eat this cookie.'" One sister was dropped from the school's cheerleading because she was too fat. . . a size 2.

According to Robbins, women's bodies are front and center through the sorority selection process, and according to a rush manual (Rush: A Girl's Guide to Sorority Success) she quotes:

For example, if you are overweight, you must try to lose weight before rush. If you have acne problems, you should work on clearing up your face. whatever problems you have, you must do your best to minimize them. Physical attractiveness plays a large part in the overall evaluation process.

Not having much to go on besides looks, sorority members rate rushees after just several minutes of conversation. When I was in a sorority and new to the "better" end of the rush process, we were instructed to rate each woman on a scale of 1-5 (1 being the best, 5 the worst). We had to shout out the numbers in front of the entire sisterhood, and sometimes debate ensued. Since hundreds of women had visited the house each day, we relied on the notes we had scribbled in unobtrusive notebooks (hidden under couch cushions, in the stairwells) to jog our memories. Having sat through this process for one year, I feigned illness the next. How can you rate a person on a scale of 1-5?

It's not hard, according to some. A visitor from our national office, who was sent to advise us on selecting appropriate women during rush, rhetorically asked: "You don't want any dogs in the house, do you?"

Once selected, and now pledges, the women are subjected to similar scrutiny. Robbins writes:

I had been under the impression that pledging practices such as 'circle the fat' and 'bikini weight' were the stuff of urban legend. I was wrong. During circle the fat, pledges undress and, one by one stand in front of the entire sorority membership. The sisters (or, in some chapters, fraternity brothers) then use thick black markers to circle the fat or cellulite on a pledge's body. The purpose is to help the pledge learn what parts of her body she needs to improve. During bikini weigh, or "weigh-in," pledges are weighed in front of either the sisterhood or a fraternity; the audience yells the number displayed on the scale.

I'm guessing this doesn't come with the same degree of support and respect as the weigh-ins on The Biggest Loser. And, helping pledges identify what parts of her body she needs to improve? Is that new information for them? Thankfully, these practices did not occur in my house, though sisters frequently binged, restricted, and over-exercised together. It's no wonder that plumbers must frequently service sorority houses, as Robbins notes, to unclog the bulimia-ravaged pipes. In an overall university environment where eating disorders are rampant, they flourish, perhaps to an even greater degree, in sororities that maintain such practices and expectations.

New York News

Congratulations to the now-famous members of this community, Shapely Prose, Big Fat Deal, fat fu, and The Rotund, who were recently featured in The New York Times "Health" section. Well done!

And, elsewhere in NY:

Spotted on a coffee mug: "Food has replaced sex in my life. Now I can't even get into my own pants."

And, on a greeting card: "Some women can eat all the cake and ice cream they want and never gain a pound. And they are called bitches. Happy Birthday"

Men in the Locker Room

One day, as I walked into the ladies' locker room at the gym, the attendant informed me that there were men inside, attending to some repairs. That particular day, I didn't have to undress, but simply had to lock up my belongings. It's funny, though, my gut reaction to hearing there were men inside: "So?"

Because I'm not a stripper, I wondered about my cavalier attitude to the presence of men. What became clear was my underlying belief that men in the locker room would be less inclined to stare at my body, at least in a critical way, less inclined to judge than my female counterparts.

More recently, I stepped up to one of the vanity/hairdryer stations, letting my towel slip from my chest to my waist. My neighbor caught my absent-minded action and said: "Must be nice to be comfortable enough to [insert let-it-all-hang-out gesture here]!"

I suppose, but, often, it's function over form. My locker room routine involves accomplishing the most I can in the shortest period of time. One day, as I dried my hair and simultaneously applied lotion to my limbs and tweezed my brows, another woman commented, "You've just brought multi-tasking to a new level." And, I have. . .

But, what's interesting in me, is the way that women evaluate one another--yes, each of these reactions serves as compliments, I think; I'm comfortable with my body (according to woman #1) and exhibit record-breaking efficiency (woman #2). But, there's still a great deal of observation, of judgment. I can only wonder the negative evaluations that they're thinking but wouldn't dare to say, and I can't help but think that if I were a man in the men's locker room, my behavior, unless extraordinary, would go unnoticed. Women, as most of us know, are our worst critics. That eyeing-you-up-and-down gaze is never as penetrating as it when shot from female eyes. It's no wonder I'd be more comfortable disrobing in front of men.

Lip Balms On Me!

A while back, I found myself at Ricky's cosmetics chainlet, picking up a few necessities. When I placed my items on the counter, I noticed a basket full of lip balm, maybe 20 tubes or so, with a handwritten note on its rim, "Free."

"Are these really for free?" I asked the sales clerk. Right about now, you're probably wondering what kind of cockamamie university granted me my Ph.D. But, I kinda had to ask before taking, you know?

The whole concept of self-regulated, free products right there on the counter intrigued me. And this was good lip balm, good SPF-laced, organic lip balm. My dermatologist (and mother) would be so proud. How many should I take? What if I took the whole basket? Could I? I mean, they're free, but I probably should leave some of the tubes for others. Where do you draw the line? Funny thing is, I don't even wear lip balm!

You know, I've heard that women do this, stock up unnecessarily on products, on toiletries. Does the shampoo in the cabinet under your sink run three bottles deep? Word is, it's a vestigial feature of our hunting and gathering days. Women, as gatherers like to do, well, gather. We stock up on occasion, warding off the consequences of draught, at the expense of uncluttered cabinets, as the expense of our partners wondering why we need two back-up sticks of deodarant at all times.

But the reason I'm writing about lip balm, in case it's not imminently clear, is that I think we do the same thing with food. For those who have restricted over time, through dieting/anorexia/any other means, exposure to food often results in a compensantory binge, taking all the lip balm, so to speak, and hoarding it, because it might not be available for future demand. If we were to allow ourselves to eat when hungry and to eat some of the foods we crave, we'd be less inclined to want the whole enchilada and more inclined just to take what we need. Like two tubes of lip balm, leaving the wicker basket to its original, rightful owners. . .

This Is Not a Political Post

HILLARY SPECIAL 2 FAT THIGHS WITH SMALL BREAST & A LEFT WING

But, I do want to talk about Hillary. Specifically, about her body, because clearly, her body is more of a topic than Obama's, Edwards', or Romney's.

Maybe we like a svelte leader--remember the Mr. Clinton McDonald's debacle? On an episode of the wonderful, but canceled, Dr. Katz, Professional Therapist, comic Ted Alexandro quips that Jesus had "great abs" -- "That what you want in a Savior, because have you seen Buddha?"

But, Hillary, regardless of what you think of her as a person or politician, is more Jesus than Buddha in size. As far as I'm aware, none of the other candidates have been scrutinized about their bodies.

Obama's love handles? McCain's double chin? Huckabee better be mindful about gaining any weight after his highly touted 100-pound weight loss, which he chronicles in Quit Digging your Grave with a Knife and Fork: A 12-Stop Program to End Bad Habits and Begin a Healthy Lifestyle. The 12 "stops" include:

1. STOP Procrastinating.
2. STOP Making Excuses.
3. STOP Sitting on the Couch.
4. STOP Ignoring Signals from Your Body.
5. STOP Listening to Destructive Criticism.
6. STOP Expecting Immediate Success.
7. STOP Whining.
8. STOP Making Exceptions.
9. STOP Storing Provisions for Failure.
10.STOP Fueling with Contaminated Food.
11.STOP Allowing Food to Be A Reward.
12.STOP Neglecting Your Spiritual Health.

Now, if only for emotional eaters and other eating disordered folks, it did involve just 12 basic stops. . . .

Why is Hillary's shape part of the equation? Why is she the candidate whose body we need to judge?

"EAT"

Y'all know cggirl, right? A regular reader/commenter on this site, cggirl also happens to be Michal Finegold, a talented computer graphics artist, who's working on a new project (see below). Cggirl would appreciate your thoughts/comments about this work-in-progress, and I'm curious about your reactions, too, given the apropos subject matter.

Yeah, They're My Skinny Jeans, MOO-Fah!

Every once in a while, I get a mass-market email from someone who's clearly never read my blog. For instance, right in time for the New Year's diet surge, I received an email from a media marketing company informing me of a new diet "targeting women's mid-section."

Now, you realize there's a problem with our collective mid-section, don't you?

The message states, "Take a look at more of the amazing details below, thought you'd like them for your blog!" And, I do. . .

The diet consists of several small-er meals a day (no novelty here), with the inclusion of monounsaturated fatty acids at each meal. The diet calls these MUFA's, and even spells out the correct pronunciation ("MOO-fahs") for help.

What struck me beyond this tip, though, was "Cornerstone #2" of the plan. The diet encourages us to use "a mind trick at every meal," such as "arrange cut flowers in a vase and place it on the table where you eat [or] keep your skinny jeans on a hanger in full view."

Now, I'm all for cut flowers, but my skinny jeans on a hanger in full view?

The message is punitive, an ascetic demand that robs us of our power to eat intuitively. Personally, I happen to eat most of my meals at work, at restaurants, or on the run. I can only imagine my skinny jeans hanging from my office bookshelves--imagine the conversation starter there. . . .

Eat, Drink, & Be Merry

Today, I sat around and did nothing. Well, not exactly nothing. . . I read a memoir, caught up on emails, did the crossword, closed my eyes a few times, took a long lunch. . . . In short, I attended jury duty.

My book? Caroline Knapp's, Drinking: A Love Story, which so far, I highly recommend. You might know Knapp better from the chronicle of her struggle with anorexia, Appetites: Why Women Want, published posthumously* in 2004. In reading, Drinking, I'm compelled to think more formally about the similarities between eating disorders and addictions. Since I specialize in both, I'm often struck by how analogous they seem, how sometimes my language involves mere word substitution in order to convey the difference. We use alcohol or substances the way we use (or don't use) food. To escape. To distract. To numb. To cope.

Knapp writes about attending an AA meeting, where alcoholism was described as a "fear of life." Sound familiar? She goes on to write about how she, personally, would diagnose alcohol dependence:

Are you driven by a feeling of hunger and need? When someone sets a bottle of wine on the dinner table, do you find yourself glancing at it subversively, possessively, the way you might look at a lover you long for but don't quite trust? When someone pours you a glass from the bottle, do you take careful note of the level of liquid in the glass, and measure it secretly against the level of liquid in the other glasses, and hold your breath for just a second until you're assured you have enough? Do you establish an edgy feeling of relationship with that glass, that wine bottle; do you worry over it, care about it, covet it, want it all for yourself? Can you bear the thought that it might run out, that you'll be left sitting there without it, alone and unprotected?

See what I mean? Substitute food for wine, and you've just diagnosed emotional eating.

Both alcohol/substance abuse and eating disorders are coping mechanisms, which allow us to tolerate difficult emotions, to manage our lives more effectively, until, of course, the coping strategy itself becomes problematic. Both represent behavioral addictions designed to ward off distress, triggered by similar internal/external stimuli. Both involve oral (in the case of most substances) fixation, signaling, in psychobabble, unmet dependency needs. Both destroy the lives of others and ourselves.

Not uncommonly, patients will present with both an eating disorder and alcohol/substance abuse. When one remits, the other, sometimes, will worsen. It's not surprising. The bottom line is, we need a way to cope, and when we're robbed of one weapon, we're quick to return to the arsenal to determine what remains. On my two-train commute home, the walls of one advertised Weight Watchers, the other Stolichnaya.

*A quick Google search reveals that the sober Knapp, a long-time smoker, died of lung cancer in 2002.

Inspiration: Part 2

First things first, I have to apologize to Barney's for my journalistic error. The store window discussed below was not a Barney's window, but rather, belongs to Calvin Klein (the two stores abut one another). In order to compensate for my gross misreporting, I visited Barney's and promptly purchased three new pairs of shoes.

Now. . . onto Calvin Klein. . . It seems the headless, splayed-legged woman has multiplied, as she appeared (as Beth noted and all of us envisioned) immediately poised to do. Now, there are two headless, splayed-legged women. The first retains her original window and design (see previous post).

Her colleague (Compadre? Daughter?)lies beneath a giant sandal (fashion forward, ladies!) accompanied by another woman (either the first woman or a third). Perhaps Woman #1 has assaulted Woman #2. Perhaps it was the sandal.



Finally, thanks to ae's and zubeldia's comments, I sent the original post to Jean Kilbourne. Ever email Jean Kilbourne? ; ) Here's what I wrote:

Hi, Dr. Kilbourne--I'm a big fan of yours and am a psychologist that does a lot w/women and body image. Recently, I came across a holiday window display (at [Calvin Klein]) that I thought you'd find interesting. You can see the display (and my thoughts and readers' comments) here. Some of my readers mentioned your work when they saw the image. Thanks for helping provide such an important forum for discussion. Best, Drstaceyny

And, her response:

Thanks so much, Stacey. What a dreadful window. It looks as if a club is lying beside her but maybe I am not seeing it clearly. Your blog looks great! Happy holidays. Jean

Inspiration

Back in September, when writer Leslie Goldman interviewed me, she asked where I find inspiration for my blog posts. It's really not that hard--all I have to do is go about my day with open eyes and ears, and I'm sure to uncover some material.

One of my offices is directly across the street from department store mecca, Barneys. Ah, Barney's. . . I didn't choose the location of this office, but thoroughly enjoy the opportunity to, on my breaks, step outside and wander around some of my favorite floors.

Barney's, like most NYC department stores, recently unveiled its holiday windows. Each year, it seems, the department stores compete to showcase the most creative talent and ideas (with audio-visual representation to boot). This year, Barney's stepped out with a "Green Holiday" theme--store windows, oxymoronically juxtaposed in midtown Manhattan, promote keeping our earth green. A visit to the Barney's website reveals the store's larger mission: "Gorgeous green gifts, fabulously fair-trade fashion, sensationally sustainable swag, orgasmic organic denim and cashmere, environmentally conscious tchotchkes of all descriptions and philanthropic gestures to warm the cockles of your heart." Now, who's gonna discount that?

So, why I ask, does one of the windows look like this?



How is this consistent with having a "Green Holiday"? Now, I know, I might be jumping to conclusions, as some of you have pointed out. Perhaps this lovely, headless woman, replete with splayed, cleverly lit legs, is, simply, strengthening her core. Perhaps she's an accomplished yogi, who takes her practice outdoors, under still-green foliage, thus integrating the "Green Holiday" theme. Perhaps.

But, when one asks how I find inspiration for my posts, I answer that I only have to step outdoors, with camera-phone in hand, to gather material for my writing, to warm the cockles of my heart.

Untitled

In a Native American parable, the Creator amasses his animals and offers the following:

"I want to hide something from my human children until they are ready for it. . . . It is the realization that they create their own reality."

"Give it to me. I'll fly it to the moon," says the Eagle.

"No," says he Creator. "One day soon they will go there and find it."

"How about the bottom of the ocean?" asks the Salmon.

"No," says the Creator. "They will find it there, too."

"I will bury it in the great plains," says the Buffalo.

"They will soon dig and find it there," says the Creator.

"Then put it inside of them," says wise Grandmother Mole.

"Done," says the Creator. "It is the last place they will look."

Tough Love

Likelihood is you already know this, but Jennifer Love Hewitt is fat. At least that's the latest uproar surrounding some recent pictures the paparazzi snapped of her while she vacationed with her new fiance, actor Ross McCall.

Hewitt blogs:

I've sat by in silence for a long time now about the way women's bodies are constantly scrutinized. To set the record straight, I'm not upset for me, but for all of the girls out there that are struggling with their body image. A size 2 is not fat! Nor will it ever be. And being a size 0 doesn't make you beautiful. … To all girls with butts, boobs, hips and a waist, put on a bikini – put it on and stay strong.

Response to her response?

Mindful Eating Lecture

Often, I talk and write about the emotions that lead us to under- and overeat. But, what about the emotions we experience because of the food we eat? What are some of the biochemical processes, triggered by different foods, that result in us feeling happy, anxious, or tired? This is what I learned from nutritionist Mary Horn, at a lecture entitled, "Thinking, Feeling, Eating: How Food Affects Mood."

Below is much of the material from the lecture (thanks, Mary!). Did you know, for instance, that we make over 200 food choices per day? When to eat, what to eat, how much, should we add salt, sugar, do we want that with ketchup, are we full, or should we keep eating--all of these decisions, whether we consciously experience them or not, occur throughout each day.

Carbohydrates:
-Cravings are different from physiological hunger.
-Carb. cravings often occur mid-afternoon, lingering until we go to bed.
-Cravings are magnified when dieting, under stress, when skipping meals, with depression, and when we're pre-menstrual.
-Cravings do not occur because of a "lack of will-power," but because of an imbalance in the neurotransmitter, serotonin.
-Eating carbohydrates can increase energy levels, reduce hunger and depression, as serotonin levels are balanced.
-Those who experience carbohydrate cravings (or struggle with any of the above) are "doomed on low carb diets," leaving you "powerless to an all out binge."
-Horn encourages choosing complex carbs and satisfying a sweet tooth with, for example, an english muffin topped with honey, or a 1/2 cinnamon raisin bagel with jelly, in order to incur the same serotonin-boosting benefits without the blood sugar crash associated with simple sugars.
-Horn also recommended eating often, and especially eating breakfast, in order to maintain serotonin levels.

Fat:
-Our cravings for fat are largely unconscious.
-Fat cravings typically have more to do with texture than taste.
-As you'd imagine, we're more likely to crave fatty foods when on restrictive diets, engaged in erratic eating patterns, and on low-fat diets.

Omega 3 Fats:
-Omega 3 fats can also increase serotonin levels.
-A deficit is associated with depression, anxiety, impaired memory and intellectual functioning, and decreased ability to fight inflammatory diseases.
-The goal is to increase our intake of Omega 3 fats (found in fatty fish, flax, walnuts and canola oil), while limiting our intake of Omega 6 fats (found in pretty much every other fat source). Horn recommends a 4 to 1 Omega 3 to Omega 6 ratio in our diets.

Chocolate:
-Chocolate makes us feel good for several reasons: The sugar in chocolate boosts our serotonin levels, the caffeine increases dopamine, and the substance in its entirety produces endorphin surges.
-Horn recommends using cocoa powder, eating chocolate after meals (not instead of them), and buying good chocolate in small quantities.

Caffeine:
-Ingesting caffeine increases neurotransmitter levels.
-The effects of caffeine can last anywhere from 3-5 hours, up to 20 hours after you drink that cup of coffee. Now, does your insomnia make sense?
-Caffeine provides an endorphin rush and a consequent anti-depressant effect.
-In the long run, though, caffeine can lead to anxiety, headaches, muscle-tension, elevated cortisol (stress hormone) levels, and, natch, insomnia.

Alcohol:
-Drinking allow us to relax and feel good.
-Alcohol results in increased serotonin, lowered dopamine (associated with less anxiety), and increased endorphins.
-But, and of course, there's a but, alcohol can dehydrate, have an overall depressing effect, disrupt sleep, affect our food satiety, stimulate appetite, reduce inhibitions, and interact with medications we might take.

Horn's Suggestions:
-Eat mindfully (see my previous post).
-Eat 2/3 of your calories before dinner.
-Never allow more than 3-4 hours between meals.
-Balance your intake of proteins, carbohydrates, and fats.
-Produce endorphins via exercise.
-Manage stress.
-Increase Omega 3's.
-Get adequate sleep.

Well, possibly easier said than done, but it is interesting to understand the biological underpinnings for why we crave certain foods. Horn asked the audience about carbohydrate cravings, and every single woman raised her hand. She noted that women typically crave carbohydrates, while men are more likely to crave protein. Is this true for you? If so, does this help explain why?

Mindful Eating Exercise

Recently, I visited a spa that prides itself on its mindfulness programming. Activities include physical challenges (that focus on mindfulness), mindful decision-making, mindful communication, mediating, and, of course, eating.

I decided to attend a mindful eating breakfast, craving the experience both for myself and to bring back to my work. So, at 9am on a Saturday morning, I sat down with a couple of other women and began a mindful eating exercise.

We were instructed to visit the restaurant buffet, paying particular attention to all of our senses as we made our food choices. We were instructed not to focus on the "shoulds," but rather on what appealed to us.

I piled food on my plate, paying attention to vibrant color and texture. I stood over the bowl of flax seed for a moment (this is a healthy place!), thinking, "I should probably add some flax seed," but quickly caught myself and headed back to the table to begin the exercise. For the record, I chose some berries, oatmeal, and a vegetarian/cream cheese omelet.

The challenge: For 10 minutes, we were to eat mindfully--to meditate over our food, with awareness, without conversation.

That 10 minutes felt like an eternity.

Have you ever timed how long it takes you to eat breakfast, especially if you're not talking to someone else, watching tv, reading the paper, etc.? I'm guessing most us (myself included) scarf down our food in fewer than 10 minutes. . . and usually with one or more distractions.

So, here's what I learned, as I stared at my plate for 10 minutes, looking at the food, swirling it around with my fork, chewing slowly, paying attention to my appetite, to color, texture, and taste.

1) I don't even like raspberries. They're pretty bitter to me.
2) I really like strawberries. Did you ever notice how evenly dispersed the seeds are? I did!
3) Omelets are kind of plastic in a way I don't particularly enjoy.
4) The texture of oatmeal is much more appealing when I allow it to settle in my mouth, bathing my teeth and tongue in its chewy, little lumps. And, I love, love, love the squishy sound of oatmeal stirred.
5) 10 minutes at a table with several other women is a really long time to go without speaking. We stared at our plates, at our food, but it felt somehow asocial. It made me realized how conditioned we are to communicate, to focus on others (and other things) rather than what we're ingesting.
6) Without these distractions, I easily registered my satiety, putting my fork down at the first sign of fullness.

Have you ever tried an exercise like this? What are your thoughts/feelings about trying?

Thanks

In the spirit of the season (for those of us in the States), check out Leslie Goldman's current article in Shape magazine. If you remember, I interviewed Leslie back in September, and her book, Lockerroom Diaries, appears on my sidebar to the right.

And, some thanks to all of you:

1) For reading and providing me a consistent audience toward the goal of eventually getting this book published

2) For your thoughtful, frank, and insightful comments

3) For the fact that I've actually been able to meet some of my readers (and may, in the future, even meet more!)

4) For your continuing to challenge me to clarify my ideas

5) For serving as a large, internet-based support group: Recently, I attended a group therapy training (as someone who typically leads 4-5 groups per week, I feel that it's important to continue to hone my skills). During the training, I kept reflecting on my readership and how it approximates a live support or therapy group--how you influence one another (and me) with supportive, but honest, feedback; how you are able to express your feelings and ideas so articulately; how you, through this blog (and its many sisters) have helped develop a community that is loving, respectful and working to empower each other and ourselves.

For this, I thank you. . .

The Anti-Diet Center

In a couple of weeks, I'll be moving my office about a block away from my current location. Not a big deal, right?

I'll be moving into a suite already occupied by a social worker and a neurologist. Perfect.

Now, here's the hitch: There are two other office suites (both in clear view) on our floor. One's a physical therapy office, the other, a nationally recognized diet center.

When I went to look at the office for the first time, I paused in front of the diet center. "What's wrong?" the social worker, who was showing me the suite, asked. "I'm just having a reaction to the diet center. I do a lot of anti-diet work." Oh, the irony, I thought.

It actually factored into my decision-making process. Should I not take the suite given its proximity to the diet center? Should I tempt my clients, whom I educate with anti-diet approaches, by offering them a chance to diet. . . on the exact same floor?

Ultimately, it wasn't enough of a detraction, and I'm scheduled soon to move. I'm also scheduled to begin an intuitive eating/body image group (essentially, an anti-diet group). I have a fantasy of erecting a sign advertising the title of this post. As clients exit the elevator, it'll say "Go left!" (toward my office), because dieting is "right," but often leads us in the wrong direction.

Mass Appeal

Snooping through The New York Times "Book Review" section this weekend (when one wants to publish her own book, this kind of research is always illuminating), I came across the "Advice, How To, and Miscellaneous Section." Under the paperback list, here are the top four books, in order:

1. The Wisdom of Menopause. Making menopause a time of personal empowerment,and physical and emotional health.

2. Skinny Bitch. Vegan diet advice from the world of modeling.

3. Women's Bodies, Women's Wisdom. Advice and information on nutrition, fertility, hormone replacement, sexuality and more.

4. What to Expect When You're Expecting. Advice for parents-to-be.

With all this focus on women's bodies, several questions emerged:

1. First, why are these the top four books on the NYT list? What does it say about women and our bodies?

2. Where are the men's books?

3. Is the "wisdom" referred to twice (and the joy of impending childbirth) enough to counteract Skinny Bitch?

4. Is there really a place for EWHAED (or alternate title)?

5. Which of these have you read? Any comments?

Halloween Post-Mortem

Don't you just love it when someone puts in print exactly what you've been thinking? Well, what we've all been thinking? Take Halloween. . . and women's costumes. . . Just the other day I was having a conversation with another woman about how no matter which costume you choose, you're ultimately going as a sexpot.

And, then, I come home to my copy of New York Magazine, where in an article entitled, "Halloween Is For Lovers," a male friend of the authors, named Chris, is quoted as saying, "'Women should wear anything with a short skirt and nylons. . . . Nurse, witch, angel, janitor--it's all the same costume, just different colors.'"

He's right. It really doesn't matter if you're a pirate or a wench, a dominatrix or a nun, you'll pretty much look the same.

The writers, "Em & Lo," weigh in:

Em thinks sexy costumes are only slightly less annoying than those Axe Bodyspray commercials and are for women who are too chickenshit to dress provocatively the rest of the year. Lo, on the other hand, sees nothing wrong with a holiday that sanctions a little light role-playing for everyone. . . .

My question is: Are our costumes designed to attract men, or are we, ourselves, chomping at the bit for a bit of exhibitionism, playing out a playful fantasy on our own? Are we slutting it out for others or ourselves, or do we no longer know the difference?

Tyra Today

Thanks to my alert readers who informed me that The Tyra Show will be covering "The Vagina Dialogues" (yes, that's what she called it, too!) If you have some time (or a DVR), check it out!

Eight Things

Inspired by April's challenge, posed here--Eight Things I Like About My Body:

1) My height
2) My large, expressive eyes
3) My strength (the look and function of muscles)
4) The softeness of my hair
5) My big, white smile, used somewhat judiciously
6) My (word of the day) countenance, capable of conveying almost every emotion, sans words
7) My walking stride, which is unintentially "bouncy," allowing me to appear quite peppy
8) My solid legs, which have held up, with minor exceptions, the last few months and which I hope will send me sailing on Sunday!

Now, your turn. What are your eight things?

Not Another Teen (Short) Movie

Recently, a reader sent me an email about a short film her daughters had produced:

My three teenage daughters made this movie. When they had to come up with a story I was surprised that this was on their mind. It's a short movie (2.5 minutes) about a girl and her decision to stand up against the onslaught of marketing messages that pressure girls to change their bodies. It's meant to help start a discussion on the subject of eating disorders. If you think it is appropriate could you pass this on to other people, if the film receives enough votes to place it in the top 25 vote getters it will be placed on iTunes so everyone can get this message. You can go to www.rustsisters.com to learn more about the film and find a link to the apple website to view the movie and vote. If they win they will get some laptop computers and software for movie making so they do benefit from publicity, but having said that I still think that the short movie turned out as a good conversation starter, it certainly did for me and my daughters and maybe it might make someone else realize that they might be following the same destructive path.

You can check out the Rust sisters' site as well as watch the movie here. Let me know what you think. . .

The Vagina Dialogues

Today, I'd like to talk about your vagina. All of ours, in fact.

Of course, we probably shouldn't say that.

In an article in the Style section in this past weekend's New York Times, Stephanie Rosenbloom examines the acceptance of the newly introduced slang, "vajayjay."

Cute, huh?

It appeared on Grey's Anatomy. It's tossed around casually between friends. Hell, Oprah used it!

But, there's a little bit of a problem here, I think. Yes, it's catchy, playful, even F.C.C.-friendly, but, more than anything, it's avoidant. And it connotes that our vaginas are. . . not so acceptable to us (or anyone else).

It seems, according to the article, that the folks at Grey's were forced into vajayjay territory after using the word vagina one too many times in an episode script. Apparently, there's a limit to the number of times you can say vagina on tv (which, incidentally, appears to be lower than the number of times you can say penis), and thus vajayjay was introduced into our current zeitgeist.

Which saves us, thankfully, from having to utter vagina. Or worse, yet, vulva, labia, or clitoris.

But, the less we say these words, the more problems we introduce. The Times quotes Eve Ensler, of "The Vagina Monologuea" years back: "'. . . what we don't say becomes a secret, and secrets often create shame and fear andmyths.'" Ensler refers to vagina as a word "'that stirs up anxiety, awkwardness, contemmpt and disgust.'" Kinda makes me want to say vagina, over and over again, in a classic exposure paradigm. Given that Ensler's work focused largely on sexual trauma, I'm also wondering the effect that cutsey words like vajayjay have on women's sexual rights.

My doctoral dissertation focused on sexual communiation, conversations prospective partners have with one another about sex. The upshot is that people are much more comfortable having sex than talking about it. This doesn't bode so well for protecting ourselves against sexual assault, disease transmission, etc. Vajayjay is just another way out from having to face the truth.

And, what about how acceptance of our vaginas is linked to overall acceptance of our bodies? It reminds me of a talk radio episode I heard several years back while on the way to work. The topic was some variation of eating disorders/body image in young girls, and the discussion focused on how parents (mothers, in particular), in an effort to encourage body acceptance, should teach their daughters about "down there." What? Down where? We should be teaching our daughters about their vaginas! Because, if we avoid the words (and therefore, the topic), they will, too. I'm with Dr. Carol Livoti, an ob-gyn quoted in the article, who states: "'It's time to start calling anatomical organs by their anatomical names. We should be proud of our bodies.'"

We should. And, we shouldn't be reduced to calling a part of our body something different, something more acceptable to others. Because the more likely we are to do that, the more likely we are to feel the need to mold other parts of our anatomy, our thinking, feelings, and behavior, to others' expectations.

So, here's to your vagina, the glory of your vulva and all it's parts, because it's one aspect of our anatomy, that simply by using its given name, we can make significant strides toward sexual empowerment and body acceptance. And, that's a large part of why we're all here. . . .

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?