Why Eating Disorders and Substance Abuse So Commonly Co-Occur

Curious about the relationship between eating disorders and alcohol/substance misuse? Check out my latest blog for Oliver-Pyatt Centers!


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

Movement Manifesto

It's been just about 20 years since I was first certified as a personal trainer. I was completing my graduate work at the time, and this certification allowed me to teach fitness classes, helping me pay for school. Fast forward 20 years, and I've kept up the certification and acquired a couple of other fitness certificates along the way.

Now, along with my work in therapy, I teach two group cycling classes each week. My rides are challenging but body-positive. We set intentions, I bring in inspirational quotes, we visualize and engage in mindfulness exercises, and there isn't a word ever about calories or weight. I love this marriage of my two interests - how my work in eating disorders and body image can so seamlessly merge with my background in fitness. Sometimes, when my patients who struggle with eating disorders find out that I teach group cycling classes, they respond with discomfort or disbelief. Isn't spinning just a symptom? It can be. But, movement can also be joyful, healthy, and recovery-based. Unfortunately, the fitness industry has corrupted fitness with messages, images, and goals that reek of disorder. Here's the message that I want to share:

~I believe that movement is naturally rewarding, sometimes challenging, and often disordered.

~Pairing movement with the food we eat or with body dislike robs it of its natural joy and value. Physical activity becomes a tool that we use to attack ourselves.

~Capitalizing on motivations like "calories in, calories out" is woefully reductive. Instead, exercise is a health behavior that has a significant, positive impact on our mental health and overall well-being.

~Engaging in physical activity to burn calories, compensate for meals, or lose weight can be toxic, addictive, and can ultimately, create a pathway to disorder.

~Exercise is not punishment, payback, or compensation.

~Let's disentangle food, weight, and exercise, allowing movement to resume its inherently joyful and rewarding place in our lives.

~Let's run and jump and dance because we want to, not because we have to.

~Let's move our bodies, motivated by self-love, not self-attack.

~And let's band together to challenge the stereotypical, limited, and disordered cultural messages we're exposed to regarding physical fitness. Be part of the movement that demands change in this arena.


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

Why Is Everyone a Nutrition Expert?

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

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

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

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

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

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

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


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

Fitness at Every Size

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

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

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

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

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

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

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


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

News Bites

1) Have you heard about the ANGI? Here's their latest:

The Anorexia Nervosa Genetics Initiative (ANGI) will be coming to a close in the following months and we need your help! We are still recruiting individuals with a history of anorexia and individuals without a history of an eating disorder to participate. But hurry, the deadline to participate is June 30, 2016. All that is required is a brief online questionnaire and a blood sample. To make it easier for you, we’ll even send the phlebotomist to wherever you are, nationwide!  

Participants will receive a $25 Amazon gift card to say thanks. We can’t do this important research without you! 

To find out if you are eligible to participate, visit this link and fill out the survey: https://unc.az1.qualtrics.com/SE/?SID=SV_b7KDMDd8SuM1o 

For more information call 1-855-746-2547, email ANGI@unc.edu or visit www.unceatingdisorders.org/angi.

2)  Would you have any interest in an Intervention-style show on eating/body image issues? Here's a blurb from production:

A new documentary style TV program about people with body image issues: We are looking to conduct a 30 minute Skype/FaceTime interview with someone who is currently battling anorexia. The project is in the development stages so the interview would never air/broadcast but will hopefully help us help others. If interested please email us (@jessicamelz@gmail.com) directly. All information will be kept strictly confidential. Thanks so much.

3)  Check out my latest interview on Refinery29 on the snarkiness/gossip around friends with eating disorders.


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

Kick the Scale Interview

Remember my interview with Erin Konheim Mandras?

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


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

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

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

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

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

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

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

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

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

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

Happy Holidays/NEDA Article/Another Award

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

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

Recovery is possible.

Happy holidays.


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

Interviews in Recovery - A Conversation with Erin Mandras

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

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

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

SR: How did you get motivated to recover? 

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

SR: How did you recover? What helped? 

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

SR: What was the most challenging thing about recovery?

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

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

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

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

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


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

Holidays, Fitness, and Food

Here we are on the cusp of the holiday food season, and the diet/exercise talk has already intensified. On the day before Halloween, that dreaded candy-workout image reappeared on social media - you know, the one that identifies different types of Halloween candy by what types of workouts you'll need to burn them off?

Here's why this type of thinking is dangerous: If you choose the Reece's over the Twix only for calorie count, you're missing out on an opportunity to eat intuitively, to find pleasure and enjoyment from food. To me, it doesn't so much matter if you choose one or the other (or neither or both), but if you're going on calorie count alone, you're ignoring your preference, something that could end up backfiring in the long-run.

Do your kids want candy? Let them eat it. The allure will fade away soon. I like this mom's approach. 

And how about those exercise equivalents? So often, we're positioning exercise as a punishment for something we enjoy. We're robbing movement of its innately reinforcing value and instead suggesting that exercise only exists for the purpose of calorie compensation. But this isn't true! This is a myth that the diet and fitness industries use to lure people to buy products, pills, plans, and memberships. But what if fitness were fun?

For several months now, I've returned to my fitness roots, leading group cyling classes at a local university. I can't tell you how much I enjoy teaching again! I love the opportunity to encourage and inspire students, to lead them through a challenging but manageable course, to appreciate good music together. I love that I'm helping them improve their physical and mental health. 

But my favorite part of returning to teaching is making a small dent in an often disordered industry, one that celebrates unhealthy weight loss, views exercise as punishment for eating, and tries to motivate through self-attack. My classes are about building strength and power, celebrating our capabilities, and mostly, about having fun. I'd rather have students approach me after class and tell me that they enjoyed my music (which they do!) than comment on their calorie burns. It's the joy of movement, and the feelings around it, that sustain a lifelong commitment to physical activity.

So, if you want the Twix, eat the Twix. If you want to exercise, do that, too, But keep these things mentally separate to avoid that slippery slope. 



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

Anna's Law and Eating Disorder Lobby Day

"My insurance is cutting out."

That dreaded sentence professionals fear most.

When I first began doing this work, I was struck by the irony of hoping someone would become more symptomatic so her insurance company would authorize her to get help. . . that someone already receiving care would continue to struggle so that her insurance would keep paying for the care she so desperately needed. Even then, her insurance might cut funds for lack of sufficient progress. It's the Catch-22 of health insurance. Do well and they cut off. Don't do well enough and encounter the same risk. 

I've seen patients denied access to care because they aren't sick enough. I've seen insurance cut out when patients most need support. And I've seen insurance refuse to pay when patients and families are struggling to finance a physically, emotionally, and fiscally debilitating illness.

Something has to change.

The Anna Westin Act of 2015, also known as Anna's Law, was introduced by Kitty Westin, who lost her daughter to anorexia. Kitty's advocacy efforts focus on holding insurance companies accountable for paying for eating disorder care. To learn more about why we need Anna's Law, click here.

Tomorrow marks the final 2015 eating disorder lobby day. If you can't be in Washington this week, you can still do something. Donate, write a letter, contact your state's insurance commissioner when an insurance company refuses to pay. Help a growing movement gain momentum toward the goal of making eating disorder treatment accessible and affordable for all.


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

Enough with the "New Skinny"

"Strong is the new skinny."

"Healthy is the new skinny."

"Curvy is the new skinny."

Everything is the new skinny.

These slogans, presumably constructed to promote body acceptance and offer an alternative to the thin ideal, still posit a common end-goal. We're still striving for some iteration of skinny and continuing to promote thinness as the gold standard of success.

So let's step away from skinny as the solution - and focus on strength, health, curves, or whatever else we value without a tired target diluting our intention.

We don't need another skinny.


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

Misinterpreting Intuitive Eating

As a proponent of intuitive eating, I'm often presented with challenges to the model that seem to misinterpret its basic premise. I've heard some interpret intuitive eating to mean that we're advocating that people eat cake each and every time they're hungry.

But that's really missing the point. Intuitive eating is a flexible practice that encourages you to trust your body - but it encourages you to be mindful of the signals your body is sending before, during, and after you eat.

In her piece, "Why I'm Not an Intuitive Eating Coach," Isabel Foxen Duke offers some additional misconceptions around the practice of intuitive eating. While she's right - that many will turn intuitive eating into a diet - the premise of intuitive eating is based on rejecting the diet mentality, so if you're turning it into a diet, you're not doing intuitive eating. If you're creating rules related to intuitive eating, then you're still interacting with the food police.

Intuitive eating, as discussed by Tribole and Resch, offers a set of 10 practices that are just that - practices. They aren't rules, rigid guidelines, or anything else so structured as to invite rebellion and dissent.

That said, they offer a decent blueprint for developing a healthy relationship with food. Note that only two of the ten practices involve how people normally define intuitive eating - eating when you're hungry and stopping when you're full - "Honor Your Hunger" and "Respect Your Fullness." When someone turns intuitive eating into a diet, she's really ignoring the rest of the principles and overly, rigidly focusing on these two.

What's more, intuitive eating, in my understanding, was developed as a compassionate approach toward healing disordered eating. If people eat past fullness or use food to cope with feelings, they aren't shamed or berated by their counselors; rather, the information is used as a learning opportunity. The spirit is of collaboration and compassion, diametrically opposed to the diet mentality.

Intuitive eating promotes eating for nourishment and pleasure, a balance, which, as a delicate dance, is fluid, evolving, and forgiving.

Dear People. . .

Dear People Magazine,

I recently happened upon your exclusive video, Kendra Wilkinson on Why She Can't Really Have a Six-Pack Right Now, and I wanted to share a few thoughts.

Kendra's six-pack, or lack thereof, isn't news. Some may argue that all celebrity gossip lacks journalistic integrity, but this item is particularly insignificant.

More, Kendra shouldn't have to defend the fact that her abs currently lack chiseling. No excuses are necessary for her body shape or size. And suggesting that she doesn't have a six-pack "right now" implies a promise of abdominal contouring to come. People readers don't need a guarantee.

Women's bodies - their weight gains and losses, their cellulite, their "problem areas" - need not fill your pages. You could publish an entire year's worth of magazines without a single feature, or even comment, on a celebrity body - and in doing so, you would contribute to a growing culture of positive body image promotion and self-acceptance. Imagine how newsworthy that would be!


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

Happy Bookiversary and Another Book Giveaway!

In honor of the one-year anniversary of the publication of Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight, I'm hosting another book giveaway!

To enter the contest, either email me privately (drstaceyny at gmail dot com) or comment below on the topic of: "What Recovery Means to Me."

The deadline for entries is 6/29/15. Two winners will be selected at random that week, and the books should arrive around Independence Day.

Fine print: Please enter the contest only once. For those who submit via email, please include your mailing address to receive a book if you win. If you submit via comment, be sure to send me a follow-up email with your mailing address. By submitting an entry, you authorize DEWHAED to post your anonymous response. Winners will be selected by drawing so as to preserve response integrity. Prior contest winners are ineligible to win this contest.



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

A Love Letter to My Patients in Early Recovery from Anorexia

You recently accused me of wanting you to be fat. Here's what I've been thinking. . . . Long after we part ways, I'll remember the sound of your voice, the tender and emotional moments we shared, those times we burst out laughing together. I'll have little memory of what you weighed.

I have no investment in wanting you, according to your eating disorder, to be fat. What I care about is your brain, that it's nourished sufficiently for you to think clearly and be yourself again. I'd like to see you return to the you you were before this ugly illness hijacked your anatomy and convinced you to accept this as your new normal.

I want you to be healthy - yes, I know you hate this word right now - but, I do. I want you to be able to swim in the ocean, sit comfortably in class, breathe in the mountain air, sleep like a baby, and have a baby (if you're a woman and that's what you want).

I want your bones to be strong enough to remain fracture-free, to support you on the dance floor and through old age. Hopefully, you'll live long and hard in recovery.

I want your hair to return to its previous fullness and luster.

I want your organs to function efficiently, as if to shout, for example, "This is what it looks like to be a working kidney!"

I want your heart to beat at a normal rate and rhythm. I want your most precious muscle to be stable and strong.

I want you to experience less depression and anxiety, for you to rest comfortably through the night, and for those frightening suicidal thoughts, that never plagued you before, to fade into the darkness.

I want you to feel energized, strong, and capable.

You're so immersed in this illness that you don't think anything's wrong. But there is. And I know that the core you, the real you, is terrified and pleading for help.

I don't want you to be fat. I just want you, in multiple definitions of the word, to live.


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

Two Awards this Week!

This blog was the lucky recipient of not one, but two awards in the blogosphere this week!

The first came from Psych Central, which named DEWHAED one of the Top 10 Eating Disorder Blogs of 2015.

The second award came courtesy of Healthline, awarding DEWHAED one of the Best Eating Disorder Blogs of 2015.

Many thanks to these sites for recognizing my nine years(!) of blogging dedication. I encourage my readers to check out my great company on both lists for additional reading suggestions. 

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

Helping Patients with Binge Eating Disorder Drop the Weight (Mentality)

A woman, who reported she struggles with Binge Eating Disorder, contacted me recently online. She was scheduled to participate in a medical weight-loss program but wondered if she should address her BED first. Unfortunately, this woman is not the only person with BED who has fallen prey to the weight-loss industry.

One of the most challenging things in my work with patients with BED is disavowing them of the diet and weight mentality. Most patients come in with a significant diet history and, despite many failed diet attempts, are intent on losing weight in treatment via the latest diet trends.

I've found through the years that with some patients, getting them to commit to working on their binges, rather than focusing on weight, is a relatively easy switch, while others remain firmly entrenched in a weight-centric mentality. With these patients, I see little-to-no progress. They're they ones that drop out of treatment prematurely when I tell them that their most recent return to Weight Watchers or Jenny Craig is contraindicated with our work. It's a major paradigm shift that's required, and my experience is that patients who are able to think outside the box have an easier time catching on. 

Here are 10 treatment factors I've found that can help bring many patients with BED around to more of a focus on their relationship with food than the current number on the scale.

1) Refuse to set a weight loss goal. Instead, set goals around reducing binge eating and improving the patient's relationship to food.
2) Provide information on the relationship between food restriction and binge eating  (e.g., the diet/binge cycle, the Minnesota Starvation Experiment). Create a timeline of the patient's diet/weight history, noting weight losses followed by inevitable gains. 

3) Do not support the patient's participation in eating trends, cleanses, jumpstarts, etc. Focus on what the patient can add to his current "diet," rather than take away.
4) Operate from an intuitive eating perspective and encourage the patient to legalize off-limits foods in a mindful way.
5) Explore the emotional function of binge eating, as well as how an attachment to the diet mentality may trigger binge emotions. 

6) Provide information on the "Health at Every Size" movement, as well as on the media's inflated damages of obesity; cite meta-analytic studies suggesting that those who are overweight or low-level obese are just as healthy as their "normal"-weight peers.

7) Educate the patient on societal and internalized weight stigma and the toll these experiences can take on her physical and mental health.

8) Work with the patient on acceptance and self-care of his body as-is.

9) Encourage a relationship with movement that is joyful and reinforcing and thus more likely to persist beyond sporadic, diet-centric efforts.
10) Recognize that healing from an eating disorder might be a bumpy road but that, with persistence and attention to the above factors, recovery is entirely possible.


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

Women's History Month at Miami-Dade College

A couple of weeks ago, I had the honor of speaking at Miami-Dade College for Women's History Month. A number of the students in attendance, as part of a class project, had constructed life-size body collages exhibiting information about eating disorders. Here's a panoramic shot of the students with their projects, their professor, and me:

So wonderful, right? And here are some of the individual projects close up. The first is a visual representation of the emotional pain and body distortion inherent to anorexia:

The second collage highlights the relationship between eating disorders and pregnancy, commenting on the impact of disordered eating on a growing fetus:

I even got to pose with a life-size Barbie, one student's interpretation of Mattel's popular diva:

This Barbie sported post-it notes highlighting her "thin arms," "thigh gap," and other unrealistic, culturally idealized body features. Even life-size, though, her facial expression was manufactured by a printer, and she's barely three dimensional. There's just something much more compelling about real-life people, isn't there?

One of the most sobering parts of the event  occurred as I was gearing up to speak, witnessing various students, faculty members, and other passersby observe the students' creations. One middle-aged woman took a casual glance at the body projects and commented, "I wish I had an eating disorder."

It's never too late to incorporate another anecdote into a talk. . . .


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

Recovering Around a "Backdrop of Disorder"

Check out my latest NEDA blog about recovering around a backdrop of disorder - thanks NEDA for publishing my words!


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