(Photo)shopping for the Holidays

By now, you've probably heard about H & M's recent advertising snafu, in which the Swedish retailers plugged real-life faces on computer-generated bodies.  The story was exposed earlier this month.

And what about the notorious Faith Hill photoshopping job on Redbook magazine?



Revealed several years back, the side-by-side comparison spoke volumes about what the industry will do to sell a star.

But, in all of this, we're reminded of what this re-imaging does for the every woman--setting an unrealistic, unattainable standard.  H & M models do not exist in reality.  Not even Faith Hill can look like Faith Hill. Let's continue to expose the myths that fuel the fire.  It's so important that we do.

Happy holidays. . .

Let's Say. . .

Scenario 1:  Let's say that there's this young woman who comes to therapy.  We'll call her Diana.  Diana doesn't have an eating disorder.  What brings her into treatment is panic attacks.  In the course of her anxiety, let's say Diana loses weight.  She's panicky, on edge, and she's not eating enough.  Let's say that Diana was "at a normal weight" (whatever that is) before and that when she loses weight, she looks unhealthy.  Let's also say she has a psychiatrist who's treating her for her anxiety.  Then, let's say that Diana's therapist expresses concerns about her weight loss and discusses with her how she can get adequate nutrition even with low appetite.  Remember, Diana doesn't have an eating disorder, so this isn't the most complicated thing.  Next, let's say that Diana starts to feel less anxious.  Some combination of medication and therapy is helping her, and her panic attacks remit.  Let's say, that in the process of this, she gains back the weight she had lost.  Let's say that Diana is again "at a normal weight" (whatever that is).  Finally, let's say that she visits her psychiatrist after some time, who mentions Diana's weight gain and states that 1) Diana needs to lose weight and 2) She needs to do so by their next visit.


Scenario 2:  Let's say that another woman who has been in therapy for many years for anxiety, depression, and a sub-clinical eating disorder, is seeing a relatively new psychiatrist.  We'll call her Sharon.  Sharon likes her new psychiatrist because she seems compassionate and responsive to her.  Like many psychiatrists she's had in the past, Sharon's current psychiatrist is eager to try out new medications and doses of medications with her, in order to alleviate her symptoms.  During one appointment, Sharon, who is "at a normal weight" (whatever that is), expresses concern about her psychiatrist's recent recommendation that she up the dosage of her medication in order to address her residual anxiety.  "Doesn't that cause weight gain?," she asks.  Sharon is concerned because she has a history of binge eating, and she doesn't want to be on anything that exacerbates this condition.  "It could," her psychiatrist replies, "But that's when you just need to focus on portion control."  To Sharon, who again has a history of binge eating, hearing the phrase "portion control" creates such anxiety in her that she actually wants to binge.  She's had many attempts at trying to restrict what she eats (in fact, that's what led to her binge eating, according to her understanding of it all), and this does not seem to be an adequate solution.  

Do you have any reactions to these scenarios?  They can and do occur, highlighting the importance of consulting with professionals who have specific education and training in the field of eating disorders.  A simple, innocuous comment as processed by someone with an eating disorder can do significant, unintended damage.  Ideally, those struggling with eating disorders can arrive at a place in their recovery where a single comment isn't so threatening (as they may come from various sources), but until and unless this happens, it's important to select a treatment team sensitive to these concerns.

Celebrities with E.D.'s

A while back, a reporter asked me my position regarding celebrities disclosing that they have struggled with eating disorders.  She asked if I thought the disclosure was helpful or hurtful for the general public.  I went with "helpful," and here's why:  Obviously, I wish that no one had to suffer the physical and psychological damage of an eating disorder.  But, since people do develop them, and since we're still learning how to best treat them, pay for treating them, etc., I think any type of public awareness is beneficial.  For fans who struggle with eating disorders, learning of someone else's struggle may help with feelings of shame or isolation around the disorder.  Moreover, I think it's important for the public to understand that a number of the singers, actresses, and models they admire are not as naturally thin as they appear.  In many cases, they must go to drastic measures, in order to conform to our current body ideal (see Adriana Lima's recent revelation to the Telegraph for proof).  For some, these measures may lead to the development of full-blown eating disorders.  In my opinion, the more information we have that counteracts the idea that skinny (for all women) is healthy and effortless, the better.

What are your thoughts?

Come Back to Carbs

Can one woman hail the return of entire macronutrient?  I'd like to try.

We live in a carb-free, low-carb, healthy-carb country.  We're encouraged by experts to up our protein intake and lower our carbohydrates, with the premise that this is the key to arriving at a healthy (read: aesthetic) weight.  

Recently, I went to a dinner party and brought a lovely quinoa.  It went untouched.  Because of the carbs.

Later that week, I stopped at my gym's snack bar to pick up a sports drink prior to yoga class.  Amidst a sea of no-carb, high-protein drinks (many infused with artificial sweeteners in order to claim the title), I finally stumbled on some fruit juice that fit the bill.  

I get it.  We realized that we'd weigh a little less if we cut back on carbs.  But, what we didn't realize is that we'd be eliminating a major energy source, one that fuels our muscles, organs, and brains.  Carbohydrates have a significant impact on mood, as well.  Just ask someone who's going carb-free.  

Your trainer tells you to cut out bread.  Your gossip magazine shows you a day in the life of your favorite celebrity, proving that lean protein and vegetables for lunch and dinner is not only doable, but leads to the intended results.  Your coworker went low-carb and quickly dropped 15 pounds.  

The thing is. . . not one nutritionist I respect has ever recommended this type of diet to anyone I know.  They understand the importance of all three macronutrients.  They understand what cutting carbs does to one's energy and mood.  And then understand, as I do, that the weight-loss benefits of going low-carb are temporary (only for as long as you're on the diet), and that depriving ourselves of something (anything, really) often backfires, obfuscating the point entirely.  

I wish that I had a dollar for every person I meet who complains of an inability to ward off mid-afternoon candy runs, or who shamefully confesses to late-night binges on chips, cookies, or cake, who, by the way, is also restricting her carbs.  When she begins to reintroduce this necessary nutrient, she finds that her carbohydrate cravings remit.  It's her body's way of saying, "Thanks for giving me what I need."

America the Beautiful 2

Have you seen it?  I went to the Hollywood premiere a couple of weeks ago, and Darryl Roberts, the filmmaker, was there, along with several members of the cast, and all were available for a Q & A!

It isn't ground-breaking, but it does bring more, much-needed attention to eating disorders and our national focus on obesity.

And, speaking of fighting stigmas against weight and shape, try this one on for size:

The editor writes:

"I'm seeking personal essay submissions from women who have made strides in overcoming societal stigma around body size/weight and who now love/feel positive about their curvy/chubby/fat bodies. The submission deadline is quickly approaching. . . . I am offering contributors of accepted submissions $50."  


Because if you're going to fight this stigma, you may as well earn some cash in the process!

The Weeks Keep on Coming!

Did you know that this week is Fat Talk Free Week?  Check it out here!

Can you commit, for the remaining few days, not to utter a word about your body or anyone else's?  I know, I know, there may still be that silly negativity squatting in your head.  But, at least for conversational purposes, can we spend the rest of the week avoiding comments about weight, shape, or size?  Can we, if approached by others to join in such dialogue, respond like Jessica Weiner does?  ("I'm sorry, I don't speak that language.") And can we, freed up from useless chatter, use our time and energy to connect with others in a more meaningful and authentic way?

Try it out.
Take the pledge.
Then tell me, what will you talk about instead?

Health At Every Size

Did you know that last week was the Binge Eating Disorder Association's First Annual Weight Stigma Awareness Week?  Either did I, which is why I'm posting about it now.  This gives us plenty of time to prep for next year!

In light of this, I'd like to share Dr. Deb Burgard's recent piece on Health Speech.  Burgard is a key player in the Health At Every Size and Association for Size Diversity and Health movements.  

It never ceases to amaze me how medical doctors will often tell heavy people to lose weight, even when the patient shows no objective signs of disease.  At the same time, the significantly underweight, eating-disordered patient will often fly under the radar, reporting that she's never discussed her eating disorders with her primary care provider who has, in turn, never asked about her about her low weight.  

I hope that by promoting these movements we can move toward a place of greater size acceptance and can refocus agendas and efforts on health, rather than weight.

Sweet Honey in the Rock

Don't you just love it when you come across something so wonderful?

Body Image and the Media

I'm often asked to provide quotes and commentary to the media about eating disorders and body image.  Sometimes, I'm told where the interview will appear, and other times, (no laughing!), I find my words by periodically googling myself.  Recently, I answered a reporter's questions via email.  I'm not sure if my words will appear in print, but I thought they might be of interest here, and I'd love your feedback on what I said. . .  .

1) Where does our unrealistic body image come from?  Is it different for men vs. women?

Our ideas about the ideal body are contextual, linked to time and place.  The media portrays certain images that are judged to be ideal given the context, which reinforces the ideal.  I think it used to be that women seemed to have a more unattainable body ideal, while men were allowed to "get by" w/other attributes, but the tide seems to be turning, and the standards for men are becoming increasingly difficult to reach (see the new male mannequins w/27-inch waists!)

2) Why is comparison (with celebrities or people around us) so counterproductive?

Only a certain, small percentage of people have the genetics consistent with the current media ideal.  That means that the rest of us, to varying degrees of success, and with varying degrees of negative physiological and psychological consequences, will be forever chasing the thin ideal.  We're just not all mean to be or look the same.  In just the same way that many of us are forced to accept our height or shoe size, it would be wonderful if we could do this with weight, exercising in a healthy way and eating a balanced diet, but not doing these things to contort our bodies to unrealistic proportions.

3) How can you figure out what your own "ideal" body is?

I usually say that your natural weight is how much you would weigh if, over time, you ate in a balanced way (eating nutritious foods AND responding to food cravings), were eating primarily out of physical, rather than emotional hunger, ate when you were hungry and stopped when you were full, exercised regularly, but not compulsively, and refrained from food restriction, bingeing, purging, use of diet pills, enemas, laxatives, or other compensatory strategies. 

4) Any tips for correcting negative thinking when it comes to body image?

I think it's important to challenge the thoughts that suggest that body shape/size (or even appearance in general) determines happiness.  I've worked with plenty of heavy, happy women, as well as plenty of women who are skinny and unhappy.  We're conditioned by the media to place way too much emphasis on body image in terms of where we think it will get us in life. 

5) Are body image issues on the rise in the US? if so, why?

I think we're seeing more issues among men, plus we continue to see eating disorder rates increasing, especially among younger and younger children.  Media access is so available and immediate these days, and the images come to us through various forms.  We now have people comparing themselves to their "friends" on Facebook.  I've spoken with a number of women who avoid social events because they know that the pictures taken there will be posted on social media sites, which will stir up their body dissatisfaction.

6) How can our readers be more accepting of their bodies?

One of the best things I think people can do is learn about how the media distorts images to promote the ideal. The more we learn about cropping, airbrushing, etc., the more we realize that even the celebrities don't look like themselves.  Also, see attached (article I wrote on radical body acceptance) for more recommendations. 

Fall, 2011

Check out this magnet I found in the UCLA bookstore:

At first, I loved it, but then, as I walked away, I began to think: "No, wait, Barbie should be happy being Barbie!"

We psychologists over-think everything.

Have I mentioned I moved to Los Angeles?  That's what I did during my summer vacation.  How about you?

As I return to blogging this fall, I'm interested in what you'd like to see me write about.  Any requests for topics?

There's a lot brewing in the Does Every Women Have an Eating Disorder? world. . . .  I already have talks lined up for September and March, and now, being in Los Angeles, where eating disorder treatment centers seem to be everywhere, I have a number of meetings scheduled with other professionals.  I've hung my shingle in Southern California and am seeing new patients here.  I continue to scour the internet, magazines, and television ads for cultural illustrations of my premise.  Just the other day, I saw a commercial (I believe it was for Home Goods), in which a woman returns from her lunch break, bragging to her colleague that her meal was both affordable and calorie-free.  As it turns out, she visited a Home Goods store and made a home purchase there, skipping lunch entirely.

Please help me in fighting this fight. . . .

Bringing Summer Back

On this weekend, the unofficial start to summer, I'm aware that we've lost the meaning of the season.

Summer is not supposed to be about hating your body.

It's about coconut lotion, popsicle tongues, and cartwheels in the sand.  Summer camp, porch swings, and shvitzing in the shade. Slip-and-slides, fireworks, and forever dusk.

And yes, it's about food. . .  hot dogs, ice cream, and corn. . .  picnics and barbecues, blueberries, and tea (iced tea, that is).

As a child, no one had to tell you how to prepare for swimsuit season.  The same holds true now.  Getting "bikini-ready" is as simple as: 1) taking off your clothes and 2) putting on your bikini.

So, join me these next few months in bringing summer back.  Let's keep in mind the wonderful culture of summer, where the size or shape of your belly, upper arms, thighs, hips, and butts have nothing to do with barreling into the surf,  hurling watermelon seeds, or catching fireflies in a jar.

Goodbye, Mia

I'm deeply saddened by the loss of Mia Amber Davis, plus-sized modeling pioneer (Mia's site).  It's difficult to conceptualize a loss at such a young age.  Even more so when you've met her.

I met Mia a couple of years back, when we served on a television panel together.  I was immediately impressed by her presence, a confident, intelligent, beautiful young woman, who spoke so articulately about the relationship between culture, self-esteem, and weight.

It's sad to think that the (plus-sized) modeling industry has lost such a bright, young star.

Glee?

In the latest issue of Self Magazine, Gwyneth Paltrow "shares her secrets for eating healthy and having a body to envy."  Paltrow, promoting her new book, My Father's Daughter:  Delicious, Easy Recipes Celebrating Family & Togetherness, discusses the evolution of her relationship with food, from developing an interest in cooking with her father; to adhering to an organic, local, macrobiotic diet (eliminating dairy, sugar, meat, liquor, and gluten); to fulfilling pregnancy cravings; and finally to preparing delicious offerings for those she loves.  Sounds good, right?

But then, in a sidebar titled, "How She Got That Body," Paltrow is interviewed regarding her exercise regime.  The super-slim Paltrow, who admits to being in the best shape of her life, fesses up to 90 minutes of exercise five days a week.  She goes on to say, "If I'm prepping for something or I've been eating a lot of pie, I do two hours a day, six days a week for two weeks."

Last I checked, this constitutes excessive exercise.  I get that stars like Paltrow have to look the part, and I understand that logging hours with celebrity trainers and chefs helps them fit the bill.  However, exercising more to compensate for one's eating (and by more, I mean hours more a week!) gets a little fuzzy, don't you think?

Self advertises the story to explain how Paltrow arrived "at her happy relationship with food."  Paltrow seems to enjoy cooking and eating, even her no-fry fries, recipe included, her raw almonds, and homemade kale and lemon juice.  But, it's the relationship she's forged between food and exercise that seems not-so-happy to me.  Paltrow states, "I say I always eat right, but last night, I had fried clams, pasta with duck sausage and two glasses of red wine.  When I want to lose, I eat less pasta, bread and potatoes. Before last year's Iron Man 2 premiere, I did green juices and salads for three days."

So that's how celebrities achieve the red-carpet look!

When asked about her motivation for working out, Paltrow responds, "I like feeling strong and healthy, but mostly I think about the fried zucchini I'll eat later."

My concern is that millions of readers may believe that exercise-as-compensation is the way to go.  Many women will come to me in frustration that they can't maintain a celebrity diet (think the magazine sidebars we often see, detailing the egg-white breakfast, salad-with-grilled-chicken lunch, and fish-and-veggie dinner that many celebs will tout).

What I try to remind people is that most of us do not live celebrity lifestyles, have celebrity staff, or know what goes on behind closed doors.  Just like non-celebs, stars will often go to extreme, unhealthy measures to maintain their weight.  I'm not trying to condemn Paltrow's food or exercise choices.  It's just important for us to recognize that Gwyneth isn't gospel, that a celebrity's relationship with food or her body is not always attainable or ideal.

So Sad

Did you hear about this?

Eating Disorder Study

I'd love to have a dollar for all the people who, after learning that I work with eating disorders, say something to the effect of, "I wish I had an eating disorder."  Then, there are those who think recovery is simple--just eat, or just limit what you eat--when it's not.  Eating disorders are not simply choices.  New research (see the abstract below) actually provides evidence for such interpretations of eating disorders and recovery.

A Comparison of Stigma Toward Eating Disorders Versus Depression. Objective: The goal of this study was to compare the degree of stigma associated with anorexia nervosa (AN), bulimia nervosa (BN), and depression. Method: Participants read one of three vignettes describing clinical cases of AN, BN, or depression, and answered questions assessing stigma toward individuals with one of these three mental disorders. Results: Attitudes toward individuals with eating disorders were significantly more stigmatizing than attitudes toward individuals with depression. Individuals with an eating disorder were rated as more fragile, more responsible for their disorder, and more likely to use their disorder to gain attention than individuals with depression. Furthermore, the majority of participants reported that they admired certain aspects of eating disorders, thought that there might be some benefits to having an eating disorder, and that others would be motivated to imitate eating disorder behavior. Discussion: Stigma toward individuals with eating disorders is greater than stigma toward depression and includes unique features such as attitudes of envy. Implications of these results for the understanding of mental disorder stigma and eating disorders are discussed. Source: Int J Eat Disord. 2010 Nov 1;43(7):671-4.

A Meditation on Forgiveness

Can you forgive yourself for being imperfect? 

For making mistakes each day, for not getting it right. . .

For failing to meet your your expectations each and every time. . .

For just getting by when you wanted to excel. . .

For walking when you wanted to run. . .

For eating more than you'd like, for weighing more than you'd 

like. . .

For engaging in unhealthy measures to control how you look. . .

Can you take this moment to forgive yourself?

"Finish each day and be done with it. You have done what you could. Some blunders and absurdities no doubt crept in, forget them as soon as you can. Tomorrow is a new day, you shall begin it well and serenely."  Ralph Waldo Emerson

Weight

I recently came across this post by blogger, Jen Selk, and thought you might enjoy. . . .

January Happenings

Happy New Year!

Resolved:
To start the year off on a positive note, how about some resolutions that don't involve disliking yourself?  Rather than focusing on losing weight, why not resolve to improve your relationship with food, and while you're at it, your relationship with your body?  This will help you NOW and will last way beyond the crash-diet/gym-heavy January norm.

Action Plan:
For those in/around NYC, I will be starting a six-week Eat in Peace. group on January 19th, 2011.  Co-led with a registered dietitian, the group will focus on developing a healthier relationship with food.  To sign up, or for more information, email me by January 14th at drstaceyny@gmail.com.

For those in the Northeast (or those from farther locales, looking for a winter escape), register for the Lose the Diet. Love Your Body. Eat in Peace. weekend-long workshop I will be leading January 21st-23rd at Kripalu Yoga Center.  For around the cost of one therapy session, you get a whole weekend with me!  What could be better than two full days of yoga, programming around mindful eating, connecting with like-minded individuals, all in the beautiful Berkshire mountains?   Registration will close tomorrow, January 7th, so sign up now!