EDNOS

Eating Disorder Not Otherwise Specified (EDNOS) is a clinical eating disorder that captures eating-disordered thoughts, feelings, and behavior that do not meet full criteria for Anorexia Nervosa or Bulimia Nervosa. While no specific criteria distinguish this diagnosis, the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM IV-TR) offers the following examples of symptoms that would warrant a clinical diagnosis:

1. For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses.
2. All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual’s current weight is in the normal range.
3. All of the criteria for Bulimia Nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than three months.
4. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies).
5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
6. Binge-eating disorder: recurrent episodes of binge eating in the absence of the regularly use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa.

DrStaceyny’s input (by number):
1. One of the required symptoms for a diagnosis of anorexia is that you present with amenorrhea (having no menstrual period for at least three months). So, if you meet all other criteria for anorexia (less than or equal to 85% of what you should weigh, fears of gaining weight, body-image disturbance), but are still getting your period, your diagnosis would likely be EDNOS.
2. The first criterion for anorexia is “refusal to maintain body weight at or above a minimally normal weight for age and height.” This is often translated to the 85% rule stated above. However, some people might have started out at a heavier weight, and thus, even if they lose lots of weight, they’re actually not below “normal” weight expectations.
3. Think of this one as less-frequent bulimia—there is bingeing and purging, but not at the same rate (or for the same duration) as what would be required for a bulimia diagnosis.
4. This example captures those who don’t, by definition, binge, but who still rely on compensatory strategies (vomiting, laxative use) following even small amounts of food consumption (sometimes referred to as “purging disorder”).
5. Pretty straight-forward.
6. Binge Eating Disorder is, as of now, what’s called a “criteria set.” The American Psychiatric Association has recognized the condition as one which warrants further empirical attention, and it’s quite possible, that by the next revision of the DSM (supposedly in 2010), Binge Eating Disorder will be recognized as its own diagnosable (read: reimbursable) condition. Other disorders similarly on deck include: Premenstrual Dysphoric Disorder (now coded under a type of depression), Mixed Anxiety-Depressive Disorder, and Caffeine Withdrawal.

The list of six examples given above is not intended to be a comprehensive list of all of the symptom constellations that might qualify as EDNOS. Symptom presentations, as individual, may vary, and it is important to recognize that for those who suffer from EDNOS, this is a serious condition no less painful, no less subjectively detrimental, no less of a personal hell than anorexia or bulimia. While it is likely that EDNOS is not as fatal as anorexia or bulimia, EDNOS can still cause substantial ruin. EDNOS can ruin your self-concept. It can ruin relationships. It can ruin your work and your interests. It can still ruin. . . you.

Score One for the Home Team

The rain in Spain falls mainly on the plain—well, not anymore, because (tiny) curves are in in Madrid! AOL News* reports that Spain’s hottest fashion show, Pasarela Cibeles, forbade a number of models from participating this year. . . because they were, oops, too thin. In a surprising example of how Body Mass Indexes can be an effective and reliable health/wellness tool after all, pageant officials calculated models’ indices and dropped each hopeful with a BMI shy of 18.

The show, which features primarily Spanish designers, decided to enact this measure following the aftermath of last year’s show, which featured “bone thin” models. Aghast feminists and medical professionals spoke up, recognizing how parading these forms on the catwalk can fuel national eating-disordered behavior, particularly among young girls. The decision to step in seems to be a collaborative effort of Madrid’s regional government and the Association of Fashion Designers of Spain. AOL readers, it seems, would likely offer their support, as well. In an on-line poll of over 55,000 voters (when I voted), 91% believed that the presence of “ultra-thin” models contributed to the development of eating disorders.

As New York City launches its fall fashion week, I wonder if the U.S. (and other countries) will follow in the Spaniards’ footsteps. After hearing the news, Ryan Brown, of the Elite Modeling Agency in New York, is quoted as saying: “I think it is great to promote health.” Time will tell how many fashion weeks will come and go before such a sentiment is turned into practice on American soil. As for now, Brown notes: “They don't want voluptuous girls any more,” though he adds: “It would be nice if fashion got back to that.” Yes, Mr. Brown, it would.

*thanks to the readers who sent this my way

Google Me This

Coming up on my last week of daily posts, I thought it would be interesting to explore how people found my blog, since when I started out, I only shared the site with a handful of colleagues, family, and friends. As such, I’ve been periodically tracking the Google searches that have landed readers here. Many of them relate to celebrity diet/weight concerns:

-Is Mandy Moore getting fat?
-Beyonce Knowles’ recent weight-loss secret
-Katherine Heigl bra size
-Jessica Alba eating disorder squats
-Jamie Sigler eating disorder
-Katie Couric fat arms

We also seem to be very interested in celebrity dress sizes, including the sizes of some of the aforementioned stars, as well as others.

One of the more popular searches that lands people at my site?

-Woman eating shit

So. . . uh. . . I have absolutely no idea what to say here.

Other searches focus on dieting and eating-disorder tips and techniques:

-What WW members eat
-Non-purging bulimia
-Starve and barf
-Bingeing restrictions
-How to hide an eating disorder

In fact, many are of the pro-ana/pro-mia variety. I can’t even count the number of searches for these terms. I also can’t imagine the disappointment in trying to find a pro-ana site and getting stuck with me. We seem, overall, to be very interested in anorexia and the disappearance of flesh.

-Anorexic 75-lb woman
-Freudian anorexic pregnancy
-Ballerina anorexic images
-47-pound anorexic ballerina
-Anorexic role models

And, the most harrowing query to date?

-How little can a woman weigh and still live

Parenting

A recent study conducted by Boston University’s School of Medicine, and appearing in the June issue of Pediatrics, revealed that children of authoritarian (strict disciplinarian) parents are five times more likely to be overweight by the first grade than those reared by more authoritative (democratic) parents. True, children of overly permissive and/or neglectful parents were even more likely to be overweight, but the question remains—why would kids raised by overly strict parents tend to be more overweight than those exposed to more flexible parenting?

The study’s lead author, Dr. Kyung Rhee, provides some clarity, suggesting that authoritarian parents may inhibit children from developing their self-regulatory abilities. Children instructed to eat brussel sprouts, for instance, instead of vegetables more palatable to them, lose their sense of autonomy and personal choice, which may, in turn, affect their abilities to “listen to their bodies about how full they are,” Rhee says.

Another factor, I’d add, is that children of excessively strict parents may soothe themselves with food in an effort to comfort themselves following (or preceding) frequent disciplining. Moreover, in a system where rigidity is key, children may rebel by overeating, sneaking food as an effort toward self-expression and/or separation from the family.

My Time in the Zone

The story, of which I have no recollection, goes something like this: When I was five, my mother served hamburgers one night for dinner. Always inquisitive, I posed a question to her: “Mommy, how does the cow make the hamburger?” My mother, not wanting to mislead me, replied, “Stacey, this is the cow.” I pushed my plate away.

While I did go on to eat meat again, fast forward about twelve years, and, fueled by burgeoning ideas about animal ethics, as well as a general unrest about chewing animal flesh, I became a full-fledged vegetarian.

A few months before beginning this book, I went on my first organized diet. I wasn’t really trying to lose weight (ok, maybe a few pounds), but was more interested in healthy eating and balancing protein and carbs, as the media told me I should be doing. As a vegetarian, I’m often asked, “Do you get enough protein?” Truth is, I’m not sure I do.

One of the Zone-Diet inspired plans had recently unveiled a vegetarian program, so I decided to give it a go. My go involved about eight servings of tofu a day. I had tofu for breakfast, lunch, and dinner, and tofu before bed. As I write this, I stand firm (though, not extra firm) in my belief that tofu is not a breakfast food, no matter how closely it resembles a sausage link.

During my trial, I’m really, really hungry and am not sure they figured in my active lifestyle when calculating my portion sizes. A couple of days into the program, I go to the gym and realize my effort is about 50%. I’m tired, and can’t run far. The next time I try to run, I’m even more exhausted. I barely make it home from the gym, dizzy, faint, and unsure of what to do. My normal blood pressure is 90/60, and I can tell I’m south of that. I consider going to the closest E.R. Meanwhile, I plant myself at the computer, and search the panacea for all things medical, the web, where I learn that such diets (particularly for the uninitiated) often create electrolyte imbalances and that salt ingestion is a quick and effective cure. I grab some crackers and slowly begin to feel better, more myself. I toss the remaining meals, feeling slightly rebellious, but healthy and liberated. About a week later, I get a call from a program rep, who asks me how the diet went. I explain how hungry and tired and sick I became, detailing my near emergency-room excursion. His response: “I’m sorry to hear that. We’re offering a discount for the monthly program, which would be only $36.95 a day. Would you like to enroll?”

Gambling on Life

The Hollywood Gossip is a celebrity site that devotes an entire category of posts to eating-disorder gossip. On the site, recently, I found this poll:

Which emaciated star will disappear first?
1) Nicole Richie
2) Kate Bosworth
3) Mischa Barton
4) Paris Hilton
5) Ashlee Simpson

Games: Simon Says, Monopoly, Spades
Not Games: Taking bids on people’s lives

Body Innocence

A while back, I posed the question, “How far back do you have to go to arrive at a time when you weren’t aware of your body?” To frame the question differently, I’m curious when we lose, what I call, our “body innocence.” Body innocence has to do with knowing what your body can do, knowing what you look like, but not being “aware” of your body—not judging your appearance, not worrying about what you’re eating, not checking yourself in the mirror, or weighing yourself repeatedly. Body innocence is accompanied by cognitive innocence of all things diet and weight-related. Becoming body aware (versus innocent) does not necessarily lead to an eating disorder; however, this is often the first step down a windy, insidious path.

What causes us to lose our body innocence? A starting, and certainly not comprehensive, list:
1) An unsuspecting comment by a family member, friend, or peer
2) A purposely cruel comment by a family member, friend, or peer
3) Losing some weight unintentionally and being consequently reinforced by
others
4) Realizing ourselves that we’re not as skinny as other children
5) Being involved in a weight-dependent activity, such as ballet, gymnastics,
cheerleading, or ice skating (let’s not even say, “figure skating”)
6) Exposure to constant media messages about unnaturally thin celebrities
7) Exposure to constant media messages about the dangers of being
overweight
8) Exposure to constant media messages that promote diet pills, plans, and procedures
9) Exposure to family members, friends, or peers, who aren’t body innocent
10) Abuse

Lose 20 Pounds Fast!

By now, you’ve probably heard about Katie Couric’s twenty-pound weight loss. It seems that CBS promotional magazine Watch! Photoshopped, without Couric’s awareness, a recent shot of the anchor-to-be, resulting in a cinched waist, contoured cheekbones, a smaller bust, and thinner arms and hips.

Couric’s response, according to The Daily News: "I liked the first picture better because there's more of me to love." And, really, don’t you just love her more after a comment like this? That’s what the polls say, after all. According to People magazine’s online pole, 54% of us prefer the untouched shot. In other words, we prefer Katie with a little meat on her bones.

Or, do we? Perhaps we like the natural shot because we know it’s natural. It’s the cutesy, girl-next-door we’ve grown to adore. Are we really immune to societal messages that thinner is better? Given pictures of two women who look alike, wouldn’t most, as any advertisering exec would tell you, judge the thinner one to be more attractive? Which do you prefer?

You Could Learn a Lot from a Puppet

Cookie Monster seems to have it down. The newly appointed healthy-foods ambassador (a cookie is a “sometimes food”) offers a good example of mindful eating. A recent issue of Metro (a New York daily) features an interview with the furry, blue, cookie-loving puppet.

Cookie Monster instructs us how to eat a cookie:

You got to eat cookies like this: You pick up the cookie. Look at it. You smell the cookie. It smell delicious usually and then you just go for it like this: AHHMNUMNUMNUMNUMNUM. The more crumbs, the better. Me teach you how to eat cookie professional way.

His message is funny, and grammatically questionable (in classic Cookie Monster style), but highlights some critical features of intuitive eating—allowing yourself to indulge in what you enjoy and making eating a complete sensory experience.

When asked about variety in his diet, Cookie Monster reports: “Me no ever only ate cookies. Me eat everything. Me eat you know, bicycle, fire hydrant, table, chair. Me love cookies but me also eat vegetables.”

Everything in moderation. . .

Product Review: Say Goodbye to Hunger?

The Medifast Diet keeps popping up on my computer, begging me to take a look. Finally, I acquiesce. I’m invited to try a diet that eliminates decisions, freeing me from the calorie- and carb-counting I’m presumed to do on a daily basis. The solution? They count for me, and I get roughly four. . . of each.

The program consists of five Medifast meals per day, accompanied by one “Lean and Green” meal (“lean protein and salad greens”). The Medifast website states: "The clinically proven results of Medifast are designed to create a healthy gap between the calories you take in and the amount your body burns, thus promoting natural weight loss." According to my calculations, and based on the roughly 3,500 caloric-deficit needed for a pound of weight-loss, that’s a “gap” of 2,333 calories a day. If you were eating 2,500 calories a day (and maintaining your weight at that figure), you’ll now eat 167. I don’t see any program-recommended exercise, except for that suggested during the post-diet, “weight-maintenance” stage. In fact, the website states that, “Unless you are already exercising, you should not begin an exercise program in the first few weeks of weight loss.” Clearly, with a deficit of 2,333 calories a day, you’re not going to be able to run that far.

The website advertises that “Medifast programs have been recommended by over 15,000 physicians.” What physicians are recommended this program, given that most people in-the-know do not recommend more than a 1-2 pound weight-loss per week (and this is up to 5)? I also wonder what kind of chemicals, fillers, and multisyllabic ingredients they’re passing off as a meal (the site indicates that most products use “acesulfame potassium” as a sweetener).

The copy promises you’ll never get hungry. That "fast" is part of the product name doesn't bode well for you feeling satisfied. And, anyway, how is this even possible? If you’re eating 2,333 calories per day less than you’re burning, I’d think you’d be hungry! And so do they, to some extent: The FAQ’s page encourages users to take an antacid to deal with persistent hunger pains. Other potential side effects they list? Diarrhea, gurgling stomach cramps, constipation, bad breath, feeling cold, skin rashes, heartburn, and hair loss. All this for short-term weight-loss. After all, even the Medifast people recognize the difficulty of keeping off weight, once you’ve completed the program. The site states:

You will maintain your success by making long-term changes in your lifestyle such as healthy eating and consistent exercise. You may also need to work on how you cope with life so that you don't reach for food when you are experiencing stress, depression or other emotional needs.

If you could do all this, you wouldn’t be turning to Medifast in the first
place. . . .

An Afternoon in a Coffee Shop

I’m sitting at a coffee shop this weekend, working on this book. A few people wander behind me, and I’m half-listening to their conversation as I write. One of the women asks the man, “Is that your lunch?” And then I hear (from the man): “Yeah. I’m on a diet. My goal weight is four pounds.” I turn around. He notices me, noticing him, and asks, “What do you think? Is that a good goal?”

I glance back at my computer screen before replying, “I’m writing a book on eating disorders, so I’m going to go with ‘no.’”

He laughs, but then continues: “My whole life, I’ve wanted to be anorexic—but I’m always hungry. I wish I were anorexic.”

“No you don’t,” I quip.

“Yes, I do—my sister was anorexic. I was so jealous.” I stare. “I’m just kidding,” he says. “I joke a lot.” I freeze, caught between a general tendency toward humor appreciation and not wanting to condone a joke about an issue I take so seriously, managing only a half-smile in return. He tells his companion, “I’m going to go back there (he points), before she hits me in the head.”

A friend overhears the exchange and states the unspoken truth: “Theoretically, you could never stop writing, because people are going to give you material wherever you go.” It’s true—even as I sit here writing, there’s something more to tell. At some point, I hope to put this in print, but long after I tire of writing on this topic, there will always be another story, another joke, another conversation. . . .

Generations

The Oprah show recently focused on the body dysmorphia now common, even amongst little girls. The show featured two pre-schoolers and a teenage model, all of whom hated their appearance or took drastic measures to conform to a beauty ideal.

The first guest was a three-year-old little girl, a regular Victoria Secret catalogue reader, who throws tantrums when not allowed to wear make-up like her mom. According to her mother, the girl screams, “I hate you Mommy!” when she doesn’t feel pretty enough. Explanations for this? Her mother seems to spend quite a bit of time prepping herself when going out, applying make-up and performing multiple mirror-checks. Mother says, “I don’t recall ever being told ‘You’re beautiful,’ so I’m constantly telling her how beautiful she is.” So, why doesn’t her daughter listen to her? It seems the adage, “Do as I say, not as I do” is most illustrative here.

The second guest, a skinny four-year-old is intensely afraid she’ll become fat. How might such fear arise? Her mother insists that her daughter’s pre-school classmates called her “fat,” stating, “I honestly believe that she’s learning it from just being around other girls.” You do? Because what about, as the show later reveals, your history of anorexia? Turns out mom struggled with anorexia for years, and even now limits all food intake to servings “smaller than a cup” and exercises daily, sometimes twice a day. It’s not surprising that her daughter is restricting her portions and leading her own makeshift aerobics class in the home, is it?

The third guest is a 19-year-old model and soccer-team captain. She reports that at age seven, she couldn’t go to school because her face was “too ugly,” and today, she tends to shatter mirrors and destroy pictures of herself. She, at times, turns her destructive impulses on herself, reporting suicidal ideation and a history of cutting. After hearing from this young woman, we meet her mother, whom her daughter often overhears as saying, “I’m so ugly!” Mom and daughter, from time to time, compete in the “Who’s fatter?” game.

In all three cases, we see daughters, despite well-intentioned mothers, who internalize their self-reproach. A daughter whose mother struggles with body acceptance will likely do the same, as her mother tacitly, but forcefully, conveys that thinner is better and condemns any shape that does not conform. It is my contention that for mothers, no matter how much love you give your daughter, or how much regard you show her, if you dislike your body, your daughter will do the same.

You Should Consider This

Karen Horney, a pioneering psychoanalyst, who followed in the footsteps of Freud, spoke of the “Tyranny of the Shoulds,” the self-haunting that occurs when we compare how we are to how we think we should be. Focusing on this discrepancy results in, as you’d expect, significant distress, and the solution, according to psychologists, analytical and cognitive alike, is to avoid the use of should—not just to remove the word from our vocabulary, but to be more compassionate with ourselves and lighten up with (often) unrealistic expectations.

I should lose 10 pounds.
I should exercise for two hours today.
I shouldn’t eat that cookie.
I should stick to my diet without any exceptions.
I should be thinner than I am.

Also, beware of the relatives of should: have to, need to, want to (with sufficient angst). Why are these all so damaging? Because truth is, it’s hard to lose weight, to exercise regularly (and excessively), to restrict, to limit, and to shrink your body beyond its natural weight. And when we get caught up in the “should” (instead of the “could” or the “would like to”), we set ourselves up for disappointment and self-reproach, both of which play an integral role in sabotaging our personal goals and further unsteadying an already shaky self-regard.

Hmm. . .

I was at some friends’ house for dinner one night. On the kitchen counter, they had a baby picture of their niece, now five years old. Another guest commented on how chubby the five-year-old had been as a baby—“fat baby,” “not a cute baby,” and how “it’s a good thing she turned out cute.” Half an hour later, the same guest is talking about children’s clothing and specifically about her young daughter’s preferences. “Would you believe that she’s only six, and she already won’t wear one of her coats, because it makes her look fat? I don’t know where she gets that from.”

A Girl Can Dream

(written to the editor of Star magazine)

Dear Editor:

I am writing in regard to your recent (August 28th) feature about Nicole Ritchie, entitled, "Bare Bones!" As Pearson, Clark, and Levine note, Ms. Ritchie is grossly underweight.

My concern is that anorexia, a serious (and often lethal) physical and psychological condition is not represented properly in the article. The writers quote Christine Bybee, a "nutritionist and fitness expert" regarding Nicole's condition: "'A true anorexic looks like a walking skeleton. . . . At that point, a person needs to be hospitalized. Nicole isn't there yet."

Unfortunately, Bybee's statement is wholly untrue. First, it is impossible to judge whether someone is anorexic simply based on her appearance. A comprehensive clinical interview is necessary, and, even then, a diagnosis may be difficult if the patient is not forthcoming. Second, not all anorexics have the look of a "walking skeleton," as the diagnosis requires (amongst other criteria) that a patient weigh less than 85% than expected--how this translates into "looks" varies by individual. Finally, hospitalization can and does occur at various points along the continuum of eating-disordered symptoms and is not simply a stop-gap, life-saving measure once a patient appears to be "a walking skeleton."

I write with concern that your readers may, based on the above misinformation, understand anorexia to be less serious (or more black-and-white) than it is. Nicole Ritchie is, even by her own account, "too thin," but to label her as anorexic (or not) is questionable journalism, given the complexity of the diagnosis. Moreover, information about an eating disorder (a mental health disorder) diagnosis and treatment should come from a mental health professional, not a nutritionist or fitness expert.

I urge you to promote responsible journalism, particularly with regard to a disease as grave as anorexia, as many young women are turning to celebrity magazines for information about this condition.

Sincerely,
Drstaceyny
Licensed Psychologist (specializing in eating- and body-image concerns)

I'm Worried About Your Health

In The Diet Myth, Paul Campos discusses the “disease” of obesity as a socio-cultural construction designed to underhandedly fuel bigotry against fat, as well as to potentiate racist and ethnocentric thought. How many times have we heard, “You see, it’s not that you don’t look good—it’s just your health that I’m concerned about”? In his journalistic account of the weight-loss research enterprise (and industry), Campos debunks this myth by presenting facts exposing that (exact quote):

1) The health risks associated with increasing weight are generally small, in comparison to those associated with, for example, being a man, or poor, or African American.
2) These risks tend to disappear altogether when factors other than weight are taken into account. For instance, fat active people have half the mortality rate of thin sedentary people and the same mortality rate as thin active people.
3) There is no good evidence that significant long-term weight loss is beneficial to health, and a great deal of evidence that short-term weight loss followed by weight regain (the pattern followed by almost all dieters) is medically harmful. Indeed, frequent dieting is perhaps the single best predictor of future weight gain.
4) Despite a century-long search for a “cure” for “overweight,” we still have no idea how to make fat people thin.

It’s interesting how often the “health” card is invoked, even amongst medical and psychological professionals. Truth is, there’s really no way to evaluate people’s health based on how they look. And yet, we do it all the time. So, now what? Without the “health” argument to back us up, how should we disguise our disgust with fat?

Housekeeping

I'm 82 posts into my 100-post, daily (weekday) goal (yes, this one counts!), and I thought I'd take a moment to reflect, as well as to ask for feedback.

Starting out, I made two conscious decisions (well, at least two, let’s hope) in designing this blog. Number one, I decided I wouldn’t sell out to Google. Not because I wouldn’t like the money that would come with your every click—I would. But, you know exactly what would happen if I signed up for Ad Sense—in no time, you’d see ads on my site for diet pills, weight-loss gimmicks, and a host of other products designed to make you feel bad about yourself. Not here.

Second, I’ve purposely withheld information about my current weight or shape, as well as pictures of myself. My thinking here is that I don’t want to align myself with fat or thin, or with any other point on the body size continuum. Part of the motivation for this book is to illustrate how widespread eating problems are, and how they affect (and unite) us, big and small. This struggle belongs to all of us.

As I'm turning the final corner for my daily-post goal (after 100, I'll still post, though likely not with the same consistency), I have a couple of thoughts that I might like to explore the next several weeks. To start, I am forever grateful for your thoughtful comments. They've helped me to solidify many of my ideas, as well as to engender new ones. That said, I encourage those readers who read regularly but haven't commented to speak up--I'd love to hear from you.

Given the interesting questions that regularly come up in the comments section, I'm thinking about devoting one day a week to a Q & A process. If you'd like to ask a question, please email me directly, and I'll compile and present them once a week. Questions could be personal, general, about you, about me, about anything. . . . You know the (disclaimer) drill--what I write shouldn't subsitute for face-to-face contact with a trained professional.

I'm also considering the idea of allowing a couple of regular readers to guest-post about their experiences related to food/weight. Let me know, again, by email, if you'd like to participate. Related to this, if you like to tell your "story," please let me know if I might contact you re: "appearing" in my manuscript (with all identifying information removed, of course).

Within the month, I'll be submitting some of my work to agents (yes, now I've committed myself to a deadline!), so please let me know if you have any feedback (what you liked/haven't liked), as I pull together various posts.

Again, thank you so much for all your insights. I hope that some of the ideas presented here have been as helpful to you as you've been to me. . . .

Mixed Messages

In a Details magazine feature, entitled, “Why Fat Is Back in Hollywood,” writer Holly Millea discusses how the super-thin look is slowly being countered by a curvy, more feminine look, reminiscent of old Hollywood and pin-up stars. Millea offers Catherine Zeta-Jones, Scarlett Johansson, and Drew Barrymore as evidence. Even Rachel Weisz, Lost star Evangeline Lilly, and Mandy Moore are thrown in the mix.

But, let’s take a step back. These women are so far from “fat,” that I’m afraid they’ve landed in the wrong article. Rachel Weisz might only be described as “curvy” when with child, Evalengline Lilly is as athletic and toned as they come, and Mandy Moore is. . . Mandy Moore. Are we that skewed that these women are the only ones we can identify as “fat”? (The answer is “yes,” I’m afraid.)

Millea makes some interesting points and challenges us to confront the status-quo assumption of thinner-is-better. She asks, “Seriously, would you prefer to get a Grey’s Anatomy lesson from an hourglassed Katherine Heigl or a reedy Ellen Pompeo?” Point taken, but even here, we can’t look at their bodies without objectifying them, without bringing it back to sex. There’s no beating around the bush here:

You see that look in the faces of formerly fleshy sexpots who have morphed into pinched, prematurely aged superwaifs. What do they do for fun? Food and sex are appetites inextricably linked in the human psyche. One could speculate that for those obsessed with not eating, even the boyfriend’s salami goes the way of the bread basket.

The message? Don’t starve yourself down, not because it isn’t healthy or because it irreparably damages your psyche and your will to live or even because it sets up an (often deadly) unrealistic standard for your fans, but because it’s just (shoulders raised) not so sexy. Hit ‘em where it hurts, and, maybe, we’ll tackle some ground.

Hillea realizes the difficulty of positing a world taken over by the “lush,” “curvy,” forms of Johanssen and Zeta-Jones (now that we’re on the topic, are they really larger than a Size 6?):

Of course, it’s easy for anyone who isn’t an aspiring actress to beat the drum for weight gain. Our careers don’t depend on being a jean size smaller than the next girl. As one male studio executive who asked not to be named says, “Do we really want stars to look like the rest of us? If actresses represented the way the public really looks, the mother from Gilbert Grape would be a sex symbol.”

It seems that that’s the ultimate fear—if we accept Drew Barrymore as body-beautiful, then we’re just a couple of steps away from accepting obesity (in others and ourselves). Not to mention the fact that 500-pound Bonnie Grape is no more representative of her public constituents than Kate Bosworth, Nicole Richie, or the shrinking Keira Knightley.

I’m always interested in journalism that confronts body stereotypes, and the premise here is pure. Even the article’s subtitle, “In an industry rife with painfully thin stick figures, women with some meat on their bones are—lucky for us—rising to the top” offers a respectable purpose and heralds writing I’d like to read. But, sprinkled with not-so-fat celebrity examples, black-and-white thinking (see quote above), and an accompanying graphic (see below) that all but refutes anything said, the take-home message is confusing and elusive at best.

Transgressions

The National Eating Disorder Association’s (NEDA’s) media watchdog program, which began in 1997, targets advertising that portrays unhealthy messages about body shape and size, with the understanding that such messages may contribute to the incidence of eating disorders. According to NEDA, over 50% of the protested ad campaigns have been discontinued as the result of such advocacy.

In 2002, when I first learned of, and became involved in, the campaign, I met with female students at a local university in order to get their feedback on the ad above. The promotion, for Nutri-Grain breakfast bars, features a slim, attractive woman with two cinnamon buns affixed to her rear end. You may remember similar television ads, including one, this time whose subject was male, who wore a frosted doughnut wrapped around his middle.

Aside from the obvious untruth (cinnamon buns don’t land directly on your buns, nor doughnuts on your waist, and it’s exactly this type of thinking that encourages people to seek out widely proliferated, but highly ineffective, techniques for “spot reduction”), what struck me most about this ad, and when led to the most interesting discussion at the college, was the copy, which does away with subtlety and diplomacy and instead bodes consumers to “Respect yourself in the morning.”

Lest this be unclear, eating a Nutri-Grain breakfast bar allows you to maintain your self-respect. Eating a cinnamon bun (or two), quite obviously akin to engaging in an unplanned, unladylike, orgiastic feast the night before, does not.

It’s interesting, this juxtaposition of food and morality (sprinkled with a healthy dose of sex) that seems to repeatedly be played out in our thoughts and conversations. “I was good” or “I was bad” don’t have anything to do with characterological or behavioral transgressions, but instead with what we ate. It’s not surprising that Madison Avenue caught on, recognizing that how we rate ourselves morally, and how we feel about ourselves in general, is largely tied to what we eat. Breakfast bar or cinnamon bun? Madonna or whore? You make the call. . . .

So You Think You're Thin Enough?

Are you following So You Think You Can Dance? They’re down to the final two female dancers, and I can’t help but notice that Donyelle has about 25 pounds on Heidi. I know it’s not just me. Either the contestants themselves or some higher ups on the show notice the discrepancy, too—it’s reflected in their costume choices. While Donyelle is typically covered, often in long pants and sleeves, Heidi’s look is as skin-baring as possible. She gets to wear the sequined skirts, midriff-baring tops, and form-fitting dresses that we’ve come to associate with dancing, skating, pageantry, femininity, and. . . being thin.

When the two performed a number together, wearing two-piece, pin-striped suits, Heidi’s top cut off about four inches above Donyelle’s. It’s interesting how a weight-discrepancy wouldn’t be so obvious amongst male contestants, where costumes aren’t typically as flashy and revealing as they are for the fairer sex.

Let’s be truthful, when it comes to bodies, Heidi’s closer to the American ideal (in more ways than one). Perhaps aided by her boxy shoulders and jutting hips, her lines are angular, and her dancing seems crisp. Notwithstanding technical ability, I wonder how weight and shape will influence our national vote and if it’s possible to evaluate dance without attention to size.

(The two-hour season finale airs tomorrow night.)

Stomach Bugs

This weekend, The New York Times Magazine featured an article entitled, “Fat Factors,” suggesting that a previously unconsidered factor may be to be blame for your weight—microogranisms.

The article’s author, Robin Marantz Henig, describes recent research indicating yet another biological theory of weight—we already have about 50 “guilty” obesity genes, some of which regulate appetite, satiety cues, and activity level. But now, scientists are exploring the possibility that intestinal microbes (e.g., bacteria, fungi, etc.) may play a role in how fat you come to be. And, lest you have any lingering doubts about an uncertain future, Jeffrey Gordon, the director of the Center for Genome Sciences at Washington University, informs us: “‘Microbes colonize our body surfaces from the moment of our birth. . . . They are with us throughout our lives, and at the moment of our death they consume us.’”

According to Henig’s article, microbes (microflora) accomplish a multitude of gastro-intestinal tasks, including the production of vitamins and enzymes, as well as the facilitation of digestion. Henig writes that they “help extract calories from the food we eat and help store those calories in fat cells for later use—which gives them, in effect a role in determining whether our diets will make us fat or thin.” Thus, my 450-calorie meal may be different than yours. It’s possible that I will extract and store 400 of these calories, you only 300, based on varying levels of intestinal microbes, thus complicating the classic calories-in-versus-out method of weight-loss or -maintenance. And, the formulaic 3,500-calorie reduction requisite for a one-pound weight-loss? Again, not so rigid when microbes are involved.

The Times article details animal studies, suggesting that bacterial microflora and/or exposure to certain viruses (“infectobesity”) lead to increased incidence of obesity. In other words, catching a virus can make you fat. Correlational studies in humans seem to support this notion—those with certain viral antibodies are more likely to be obese. Viruses may lead to increases in fat-cell counts and size or may toy with the brain’s satiety center.

While data are still preliminary, researchers are already toying with antibody tests (documenting exposure to one of the implicated viruses), and as you might imagine, antiviral-drug administration looms in the horizon. What I find most interesting about this report are its psychological and sociocultural correlates. Here, we have yet another biological theory of weight (the existence of obesity genes, preceding it) and yet, we still hold strong to the belief that obesity is a psychological condition, an individual failure of will-power, conviction, and self-regard, when in fact, there are plenty of “overweight” people who eat no more than their thinner counterparts. More and more, research is debunking that myth. Henig details an interesting example discussed by Rudolph Leibel, a Columbia University obesity researcher, “. . . if you take two nonobese people of the same weight, they will require different amounts of food depending on whether or not they were once obese. . . formerly fat people need to eat less than never-fat people to maintain the exact same weight.” The possibility of a microbial factor in the incidence of obesity lends weight to the notion that losing weight may be more of an uphill battle than previously thought.

And there seems to be good reason for this. Transport overweight people back in time, and they’re likely to fare better than those who are thin. As Henig notes, the “thrifty-genotype” hypothesis of weight suggests that historically, there was an evolutionary advantage to packing on the pounds. Now, technologically advanced beyond famine and draught, there’s no such need for biological stores, but let’s not underestimate the power of context—put obese people in another time and another place, and they’re royalty, exalted for their natural inclination toward getting fat and “keeping it on.” They survive, while the skinny perish, somehow unable (or not having the discipline) to eat enough.

Family Conflict

In an episode of Showtime’s series Weeds, Celia Hodes (Elizabeth Perkins) regularly weighs her daughter, Isabelle (played by 12-year-old Allie Grant), and as the scale tips, accuses Isabelle of sneaking food. The solution? Celia sneakily swaps part of Isabelle’s candy bar for a chocolate laxative, landing Isabelle in the elementary school bathroom and as the flatulent target of her peers. Isabelle’s father yells at Celia, “They called her, ‘Shit Girl!’”

“Well, better than ‘Fat Girl,” Celia replies. She continues, “It is cold and cruel out there for fat girls.”

Incidentally, the sour apple doesn’t far fall from the tree. Privy to her mother’s guile, Isabelle plants Immodium in Celia’s Trimspa bottle, rendering the bathroom-happy Celia as bloated, constipated, and enraged. As she makes camp on the toilet, reading, doing the crossword, filing her nails, chugging water, and even nodding off, Isabelle’s in bed, polishing off a chocolate bar. Her response to her mother’s frustrated screams: a smug, complacent, “Bitch.” Was Isabelle hungry? Maybe. Craving chocolate? Perhaps. But, it’s clear that rebellion trumps all else, that the chocolate bar is a prop in an ongoing family struggle that ultimately has no victor.

Honesty

(from postsecret)

Cravings

I don’t think there’s anything wrong with wanting to be thin, or thinner than you are. In fact, I’d say there might be something wrong if you were not affected by (or hadn’t internalized) the hordes of media messages we receive on a daily basis, suggesting that this be your ultimate goal. But, it’s interesting to me how body dissatisfaction so easily turns emotional and destructive.

Outside of your weight or shape, I’m sure there are things about your appearance that you don’t find ideal. Maybe your hair’s frizzy, or your complexion’s spotty. Maybe your feet are funny. As a personal example, I point to my fingernails. No matter what I do, they don’t grow. As soon as they’re about an eighth of an inch beyond my fingers, they snag/peel/break, and they’re off. Sure, there are some things I can do (nail hardeners, for example), but the bottom line is, oh, well, I’m never going to have long nails. And I’m ok with that.

Why can’t we be this way about our bodies? Desiring to be thinner, but resigned to how we are. We might be disappointed by a “problem” feature, and we may even try to fix it, but nothing, in my mind, packs the same emotional punch as not weighing what we should. Nothing has such a grip, such a soul-clamp, on who we are as the gap between our bodies and how we want them to be.

Pageant Culture

In the recent film, Little Miss Sunshine, 7-year-old, pint-sized, beauty-pageant contestant Olive Hoover is faced with a harrowing dilemma: with her family at a roadside diner, Olive orders waffles a la mode, only to draw criticism from her motivational-speaker father, to the tune of, “eating fat makes you fat.” Olive ponders the diminutive dish of chocolate ice cream before her, as her father persuades her to abstain (citing qualitative statistics—pageant contestants don’t eat ice cream!), and she dejectedly, but resolutely, resists.

Once at the Little Miss Sunshine pageant, Olive prepares for her swimsuit and talent competitions, decidedly unlike the other pre-pubescent participants. Her hair isn’t hot-iron curled, her body isn’t blasted with fake tanner, her make-up is subtle, and her mother is comparatively unobtrusive. But, prior to taking the stage, Olive, in one of the saddest scenes of the film, pauses in front of the mirror, and seems to catch her reflection for the first time. She self-consciously evaluates her childlike frame, and you can almost read her mind. It’s a moment that signifies hope shattered, innocence lost, all in pregnant gaze. She’s a bit pudgier than the other girls, and she’s probably grateful she didn’t indulge. Olive looks at her reflection with a disappointment that can only reflect the internalization of adult-like messages, and in a flash, she seamlessly morphs into a pageant contestant.

Role Model

Mara Reinstein is an entertainment writer for US Weekly, who last year, was diagnosed with enteritis, a “bacterial disease” that resulted in significant gastro-intestinal stress. Due to the disease, the normally thin Reinstein lost weight and was surprised by the reactions she received. In a recent issue of Glamour magazine, Reinstein asks, “‘Why was the outside world so thrilled with my ravaged body?’” It seems that friends and family celebrated her 11-pound weight loss, which resulted in her being significantly underweight, and which, incidentally, also resulted in her inability to hail a cab, keep color in face and ample fluid in her system, or sometimes, even, simply, to sit up.

What I find inspiring about Reinstein’s Glamour piece is her surprise about people’s reactions, as well as her commitment to re-gain her weight (and health). Reinstein writes: “‘It took a life-threatening illness to make me realize how much my peers value being ultra-thin. Now I understand why some celebrities succumb to the allure of jutting ribs in string bikinis: Their bizarre habits are rewarded with compliments from their handlers, friends, and fans.’”

Reinstein reports that she’s re-gained her weight, but has “‘never felt better about her body.’” While it may be hard for some women to identify with someone whose baseline is a Size 6, I’m happy that Reinstein wrote this piece and even happier that she can provide a different (read: healthier) perspective for the entertainment/celebrity industry. As a staff writer, maybe she can convince US Weekly editors to reduce the magazine’s features on ultra-thin women (do we really need another piece on Keira Knightley?), or maybe she’ll just hesitate to write such pieces herself. Baby steps. . .

OO

In Overcoming Overeating, Jane Hirschmann and Carol Munter presented one of the first guides for intuitive eating, namely eating when you’re hungry and stopping when you’re full. As they contend, a compulsive eater is not addicted to food, but to the diet-binge cycle. Their theory purports that overeating results from overly rigid (diet) standards, and that it is your (healthy) way of asserting yourself. Hirschmann and Munter write:

You the hopeless case feel out of control and despondent because you’ve bought the line that you’re a failure at the idealized task of body shaping. But you the rebel are a success. You break the rules and assert your right to eat what you want and look as you do. The compulsive eater is, in an interesting way, a rebel in constant protest against what has, by now, become her own imposition of cultural standards and judgments.

Their approach allows you to eat whatever you’re craving in a given moment and focuses on equalizing different kinds of food, so that you can arrive at a place where a carrot has the same value as a slice of carrot cake. Whenever you’re hungry, you’re encouraged to ask yourself what you’re craving: Something sweet? Salty? Crunchy? Mushy? Hot? Cold? And, you’re encouraged to eat exactly what you’re craving. Time and time again, Hirschmann and Munter (in their clinical work) have found that people may make some unhealthy choices early on, but eventually their bodies regulate and they begin to crave, at different times, foods across the spectrum.

Other aspects of Hirschmann and Munter’s approach include:
1) Carrying around a food bag, stocked with different types of food, in order to prevent those moments of excessive hunger that lead to overeating.
2) Cleaning out your closet to reflect your current weight—either giving away or hiding the clothing that no longer fits, since seeing it on a daily basis is a reminder that you’ve “failed.”
3) Stocking your home with an array of foods, including what they call “formerly forbidden foods.” The theory is that by exposing yourself to foods that you used to deny yourself, you’ll, over time, reduce their “glitter,” and, consequently, their grip on you. As for amounts? Hirschmann and Munter encourage you to have, on hand, three times the amount of food that you’re capable of eating in a binge. Ideally, it’s all in a single container (think stuffing three bags of Oreos into a large plastic container), so that you’re not able to get caught up in amounts (“I’ve now eaten an entire row”), but instead can focus on what your body wants. We tend to overeat when we know there’s a limited amount (possibly a relic of dieting, in which we’re stocking up before a self-imposed draught).
4) Thinking beyond meals—eating when you’re hungry and not around a preordained schedule. In practice, this results, typically, in more than three “eating experiences” per day.
5) Engaging in “mirror work,” in which you practice looking at your body, without judgment.
6) Working at distinguishing between “stomach hunger” (when you’re physiologically hungry) and “mouth hunger” (when you’re craving food out of boredom, anxiety, anger, loneliness, or any other motivation that doesn’t involve physiological hunger) and, over time, arriving at a place where you’re eating more frequently out of stomach hunger and able to identify mouth hunger and why you might be experiencing it.
7) Tossing the scale.

Various aspects of this approach (or the approach in its entirety) may seem ridiculously radical, particularly in a culture that preaches regular meals, precision, restriction, monitoring, and self-loathing. Certainly, it won’t work for everyone. But, I’ve found that it can be quite helpful for women who have historically cycled through the diet-binge chain, who would like to disempower the hold that food has on their lives, and who are interested in promoting a body image governed by self-acceptance.

Just Say No

My office refrigerator is broken. Notwithstanding the fact that New York City (the land of delivery) is one of the only places where a major kitchen appliance could be broken for months without major repercussions, I realized this week that, in fact, there is some eating-related fall-out when the refrigerator goes kaput.

Take my recent lunch experience. I ordered (delivery, of course) a slice of pizza and a side of sautéed spinach. The order arrives, and it’s enough spinach to feed a family, certainly much more than I’d like for lunch, and unfortunately, storing leftovers is not an option. As I’m spooning the spinach from the take-out container onto my plate, I pass the amount that I want and add some extra, thinking to myself, “I better have a little more, since I’m going to have to throw it out.” I catch myself and pause. What????

There are plenty of reasons for me to have more spinach, but, at the time, none of them has anything to do with me and what I want. I should eat more spinach so that there’s less to throw out? What’s that going to do? I eye the trash container on the kitchen floor and, quite mercifully, notice a number of differences between it and me.

It’s funny how the notions of “clean your plate,” “finish your meal,” “starving children in [third-world country],” subtly, but tenaciously, cling to our collective unconscious. How even someone who’s built her personal and professional lives around intuitive eating so easily falls into a trap like this.

I’m not happy that I had to throw the spinach out (in an ideal world, I would have given it to someone else), but I am happy that I tossed my amateur trash-can impersonation and recognized that just because someone gives me more than what I want, doesn’t mean I have to take it.

Neuticle Rant

Think cosmetic surgery is just for humans? Think again. More and more, veterinarians are approached by pet owners, looking to put their pooches under the knife. While it seems that most canine surgeries are performed for actual medical reasons, some, surprisingly, are not. Take the case of neuticles: testicular implants for male dogs, designed by Dr. Gregg Miller, a vet from Missouri.

In an issue of Animal Fair magazine, Dr. Miller explains that neuticles “are for ‘neuter-resistant pet owners’ who want their dogs to retain their masculinity and self-esteem.” Um. . . who, exactly, are we talking about here? The dogs? Can anyone point me in the direction of a female pet owner who insisted on installing a pair of neuticles in her pet?

Dr. Miller reports that the procedure has allowed for a reduction in the pet population (because neuter-reluctant pet owners are now willing to succumb to surgery). That’s fantastic, but is an artificially-stuffed sac really what it takes?

(And because my writing is about women and body image), is there any parallel between dogs undergoing surgery to please their (male) owners and women undergoing surgery to please their (or attract some) men? Neuticles are a hit because male pet owners use their dogs as narcissistic extensions of themselves. Sure, they may not be feeling as manly as the next guy, but their neuticle-sporting pets may help them negotiate the difference. Is it possible that a husband who encourages his wife to get breast implants, or a man who supports his already-thin partner’s decision to get liposuction, is doing just the same? Because a man with a (unnaturally) thin, large-breasted woman on his arm can advertise his masculinity (especially to other men) and compensate for a lack of self-esteem in much the same way as an extra pair of testicles for all the world to see.

Terri Schiavo

If I asked you to free-associate to the name, Terri Schiavo, you’d probably come up with something like the following: right-to-die, brain damage, family conflict, court order.

But, especially if you’re attuned to these matters, you may recall the eating-disorder speculation surrounding Schiavo's deterioration. The family battle central to Schiavo’s right-to-die case took center stage, shadowing what very possibly caused Schiavo to slip into a persistent vegetative state in the first place, an eating disorder. Reports indicate that the 5’3” Shiavo, who weighed 220 pounds at her heaviest, but who had lost 65 pounds, continued to struggle with her weight for years.

In 1990, Schiavo collapsed and her heart stopped beating temporarily. A malpractice suit against Schiavo’s doctor, brought on by her and her husband’s lawyer, Michael Fox, suggests that Schiavo collapsed as a result of an eating-disorder induced potassium imbalance. A 2003 article in The St. Petersburg Times written by Fox states: “One night, Terri purged, which caused her potassium level to drop low enough to cause a heart attack. Before fire rescue arrived and took her to the hospital, Terri's brain had been deprived of oxygen for long enough to produce catastrophic brain damage.”

In a 2005 Associated Press article appearing in USA Today, a reporter writes: “Medical records from the hospital where Schiavo was treated after her collapse note that ‘she apparently has been trying to keep her weight down with dieting by herself, drinking liquids most of the time during the day and drinking about 10-15 glasses of iced tea.’” The article also suggests that Schiavo had stopped menstruating, and that when Schiavo sought medical attention, her doctor was negligent in not inquiring about eating-disordered activity.

Of course, whether or not Schiavo suffered from an eating disorder is still debated. As other aspects of the case revealed, it seems to boil down to one person’s word against another’s. Unfortunately, even an autopsy report doesn’t provide definitive data on an eating disorder diagnosis. But, given the serious speculation, I think some interesting points arise. The USA Today article, published while Schiavo was still alive, notes: “It is a cruel twist lost on no one close to the case: A woman who is said to have struggled with an eating disorder is now in the middle of a court battle over whether her feeding tube should be removed so that she can starve to death.”

Moreover, if Schiavo did, in fact, suffer from an eating disorder, typified by concerns with body-image, self-presentation, and others’ judgment, it seems pretty clear to me that she would not have wanted the media attention she garnered during her final moments and even clearer that she would not have wanted to persist in a state that was largely unreflective of whom she hoped to be.

How Far Back Do You Have To Go?

I think it’s helpful to ask the question: How far back do you have to go to arrive at a time when you weren’t aware of your body? 12 years old? 10? 4? One woman I asked this question to once said, "I can’t even remember a time."

If you can recall a time, can you remember how it felt? To be naked, or in a swimsuit (or even clothed, for that matter), and to NOT be aware of your body. . . to have built a sandcastle on the beach and focused on the sand and the tide and not your body. . . to have run through the sprinklers and focused on zipping through the wet grass and your friends and the heat and the drench, but not your body. . . to have showered or bathed and focused on the scent of the soap or the sensation of the water striking your body, but not your body.

And, have there been any recent moments (even fleeting) when you recaptured this unawareness and reveled in the experience, without a thought of the size of your stomach or the width your hips or the dimples on your thighs? What variables contribute to your ability to ignore your body (or its appearance) in these moments? I’d guess it has something to do with being fully in the moment, absorbed by a connection, or a feeling, and that it’s impossible to be completely focused on this and your body at the exact same time.

Slink Away

Ever heard of a brand of jeans called “Slink”? A friend alerted me to them, after a frustrating clothes-shopping experience. It seems that Slink jeans run about three sizes too small. Said friend is pretty tiny and typically wears a Size 4/6. During this particular dressing-room encounter, she tried on a Size 10 which was, surprisingly, too tight.

What awful marketing, I thought, at first—clearly the Slink execs haven’t consulted with the marketing folk over at Banana Republic (who know that women love to buy clothes a size smaller than they usually are). But, perhaps this is strategic marketing at its best—to size out even normal-size (read: thinner than average) women ups the ante, placing the brand in a prized, elusive category only meant for a select few. I bet Nicole Richie can fit into Slink jeans. Keira Knightley, too. If only we can diet ourselves down, starve ourselves, purge ourselves of anything unnecessary, then, perhaps we, too, can fit into a pair of Slinks.

Cartoon of the Day

This appears in the current issue of The New Yorker, from a cartoonist named Weyant.

Thoughts? Captions?

What Constitutes a Binge. . . Disorder? (Part II)

In its proposed criteria set for Binge Eating Disorder (i.e., the disorder, not just the binge), the APA's Diagnostic and Statistical Manual (IV-TR), includes, in addition to the features of a binge (described earlier), the following points:

A. The binge-eating episodes are associated with three (or more) of the following:
1) eating much more rapidly than normal
2) eating until feeling uncomfortably full
3) eating large amounts of food when not feeling physically hungry
4) eating alone because of being embarrassed by how much one is eating
5) feeling disgusted with oneself, depressed, or very guilty after overeating

B. Marked distress regarding binge eating is present.

C. The binge eating occurs, on average, at least 2 days a week for 6 months.

D. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of Anorexia Nervosa or Bulimia Nervosa.

It's interesting to me how important the "marked distress" feature is. In fact, if you're not feeling this level of distress, but you're still bingeing (even regularly), you wouldn't meet criteria for BED. And, in my interpretation, this includes distress before/during/after a binge, as well as distress about the overall pattern.

In the July issue of O magazine, writer Anne Lamott describes her experience with a a "classic" binge. Having been largely binge-free for 15 years, Lamott recently succumbed first to the allure of a Safeway apple fritter, triggering a no holds barred journey to binge-land. In my opinion, it's not really about her food choices or how much she consumes. I think it's the emotional report that she nails: "I was so lost, and I couldn't follow the bread crumbs back to the path of mental health, because I'd eaten them all. So I ended up eating junk, off and on, until bedtime. . . . It is hard to remember that you are a cherished spiritual being when you're burping up apple fritters and Cheetos."

Interestingly, Lamott describes a critical feature of a binge (beyond quantity and control) that seems, in my mind, just as relevant to the diagnosis: the aftermath. This is an aftermath filled with guilt, shame, self-hatred and sentencing, promises, punishment, and enough of an emotional charge to knock you (as you might want to be) flat-out unconscious. It's an aftermath so uncomfortable that it can, often, only be soothed by more eating, an irony that fuels the cycle and continues the pain.

What Constitutes a Binge? (Part I)

According to the American Psychiatric Association’s Diagnostic and Statistical Manual (IV-TR), a binge is characterized by the following:
1) Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.
2) A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

Binges may occur in isolation (and without any correlated behaviors) or may be a feature of Bulimia Nervosa, Eating Disorder Not Otherwise Specified, or Binge Eating Disorder (not yet a clinical disorder, but likely will become one.) They may occur at lightning speed or be longer-lasting, may include eating one food, or many. And, clearly, even the clinical criteria are quite ambiguous: What exactly is an amount of food “larger than most people would eat”? Who are these “most people?” Are they of our same gender, size, culture, and eating-disorder status? What are “similar circumstances”? Moreover, can you always detect when you’re feeling a “lack of control” and is there even any way to quantify control? You’d think that as a science and a practice, we’d be able to do better than this. . . .

With such ambiguity (and diversity) in a clinical presentation, how do you really know if it’s a binge? Justice Stewart’s definition of pornography comes to mind (“You know it when you see it”), yet introspective awareness may be somewhat limited during a binge (though possibly enhanced after one). I think the control factor is a big one—if you feel like the eating behavior is controlling you (rather than you, it), then that could be a binge, but of course, the quantity consumed cannot be ignored (uncontrollably stuffing back a bag of airline peanuts, for example, can’t really be labeled a binge). Just because you’ve eaten more than you wanted, eaten past the point of fullness, or eaten when you weren’t even hungry doesn’t make it a binge.

I return to my old-standby, the continuum, when confronted with ambiguous topics like this. It seems it’s clear when it’s not a binge, and even pretty clear when it is a binge, but for all the shades of grey in between (particularly the darker greys, toward the binge-end of the continuum), I’d say this is a highly idiographic enterprise—I’d want to know from you as an individual—did it feel like you wanted/needed to binge? Did it feel like a binge during the binge? How about after? Because, especially when the science is so vague, the person is expert and the subjective experience quite diagnostic.

What makes it a binge for you?

BMI Tables

The Body Mass Index (BMI) is a simple measure, based on height and weight, commonly used to determine if someone is overweight. When policy makers and public health officials talk about the obesity crisis in America, they’re usually referring to BMI data, which, when considering the host of variables that should be taken into account when determining the health consequences of weight (i.e., muscle weight), emerge as overly simplistic. In The Diet Myth, writer Paul Campos offers a few examples of "fat" celebrities, according to BMI definitions (over 25 = overweight, over 30 = obese). Coming in as overweight are: Brad Pitt, Michael Jordan, and Mel Gibson. Obese celebrities include: Russell Crowe, George Clooney, and Sammy Sosa.

Campos goes on to say that current BMI definitions are not intended “to apply to people in ‘good shape.’” However, since one of the primary goals of public health initiatives (and the weight-loss industry) is exactly that, for people to be in “good shape,” then why wouldn’t current BMI criteria apply to them?

The Rape Scene

I recently learned that child actress, Dakota Fanning, has signed on to a role in the movie Hounddog. According to reports, the film takes place in the south and has Fanning’s character raped in one scene and appearing nude in others.

Any cinematographic rape scene is disturbing. But, a 12-year-old girl? Reports indicate that Fanning’s mother and agent are supportive of her casting, believing that this role could have Oscar potential. But, at what cost? Should Fanning have taken the role? True, women (even girls) are raped at alarming rates, and to deny this fact just because we’re at the movies might not seem that honest. And, true, any woman (or person, for that matter) can choose (especially with this knowledge) whether or not she’d like to see the film. But what about the people who choose to see the film because of this, who are excited and aroused witnessing the sexualized Fanning’s attack? And what about Fanning, who’s not just baring her body (a la a young Brooke Shields), but who’s vicariously victimized, who consciously knows that “we’re just playing,” but who may somehow still internalize the violence and disempowerment of the scene?

When we value a woman for her body (or, on the other hand, condemn her for it), we’re setting the stage for objectification. There’s a fine line between exposing a female body (as a commodity) and aggressing upon it, and the consequences are even more disturbing when the body is that of a little girl.

Triple Play

This past week, three of the most widely circulated celebrity magazines hit the newsstands, covers beckoning with variations on a theme:

In Touch: “Body Confessions”
US Weekly: “Extreme Diets: Inside Hollywood’s Dangerous Obsession with Being Thin”
Star: “The New Lipo: New Procedure Melts Fat & Tightens Skin in Minutes!—& It’s Affordable!”

I suppose this is more a question than an actual post: In your view, has coverage of eating and body image issues amongst celebrities skyrocketed as of late? I’ve noticed an incredible increase in the amount of attention (on television, in magazines, on the web) devoted to shrinking stars. However, I’m, as you might imagine, more attuned to these now, as part of my research and writing, so I’m willing to accept my hypervigilance as a possible confound. By asking you, I’m hoping to get some clarity—has such coverage increased, or am I just on the look-out?

Jail Time

Rapper Lil’ Kim (Kimberly Jones) recently completed a 10-month prison sentence, and as you may have noticed, the media seems most concerned with the 25 pounds (or so) she gained while in a Philadelphia jail. In Star magazine’s feature, “Not So Lil’ Kim,” Federal Bureau of Prisons’ Traci Billingsley describes generic prison meals, “‘Dinner might consist of baked chicken, a vegetable, a potato and dessert, like pie or cookies.’”

My reactions, in the order they occurred: 1) What a well balanced meal! 2) They get dessert? 3) Congratulations to Lil’ Kim for providing one of the media’s most intelligent decoys, yet. Her weight gain puts the focus on her body instead of her incarceration, leaving us little time to ponder her alleged guilt (something about perjury?), or other experiences that may have befallen her in jail. This is a woman who found her niche amongst a group of east-coast rappers [her battle cry, “Only female in my crew,” is heard in “It’s All About the Benjamins (Remix)]. This is a woman who, at the 1999 Video Music Awards, wore a sequined pasty get-up (and was consequently fondled by Diana Ross). This is a woman who understands precisely the power of the media’s focus on women’s bodies. And this is a woman whose additional 25 pounds seems to be the most compelling and noteworthy part of a two-year-long legal ordeal. That, as you may know, is called “working the system.”

Book Club

In writing her memoir, Fat Girl, Judith Moore makes clear her agenda: “I am not a fat activist. This is not about the need for acceptance of fat people, although I would prefer that thinner people not find me disgusting.” She goes on to say:

I know, from being thin and listening to thin people talk about fat people, that thin people often denigrate fat people. At best, they feel sorry for them. I know too that when a thin person looks at a fat person, the thin person considers the fat person less virtuous than he. The fat person lacks willpower, pride, this wretched attitude, “self-esteem,” and does not care about friends or family because if he or she did care about friends or family, he or she would not wander the earth looking like a repulsive sow, rhinoceros, hippo, elephant, general wide-mawed flesh-flopping flabby monster.

Despite the dichotomy created here (i.e., “fat person” vs. “thin person,”) Moore generally steers clear of politicizing the issue of weight. This is, more than anything, a personal story about one woman’s struggle with her emotions, her experiences, and her weight. But, Moore’s writing above provides a window into the socio-political context of fat: Why would thin people ascribe low willpower/self-esteem/pride to their heftier counterparts when, oftentimes, these are the very issues they’re struggling with themselves? It seems that projection is sometimes easier than introspection.

Moore continues:

I am on a diet. I am almost always on a diet. I am trying to get rid of pounds of my waddling self. I am always trying to get rid of pounds of myself. . . . I hate myself. I have almost always hated myself, but it’s not for bad things I’ve done. I do not hate myself for betrayals, for going behind the back of someone who trusted me. I hate myself because I am not beautiful. I hate myself because I am fat.

Yes, Moore happens to be fat, but it wasn’t until I read this quote a second time (out of the context of the story itself), that I realized it could apply to anyone at any size. It really doesn’t matter what Moore weighs. This could be the lament of the fat or the thin, the grossly overweight or frighteningly underweight (whatever those terms mean, exactly). It could also be written by someone with a beautiful figure, because as you know, just as it’s not about someone else’s body, it’s also really not about yours.

The Why of It All

Part of the purpose of this blog/book is to bring to light the personal struggles with food and weight that we all have in common. Psychologists use the word “normalize,” which Mirriam-Webster defines as: “to make conform to or reduce to a norm or standard.” To me, having something normalized is that phenomenon when you find out someone has had an experience similar to you, causing you to exclaim, “Oh, you do that, too?” The process of normalization is what makes support groups (and group therapy, for that matter) so effective. We realize that others are in a similar boat, and there’s a certain comfort in that. In a related way, writing (and speaking) about disordered eating/body image concerns illuminates just how common these struggles are, which hopefully provides a kind of individual solace. It also, in my opinion, weakens the grip of the issues themselves.

A metaphor I like is a storm out at sea—before hitting land, the storm has plenty of time to fester, to build up strength. But upon landfall, the storm’s power/speed/damaging potential weakens, to the point where by the time it reaches you, it may not be so harrowing at all. Through open and honest discussion, we enervate the storm.

I’d like to normalize food fixation, body hatred, and other concepts we’ve been discussing here. As individuals we may feel “crazy” or “dysfunctional” for holding such “odd” beliefs or engaging in such behaviors (as some have commented recently, who would have thought that such violent images of fat removal were so common?), but if we realize that we’re not alone, we may be more prone to discuss/work with our thoughts and feelings, which, ultimately can free us of our obsessions.

Mothers & Daughters

Do our mothers have carte blanche to comment on our bodies?

On a radio morning talk show, a male deejay reported that his mother had told him he looked fat. He reasoned that, of course, his mother was free to share her opinion, and that if she wasn’t truthful with him, who would be? Agree? Would a daughter feel the same way?

And, if that is acceptable, when does a mother cross the line? There are mothers who weigh their daughters, restrict their food, buy them diet pills, comment incessantly on their weight and shape. There are mothers, like writer Pam Houston’s, who, as she ran out to the school bus each morning would shout, “Hold your tummy in!” for all the children to hear. There are mothers who will purchase a new wardrobe for their daughters following a significant weight loss, even if accomplished via an eating disorder.

If a daughter has “a face only a mother could love,” why doesn’t the same unconditional acceptance hold true for her body?

Have You Seen This Commercial?

A Yoplait Light yogurt television ad features a swimsuit-clad woman shimmying around a boardwalk and the beach, hiding her body with an inflatable raft. When she finally lifts the raft, we see 2006’s version of the “Itsy Bitsy Teenie Weenie Yellow Polka Dot Bikini.”

But, don’t think the raft came off that easily.

At the same time, we’re introduced to the product, Yoplait Light yogurt. Our heroine would not have had the courage for this particular raft-ectomy had she not befriended the Yoplait product, marketed for its “weight-loss boost.” Fine-tuning a broader advertising campaign that focuses on the scale-savvy features of dairy, we’re exposed to the message that body acceptance will only occur if you're thin. And if you’re not, because you haven’t done your dairy, you better raft-wrap yourself again.

Problem Areas

A derivative of liposuction, called micro liposuction, is becoming increasingly popular, as revealed in an article in The New York Times.* According to the article, Dr. Luiz Toledo, a Brazilian plastic surgeon, who brought the procedure to the U.S., calls it “liposuction for skinny people.” What we’re talking about here are little “tune-ups,” aimed at people who are already quite thin or at specific areas of the body not classically targeting during liposuction.

And what areas are we talking about? The Times cites a recent edition of the journal, Dermatologic Surgery, which in an article entitled "Lexicon of Areas Amenable to Liposuction," identifies: “the ‘buffalo hump’ (upper back), ‘wings’ (bulges around the bra area), the ‘doughnut’ (around the belly button), the ‘banana fold’ (below the buttocks), the ‘piano legs’ (calves) and the ‘chubb.’” In case you’re wondering, like I was, “chubb” is defined for us by Dr. William Coleman III, one of the articles authors, as a “. . . Southern term for the kneecap area."

And who is a classic micro liposuction patient? Dr. Howard Sobel, interviewed by the Times discusses a typical micro liposuction patient: “'Some of them are perfect 10's who want to be 10½'s.'" Sobel, who reportedly has treated models and personal trainers, goes on to say: “'These patients' before pictures are what patients in the past wished their after pictures looked like.'"

The article continues: “One of Dr. Sobel's patients is Judy Goss, a former Ford model who works as a model agent. ‘By normal standards, I'm pretty skinny,’ said Ms. Goss, 38. She is 5-foot-10 and weighs 126 pounds, she said. ‘But my arms were getting a little flappy. I could feel it wiggle every time I shook hands.’ Two years ago, Dr. Sobel performed liposuction on her upper arms.”

Micro liposuction carries similar risks to standard liposuction, with side effects ranging from scarring or infection at the site to the low-probability, but still real, and lethal, chance of an adverse reaction to anesthesia. In addition to any physical consequences, though, is the psychological impact of this procedure both for the individual and for our evolving zeitgeist around (largely) women, bodies, and self-esteem.

You may have seen the show Dr. 90210 on E, a reality show which follows people seeking plastic surgery from consultation to after-shots. The show’s promo begs the question, “Can you fix the inside by fixing the outside?”

I’m asking the question, too. Of course, my immediate reaction is “no,” but I’m willing to entertain the alternative—could there be a very circumscribed “problem” that operates more or less in a vacuum and that once removed, improves your body image and allows you to feel better about yourself?

I’m reminded of a fictional exchange I came across from the book Switcheroo, penned by Olivia Goldsmith in 1998. In it, Goldsmith’s character Sylvie Schiffer consults with a plastic surgeon regarding a face lift, in an attempt to mimic the appearance of her husband’s young mistress. When her doctor asks her what’s wrong, Sylvie replies:

“Everything. Bob’s cheating on me. And I saw her. She looks just like me but younger. Just like me, but no crow’s feet. Just like me, but without the second chin.

“Age crept up on me, John. I wasn’t watching. I didn’t know I looked so bad—”

“Are you insane? You need a psychiatrist, not a plastic surgeon.”

Is Goldsmith (via the surgeon’s character) right?

With micro liposuction, where do we draw the line? Most of us have seen the popular talk show guests who’ve had repeated plastic surgeries and speak of procedures in much the same way that an addict would describe a fix. It seems that doing it once opens the door for doing it again. . . and again.

And more, if patients are seeking surgery to remove a barely visible “problem area,” should doctors have an ethical responsibility to say, “I’m sorry, it’s just not worth the risks.” I can’t understand risking your life for a little bit of chubb.

As the Times indicates, medical ethicists are starting to pose these questions, as well as to understand the implications of the procedure. Dr. Sheila Rothman, a professor of sociomedical sciences at Columbia says, “‘Maybe liposuction will become like a gym membership where you pay a doctor $10,000 for the year and you can have as much surgery as you want.’”
*sent in by a dear reader

A Word of Kindness

Leslie Goldman, author of Locker Room Diaries: The Naked Truth about Women, Body Image and Re-Imagining the “Perfect" Body encourages women to write a letter to their most detested body part, offering an apology for the disdain they’ve habitually directed toward it. It seems that the letter-writing process allows you recognize how aggressive you’ve been toward yourself (there’s something about it that allows said body part to feel more “human”) and to stir up some self-compassion, which is a critical part of restoring a healthy body-image and overall self-esteem. The process calls to mind a famous Jungian quote: "We cannot change anything until we accept it. Condemnation does not liberate, it oppresses.”

While it might be easy to identify which body part you’d address, is it clear to you what you would say? And, if you were to engage in this process, what types of feelings would you encounter?

As an example:

Dear Stomach/Butt/Outer Thighs/Upper Arms, Etc.:

I’m sorry for all the blame I’ve cast your way.

I’m sorry for even briefly, and wildly, entertaining the notion that I’d like to be rid of you. . . and, even more so, for imagining hacking you off with a circular saw.

I’m sorry that I look at you with such scorn, and that I’m not willing to accept you for who you are.

I have to admit that I sometimes think you’re cute—you’re dimply and cuddly, and, most important, I realize that if I can’t accept you, there’s really no way I can accept me.

Reverse Psychology

Many writers who address eating/weight concerns speak of “making peace with food.” I’ve always liked the premise, but I wasn’t quite sure what it would look like in practice, until I began to think about the distinction between the conscious versus unconscious mind. Many psychological theories propose that an important goal of therapy is to make what’s unconscious conscious—in other words, to bring feelings, experiences, memories of which you may be unaware into conscious awareness. I think that this goal holds with regard to eating concerns, particularly as we try to uncover reasons for disordered eating, such as emotional eating, restricting, and focusing obsessively on weight and shape—are we bored/lonely/angry/scared? What are we trying to avoid?

However, with regard to the process (and allowance) of eating itself, I wonder if the goal should be the exact opposite—to make the conscious unconscious—to return food/eating to the role of any other physiological process (sleep, breathing, urinating) and to NOT think about the whole experience so much. Imagine what it would feel like to NOT be thinking:

Have I had too much?
What else have I eaten today?
This has too many calories.
My stomach feels huge.

It seems to me that if you can arrive at a place where these thoughts and questions no longer occur to you, that is making peace with food. But, can we really accept eating as simply another physiological process? Imagine giving other biologically-driven processes the same airtime that we give food:

I really shouldn’t pee again—I went so much yesterday.
I know I’m tired, but I’m definitely not going to allow myself to sleep tonight.
Did I just take in too much oxygen? There was so much air in that last breath—my abdomen feels way too big!

Of course, these statements sound ridiculous, but substitute food/eating and you have an all-too-familiar way of thinking. As best we can, we sleep when we’re tired, go to the bathroom when we have to, breathe unconditionally—if only we could do the same with food.

Humor Me

I’m afraid I’ve lost my sense of humor. More and more, I see/hear jokes aimed at eating disorders (anorexia t-shirt). On an episode of Family Guy, a high school cheerleader says to another, “Wow, it sure is great being thin and popular. Let’s go throw-up.”

The New York Post reveals a report that the cast trailers for the filming of The Nanny Diaries (in Manhattan) are labeled according to the roles each star will play: “Glamour Mom,” “Charity Mom,” “Divorcing Mom,” “Eating Disorder Mom.” I’m not quite sure I see the parallel structure here.

In OK Weekly magazine, staff writers discuss a “beauty boo-boo” they call “blondorexia,” which is an “acute condition” that “happens when a young star aspires to the ‘more-is-more’ school of hair color.” True, some celebrities (and even we normal folk) might take hair coloring a bit too far. But, do we really have to equate this with a disease? (same goes for “tanorexia”)

On E’s 50 Most Shocking Celebrity Confessions, comedian Pat Dixon quips, “Bulimia isn’t a disease; it’s a decision.” On the same show, another commentator reports that Dennis Quaid, who after losing 40 pounds for the role of Doc Holliday in Wyatt Earp, developed “manorexia,” a term I’d describe as a cutesy bastardization of a serious illness (which, by the way, he admits to having). And, on 101 Incredible Celebrity Slimdowns, a comedienne says, “When I know I’m going to have to wear a bikini, I usually throw up everything I eat for about a week straight.”

This is supposed to be comedy.

A Word on Pro-Ana Websites

If you’re not familiar with the concept, pro-ana websites are those designed to provide support for sufferers of eating disorders. The sites describe anorexia (cleverly referred to as “Ana”) and bulimia (“Mia”) as “lifestyle choices,” not diseases, and do not encourage recovery from these conditions. An introduction to one site I found had this to say:

“This is a pro-ana website. Pro-ana is a source of support for those who are living with an eating disorder. Please leave if you are not living with anorexia or bulimia, or if you are trying to recover. Do not misuse the information on this site and let your eating disorder get out of hand. I will not be held responsible for your actions. This site is not intended to encourage people to develop eating disorders. The purpose of this website is to offer support to those who are living with an eating disorder.”

Support, though, seems to be an amorphous concept. Many of the sites offer encouragement for food restriction, glorifying starvation, as well as tips for easier purging and how to hide one’s disorder from others. Adulation is offered to those able to toe the fine line between life and death. A red string bracelet (similar to that modeled by the Kabbalah faithful, promulgated by celebrities) is worn to distinguish those who are pro-ana and pro-mia from the rest of the world.

Inspiration on the sites arrives in the form of pithy quotes, such as “Nothing tastes as good as thin feels” and via pictures of eating-disordered or grossly underweight celebrities, filed under “thinspiration.” One site warns its readers not to eat, urging, “You should be eating your own flesh all away from the inside first, before you are deserving of actual legitimate sustenance.” It also encourages e.d. sufferers to “Remember, think thin, and try not to faint too often or die.”

One site offers this tip: “If you have a sweet tooth use stevia instead of sugar. Try to stay away from stuff like Splenda. Remember, if it came from a science lab, it’s probably not healthy for your body. The best things for you are natural, and grown in a garden.” Upon first glance, this seems true and quite supportive of nutritional health. However, this also comes from a site that describes the first day of its weight-loss plan as “starve day.” Not so nutritional after all. . .

The psychological community (particularly that which serves eating-disorder populations) is, as you’d imagine, rather disturbed by the proliferation of these sites, though the question of what to do remains an issue. While the first amendment comes to play here, some web hosts, such as Yahoo (so I’ve heard), have disallowed pro-ana sites a home. Many sites are still available, however, and those who struggle with eating disorders (a persistent bunch, by definition) are easily able to find them.

I hesitate, in fact, to write at all about pro-ana sites, for fear that those unexposed will decide to visit them and find something that promotes disordered eating. However, this is a bona fide concern in the eating disorder community, and I think it’s important to expose, particularly given the appeal of these sites to young girls. Pro-ana sites anthropomorphize eating disorders, turning serious illnesses into friends (“Ana” and “Mia”) that sound more like friends you’d like to join for lunch than serious physical and psychological illnesses.

I’ve realized, though, that the sites are largely reflective of a culture that is, for the most part, pro-ana. Fashion and celebrity magazines celebrate food restriction and other unhealthy means of weight-loss (e.g., Mariah's Diet). A recent issue of Star magazine featured a story entitled, “Skinny S.O.S.! Stars’ Scary New Affliction—Foodophobia And It’s Contagious!”, but the very nature of the two-page, photo-plenty spread focusing on Kate Bosworth, Victoria Beckham, and Nicole Ritchie seemed to tacitly reinforce the unhealthy eating patterns/sizes of these stars. True, the fashion world/Hollywood does not (at least, vocally) promote subsisting on “your own flesh,” but there seems to be a very fine line between the daily messages we’re exposed to and those offered on pro-ana sites, causing me to begin to wonder if the only difference between a pro-ana website and a fashion/celebrity magazine is that the website is willing to admit what it is up to.

Jessica Weiner on the Today Show

A while back, I wrote about a book entitled, Do I Look Fat in This? written by Jessica Weiner. I saw her speak at a conference and found her to be v. warm, funny, and engaging. She has a history of an eating disorder and has made it her work to educate and inform about such struggles.

Anyway, here's a release from her press team about her upcoming appearance:

Watch Jessica do what she does best, on the Today Show with Matt Lauer
Thursday July 6, 2006 at appx. 8:09 am EST.

Please check your local listings for the appropriate NBC station and airtime in your city.

Here's a link to her site as well. (She happens to be the advice columnist for MK and Ashley's web site!)

If you're around tomorrow morning (or have a DVR), you may want to check her out. . . .

Drstaceyny's Movie Review: The Devil Wears Prada (in a Size 2, of Course)

I didn’t read the book, so the movie was my entry to the weight-obsessed consciousness of the fashion world portrayed here. It seems that one of the major plot lines involves Anne Hathaway’s (Andrea’s) weight. She is, at the story’s outset, a Size 6, which in industry terms is decidedly “fat,” as Meryl Streep’s character, Miranda Priestly, so ungraciously informs her. Early on, we learn the truth about models’ sizes—that a Size 2 is the new 4, and a 0, the new 2. Andrea’s size is equated with her matronly cabled sweaters, her sensible shoes, and her wide-eyed naïveté about clothing and the fashion world she encounters. Luckily for Andrea (and for audiences, who, by our very nature, pull for a happy ending), she encounters Dolce and Gabbana, becomes intimate with Chanel, and drops to a Size 4 before the credits roll. Phew. . .

Interestingly, the movie’s sub-text on weight doesn’t focus on Ms. Hathaway, but rather on Emily Blunt, who plays Ms. Priestly’s first assistant, Emily. In an interview with Liz Smith*, Ms. Blunt reported she had to drop weight in order to secure the roll. How much weight? During her interview with Ms. Smith, Ms. Blunt reported:

“I can eat now. . . You know, Prada was the only movie I’ve ever done where they wanted me to lose weight. I went in, and this woman asked, “How much do you weigh?’ And I told her and she made a face. And then she said, ‘You have to get in shape.’ And I said, ‘Well, really, I think I am in shape.’ She shook her head like, ‘poor thing.’ So I had to ask, ‘Look, just how thin do you want me?’ And she said, ‘On-the-edge-of-sickness thin.’ So, I figured, ‘Great, I’ll call you from the emergency room.’"

So, here’s a movie (whose audience, by the way, was filled with young girls) that glorifies sickly thinness and shuns a Size 6 as “fat.” In a country where the average woman wears a Size 14, what messages are we sending (and receiving)? Why are Andrea’s talents as an assistant (a job, for which, she’s overqualified) directly proportionate to her size? And, did Ms. Blunt actually drop the requested weight, and if so, did she endanger her health in order to play this part? At one point in the film, Emily's character cries, "I'm just one stomach flu from my goal weight!" Another fine example of art imitating life. . .

*sent in by a dear reader

More On American Idol and AOL News

AOL News begs the question, “Does American Idol Have a Body Bias?”

Uh. . . yeah.

Simon Cowell really didn’t have to ask the infamous question, “Do we have a bigger stage this year?” following Mandisa Hundley’s performance for us to know that. Yes, American Idol has a body bias, but it’s only reflecting that of the culture. To be a female American idol, you have to look the part.

Fashion director of In Style magazine, Hal Rubenstein, reveals, "Whether it’s acting or anywhere, people do tend to want to look at pretty people first. . . . It is about packaging, especially nowadays." He goes on to say: “Does Britney have a great voice? Does Jessica? Who cares? Look what they look like. And it’s an unfair world: I think it’s more so for women than for men."

As the article mentions, Reuben won Idol and Luther Vandross achieved fame, despite their weight. But those are men, and there’s a different playing field. The standards are different for us.

Still, Rubenstein argues, "In the long run, talent does win out. Luther Vandross always struggled with a weight problem. Yet women would go to his concerts and faint from happiness. If you’ve got a great voice, you’ve got a great voice, and we will listen to anything you do."

True? Do men “faint from happiness” when listening to the voice of a fat female singer? Uh. . . who, exactly, are we talking about? Janet Jackson gained weight, as did Mariah Carey (though certainly not fat), and it seemed that recent interest in their careers was piqued only after they had lost the weight (and there seems to be greater interest in how they dropped the pounds than in their voices or concert dates). Who are our Luther Vandross equivalents?

If you’re a woman, you don’t get to be a pop icon, unless you have the look. And so, with open arms, we welcome to the music world Hillary Duff, Lindsay Lohan, and Paris Hilton, whose recent single, “Stars are Blind” is currently climbing the charts. Stars may be blind, as Paris notes, but unfortunately, the public is not.