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Mary Dye_MPH RD CEDRD LDN_Director of Nutrition Services

Mary Dye, MPH, RD, CEDRD, LD/N oversees all nutrition across Oliver-Pyatt Centers as the Director of Nutrition Services. In this weeks blog, Mary offers her unique perspective on the relationships between dieting, disordered eating and eating disorders.

What are some signs you should be aware of that a strict diet is turning into an eating disorder?

Isolation & Secrecy:

If counting and measuring food, only eating in a certain way or at a certain time starts to take priority over relationships and social opportunities then we have a problem. Think of that friend who used to meet up for brunch. If she’s now suddenly not available or comes but “has already eaten” these could be warning signs. If you realize she doesn’t seem to eat with you anymore and is always full, these could be signs that her eating is so rigid it can only be done at home, likely alone.

Guilt & Obsession:

Strict diets and/or exercise regimens can require so much time, counting and focus they can feel like a part time job. When adhering to an exercise or meal plan replaces pleasurable activities and breaking the plan results in guilt, shame and anxiety, or requires compensatory behaviors there is a problem. It’s tricky because often in our culture we praise people’s devotion to dietary rules but it can be a fine line between an interest and an obsession.

Self-worth based on diet, exercise and/or weight:

Many people on diets like to talk about their diet, exercise and weight. When this becomes the basis of a person’s identity, it can be a sign of a larger issue.

Rapid weight loss & continued loss:

This may or may not occur. But if it does, consider it a warning sign. Losing over two pounds per week can resulting in negative health consequences. Often people start a diet with the goal of losing a few pounds, but once they get into the obsessive mindset and receive positive reinforcement for losing weight (which we do a lot in our culture) the diet can spiral into something more serious.

Pre-occupation with food:

If all your friend is talking about is food and living vicariously through your eating while she claims to be full: warning sign. She’s probably really hungry and is struggling to allow herself to eat the foods her body needs.

Use of food rituals:

These can vary but might include: taking tiny bites, not eating in public, breaking foods into little pieces, drinking loads of water before meals, eating only at exact times, using excessive calorie free condiments, etc. They usually have to do with extending the eating experience and filling up on low or no calories.

Compensation:

Statements like “I have to go for a run because I ate a brownie” can sound benign, but they can be a major red flag. If a person is having to compensate for their food with exercise, purging behaviors or forms of self punishment or if a person is reducing or altering their food intake and denying their hunger cues to compensate for missing a workout, these may be reasons to be concerned.

What is the difference between having an “eating disorder” and having “disordered eating?”?

There are specific criteria for the four diagnosed eating disorders in the Statistical Manual of Mental Disorders-V (DSM-V). While many people don’t meet the full criteria for a diagnosed eating disorder, many do have an unhealthy relationship with food and weight that may put them at risk both physically and emotionally. The difference has to do with the degree or frequency that a person is engaging in the disordered behaviors. A person with disordered eating would engage in the behaviors with less frequency or with a lower level of severity, yet are at risk of developing a full blown eating disorder in the future. Disordered eating is dangerous in itself, and many times goes undetected until it is a full blown eating disorder because the warning signs are less severe and the person is often highly functional in other areas of their life (this high functionality can be the case in eating disorders as well). Sadly, we live in a culture that promotes a degree of disordered eating, so many people feel uncomfortable addressing these warning signs and write them off as normal.

How has our focus on healthy eating (especially on Instagram and Facebook) contributing to eating disorders? Could they be eating disorders in disguise?

Social media certainly has intensified the pressure to “eat right” – whatever that happens to mean on a particular day. It can fuel the false idea that perfection is attainable. Since social media is accessible 24/7 – it can be visited when people are feeling most vulnerable and looking for a way to fix themselves by scrolling through photos and getting ideas on how to “self-improve”. As registered dietitian doing private food recalls for over 10 years, one thing I can say with certainty is that what people are actually eating and what they present themselves as eating, are often pretty different. I tell my clients all the time: comparisons get you no-where.

Strict regimens are fueled by reinforcement, and what better way to motivate than to get countless “likes” for a way of doing something. It can also intensify the guilt and shame that are experienced if the regimen is broken both for the person in the social media post (a sort of dual identity) and for the person viewing it (I’ll never be like her, I just ate dessert and don’t have time to go running). We also have loads of people giving nutrition and fitness advice on social media that don’t have backgrounds in these fields, so that can lead to a lot of confusion and misinformation.

I think the social media stars that have recently come forward and disclosed their eating disorders has been a wake-up call that some of what we see is an illness in disguise.

For more information about Oliver-Pyatt CentersClementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

Posted in Body Image, Recovery

GretaGreta Gleissner, LCSW is a NYC-based psychotherapist specializing in eating disorders. In recovery since 2001, Ms. Gleissner has firsthand knowledge of the challenges individuals face in the eating disorder recovery process, particularly during transitions. In her writing, she offers ways parents can help support their child with an eating disorder.

When a healthy child gets sick, parents can usually find a fairly simple answer: Tylenol, amoxicillin, cough medicine. But when your child is diagnosed with an eating disorder, parents face a problem for which there is no immediate fix. Caring for and supporting your child with an eating disorder can be confusing and scary.

Parents attempting to support their child with an eating disorder may struggle with a sense of helplessness and frustration when unable to quickly restore their child’s health. While responsible for your child, you are not fully in control. Ultimately, it is up to your child to choose recovery. As parents, your task is to create an environment of support and information for your child, so they can begin to take responsibility for their own well-being.

But what if your child is not ready to self-motivate, and their health is in critical condition?

Sometimes the priority must be stabilizing a child at a treatment facility or medical providers, to manage the dire physical repercussions of starvation or purging. But medical stabilization is only the first step in the healing process.

Once your child’s physical health has been addressed, a long road still lies ahead. Psychological and emotional healing does not necessarily happen in tandem with the physical restoration. Parents often feel an understandable impatience at this point, and an urge to accelerate and steer this stretch of the journey. But you must accept what they cannot do–i.e. “fix the problem”–while recognizing all the ways you can be supportive as their child undertakes one of the most challenging and scary tasks: letting go of their eating disorder.

One parent with adolescent recovering from an eating disorder took refuge in the serenity prayer: “Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

What You Can Do:

Get Informed: It is hard to have empathy about something that feels foreign, so familiarize yourself with eating disorders. Seek out information, get educated. Research the experts in the field. Find approaches that resonate with you. Then share this information with your child so they can understand the ramifications of the eating disorder. If they hear it enough, they may begin to understand, and decide to turn towards health.

Connect: Turn to your co-parent, or another family member or loved one, to discuss decisions and vent. The irritability, explosions, despair, and/or silence that your adolescent may exhibit when in the throws of their eating disorder can be baffling, heartbreaking, and infuriating for you as a parent. It is important to have someone to talk with about your feelings, as well as to feel a sense of partnership in making decisions.

Prioritize Self-Care: Remember the oxygen mask on an airplane technique: you can only effectively care for your child when your own needs are being met. Eat balanced meals. Get appropriate amounts of sleep and exercise. Engage in activities that feel nourishing and joyful for you. Model a healthy lifestyle for your child.

Practice Compassion: Offer yourself and your child compassion. Guilt, blame, and shame do not create the gentle conditions that best serve healing. Frame the unhealthy behaviors your child engages in not as “bad behavior” that warrants reprimand or punishment, but as symptoms of a disorder that reflect the pain they feel inside, and call for love and solace.

Cultivate Trust: Give your child every opportunity to trust you. Your child is likely experiencing tremendous shame about their eating disorder, which compels them to retreat into silence and not speak their truth. Let your child know they can tell you when they purge or are feeling fear about eating, and that you are trying to understand–even if you cannot ever fully understand. It is so important for a child to feel safe to describe aloud their fear and pain. Speaking truth takes the power away from the eating disorder, which thrives in secrecy and silence.

Believe in Recovery: It is imperative for parents to believe recovery is possible. While it is not going to be easy or linear–your child likely will make progress and then fall into unhealthy patterns again–that is just part of the long journey of recovery. Model for your child an unwavering faith that they have the courage and strength to attain health, and that stumbles are not signs of failure. Especially in times of setback, it is crucial to offer unconditional support and emphasize your belief that recovery is within reach.

Supporting your child with an eating disorder can be challenging. If you are struggling to help your child suffering with an eating disorder, please consider reaching out to us for help. We offer support for parents. We help care for your child – in college, still at home, even as young as 12 years old.

Resources:

Parent “Tool Kit” from the National Eating Disorder Association:

http://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf

Your Dieting Daughter: Antidotes Parents can Provide for Body Satisfaction, Excessive Dieting, and Disordered Eating by Carolyn Costin

8 Keys to Recovery from an Eating Disorder by Carolyn Costin and Gwen Schubert Grabb

For more information about Oliver-Pyatt CentersClementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

Lisa JimenezOliver-Pyatt Centers Primary Therapist Lisa Jimenez, MS works closely with clients suffering from eating disorders, specifically Binge Eating Disorder. She discusses our society buy in to the ideal “thinner is better”, and offers some strategies to embrace your body, no matter the size.

Everyone knows that feeling. You wake up, look in the mirror, and don’t like what you see. Bad body image, its the worst. For our women in larger bodies there seems to be an added layer. Not feeling our best, we turn to someone we love for some validation and get the dreaded response, “don’t worry, the weight will come off”. Hmm… that didn’t really help. What about my body now, right as it is in this very moment? Will people not like it? Will they think I’m too much?

We live in a society that idealizes the thin body. Those closest to us, the ones we care about most deeply, often buy into this misconception as well: thinner is better. We search for validation and acceptance in a body that’s beautiful and curvaceous, however one that others may not idealize and may not strive for.

As a larger bodied woman working with clients seeking treatment for Binge Eating Disorder (often larger bodied, however, not always the case) I’ve gathered tools both in my personal and professional life to help combat bad body image. In a society that idealizes thinness, some of these steps may be hard to believe, however, I can say confidently that they work. So why not? Be your own advocate. Give them a shot!

  1. Get inspired. There are many amazing, body positive women all over social media speaking up. Add them to your Instagram, Pinterest, and Twitter! Flood your feed with women of different body shapes, colors and sizes. Who wants to see the same image over and over? There’s beauty in diversity.

  2. Remember your unique worth. You’re a lot more than your body. Think about your values, your interests, all those people in your life that love you greatly. There’s so much to be excited about!

  3. Practice body gratitude. This one can be hard, but it is key to body acceptance. Do you remember that cool move you did in Zumba the other day? Yeah, that was your body doing its thing. How about those Latin genes seeping out of your curves? Personally, I like to reflect on how my body connects me with my ancestry. Wherever you’re from, your body is part of your history. How cool is that?

  4. Rock your style. I know it may be hard to find a wide variety of sizes in retail store, but there are some fun, stylish brands online. Order yourself something cute. Spend the money. Feel good in what you’re wearing! You deserve it. For now, rummage through your closet and thrown on an outfit you feel good in,

  5. Nourish yourself. On a day where body image is not at its best, make it a priority to properly nourish yourself, both physically and emotionally. Don’t skimp on the food. It’s the ultimate set up for mindless eating. And please, do something nice for yourself. Mani, anyone?

  6. Practice body neutrality. Okay fine, you may not love your body today, but you can still show it respect. Try a more neutral approach like “I may not love what I see but I can accept it. I am more than a body.”

  7. Gather the evidence. Will people really like me more if I lose weight? Will all my problems miraculously vanish? Is my weight truly the cause of my unhappiness? I think you get it. And if you struggle with this one (as many people do), you might need to move on to number 8.

  8. Stop the spiral. There’s a great cognitive behavioral therapy tool where you imagine a stop sign to help you stop ruminating thoughts. If you notice that your head is taking you down the rabbit hole, this is about the time where you whip out this tool. If this doesn’t work, go distract: read a book, watch a funny video, keep that brain of yours occuppied.

  9. Call a body positive friend. Hopefully you have at least one person in your life on board with body positivity. Take note of these women and call them up when you need a little extra TLC. If you don’t have a friend like this in your life, it’s time to go out and find one!

  10. Ask yourself this: when did hating my body ever result in anything positive? Never!

For more information about Oliver-Pyatt CentersClementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

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