Happy New Year, friends! While I planned on my first post of 2011 being lighthearted with some encouraging thoughts for the New Year (don't worry, those are coming soon), I felt like I needed to first address something that has been coming up the last few days in many conversations that I have had with friends and clients alike. French model Isabelle Caro died at age 28 after a long struggle with anorexia. She had been struggling with anorexia since her youth, the struggle spanning half of her short life. When she entered the world of modeling, she was already struggling with her eating disorder; however, the environmental pressures resulted in further triggering her into an extremely dangerous state which in 2005 ultimately led her into a coma. Doctors thought that she would not survive, but she came out of the coma, was discharged from the hospital and continued to model. She wanted people to see the devastating effects and impact that an eating disorder has on its sufferer, and as a result, she decided to pose nude for an Italian advertisement in 2007 in an attempt to de-glamorize the thin ideal. More recently, within the last few years, she had been on different television shows and news programs discussing her experience with anorexia. Her recent death is extremely upsetting- and this entire story has raised some really important questions for me.

First, in 2007, when Isabelle posed for this campaign, she reportedly said regarding her intentions and hopes for such a campaign.. "I've hidden myself and covered myself for too long. Now I want to show myself fearlessly, even though I know my body arouses repugnance. I want to recover because I love life and the riches of the universe. I want to show young people how dangerous this illness is. " I think what makes me so sad about this is that she wanted to recover, she wanted to live a full life, and yet she wasn't able to do it on her own. Anorexia is a mental illness, and it is extremely difficult for one to recover on her own. I guess I just wonder if her death could have been prevented. Why did the people around her continue to allow her to be the face of anorexia in the media, rather than helping her take the steps to health that she could not take on her own? I am not saying that her death is the fault of her acting coach, or booking agent, or doctor, or whomever, but when someone suffering from an eating disorder reaches a certain point (not just weight wise- but health wise), hospitalization/treatment is necessary for recovery. How is it that she was made famous by her eating disorder, and yet people stood by and let her continue in it? I'm angry that she was encouraged and supported to keep putting herself out there and it makes me wonder why the people closest to her did not stop her and lovingly get her the help that she needed. I know that the sufferer has to want to recover, and no one can force recovery, but it sounds like she did want to recover.. she just was not able to do it on her own, like so many others. I don't know if the people around Isabelle tried to get her into some kind of treatment, and I would have to imagine (or hope) that they tried at some point. But I think this whole story highlights both the nature of anorexia as a mental illness AND the importance of people receiving the appropriate care, treatment and help that they need-- and how sometimes that means that they NEED help from others in order to get there.

Secondly, the Italian fashion house that promoted Isabelle's 'no anorexia' campaign wanted to support Caro by using " the naked body to show everyone the reality of this illness, caused in most cases by the stereotypes imposed by the world of fashion. " I think that eating disorder education certainly needs to happen, and I respect the efforts of those involved to that end. What concerns me is that eating disorders are not caused by the fashion industry. Certainly the thin ideal, the unrealistic standard of beauty created by the media etc contributes, but if the fashion industry causes eating disorders, then why do we not all have them? It is because eating disorders are caused by many different factors, including significant genetic ones. 

I guess all of this got me thinking again about helpful ways to educate people about eating disorders. How do we effectively portray the severity and danger of an eating disorder while also not plastering photos around that can be more triggering and harmful than good for people to see? When someone suffering from an eating disorder sees a deathly looking skeletal body and may not look the same, she may be tempted to think that she is not really suffering or struggling as badly, or that her health is not being impacted. And in some ways, images further stereotype what an eating disorder 'looks like.' One in four college aged women suffers from eating disorders, but that does not mean that one in four college aged women are walking around looking like skeletons... or that their eating disorders are any less of a threat to their health because of what they look like. I think we need to be careful about how we communicate about eating disorders. I don't know that I have any good global solutions at this point, but I think it's important and necessary to ask the questions. 

In all of this, I am just sad that another life has been lost as a result of a devastating mental illness. I hope that her death is not in vain, and that she may serve as a reminder to all of us that anorexia (in addition to other eating disorders) is a real and dangerous illness that is capable of tragic outcomes when not treated.  

Helpful Hints for the Holidays...

I came across this creative acronym below ('happy holidays') on a site called 'Something Fishy'-- a resource for eating disorder information, as well as referral sources for treatment care providers. Anyways, Sharon Sward is the one who created this acronym, and it is a little tool that serves to remind us of some helpful things during a season in which food can be a central part of celebrations, and consequently can cause anxiety, discomfort, urges and triggering thoughts and feelings. Check it out below... 

Hunger means you eat when physically hungry instead of emotionally hungry.

Attitudes about your size have to do with the size of your heart instead of the size of your body.

People accept and value you for who you are, not according to how you look.

Problems are resolved in ways other than stuffing your feelings with food.

You spend as much time and energy on helping others as you do on how you look.

Happiness comes from within rather than from expectations of others.

Occasions for the holidays emphasize relating to others instead of emphasizing food.

Love of self means you deserve to treat yourself in the best humanly possible way.

Identity of self involves more than how you look.

Disapproval of self is changed to approval of who you are.

Acceptance of what one can not change includes your body features.

You treat yourself as you treat your best friend.

Society values you for being you without emphasis to your weight or size.

by: Sharon Sward, President of Eating Disorder Professionals of Colorado

Author of You Are More Than What You Weigh

Radio Talk Show Host on self-esteem, weight, and eating disorders

Jenifer Ringer: A Body Image Role Model for the Holidays

One of my favorite Christmas traditions growing up?? Going to see the Nutcracker Ballet. I was pretty involved in ballet until the 7th grade, so it made the ballet even that much more meaningful and special to me. I have to say it's been a few years since I've gone- I think the last time I went I saw a very 'interesting' production at the Raleigh Memorial Theatre that featured a more modern interpretation and ballet style. Because I have such positive and warm memories surrounding the Nutcracker, it was even more sad to hear about what happened recently- that something so festive and beautiful could turn into an opportunity for criticism and ignorance. 

For those of you who are unfamiliar with the story, there was a pretty big controversy recently over some comments that dance critic Alistair Macaulay from the NY Times wrote about Jenifer Ringer, the ballerina playing the role of the Sugar Plum Fairy in the New York City Ballet's production of the Nutcracker. His critical comments were focused on her weight, which is bad enough- but she has been open about her struggles with anorexia and disordered eating in the past, which seemed to make this critique even more upsetting, disappointing, and irresponsible. Ringer was interviewed on the Today Show by Ann Curry, and I was extremely moved by how strong, gracious, articulate and healthy she was in communicating about the whole thing! This clip below is the segment that was featured- it provides the backstory as to what actually happened, and also includes the interview with Ringer. In total it is about 7 minutes, and I would really encourage you to watch it. (I have watched it a few times!!) She does a fabulous job of articulating that being a dancer did not cause her eating disorder (she busted an ED myth!) and around the 6:40 mark she has some very encouraging words for us about our bodies. Check it out below.

Drunkorexia Revisited

I have noticed that there have been a few articles circulating recently on 'drunkorexia'... Around this time last year, I wrote a post on drunkorexia that I thought I would re-post it in light of the attention it has been getting in the news! A recent article was written in the LA Times just a few weeks ago (follow this link to read it!)--it's a good one!

Drunkorexia is one of the latest trends in eating disorders. Likeorthorexia, drunkorexia is not a medical or psychological diagnosis; you will not find this term in the Diagnostic and Statistical Manual of Mental Disorders. So what is drunkorexia? You might have a clue based on its name, but it is the combination of anorexic or bulimic eating disorder behaviors and alcoholic/binge drinking behaviors. The director of outpatient clinical services for the Renfrew Center, a nationally recognized eating disorder treatment facility, Dr. Douglas Bunnell explains: "Binge drinking is almost cool and hip, and losing weight and being thin is a cultural imperative for young women in America. Mixing both is not surprising, and it has reached a tipping point in terms of public awareness."

This kind of eating disorder is commonly seen in female college students, as participation in binge drinking continues to increase among this population. "Research shows that between 20 and 40 percent of women who suffer with bulimia also have a history of alcohol and/or drug problems. In one study, for example, 37.5 percent of bulimic individuals reported excessive alcohol use and 26.8 percent had a history of alcohol abuse or dependence" (Emax Health, Oct 2009). Another study was conducted in 2009 at the University of North Carolina at Chapel Hill and looked at the relationship between eating disorders and substance use in 13,000 women. What researchers found was that women who had an eating disorder were more likely to use substances than their counterparts without eating disorders. For more on this study, click hereto access this article on Emax Health.com.

It is important to highlight the connection between eating disorders and alcohol-- according to the National Association of Anorexia Nervosa and Associated Disorders, 72 percent of women who are addicted to alcohol are also engaging in eating disorders. This is a very high number. Considering the health dangers of both alcoholism/binge drinking and eating disorders, the combination is very threatening. Health professionals need to be aware of this condition, as treatment is so essential to avoid the potentially fatal consequences of such behaviors. It is also helpful for people to be informed about drunkorexia, as we all might have family members, loved ones or others that we know who are possibly dealing with it. For more information, follow this LINK to read an article published in the NY Times last year on drunkorexia.

Happy November!

It's a new month, and with a new month, comes some good news from a recent study... Results from a national survey (conducted by the National Eating Disorders Association) reveal that the general public's awareness about eating disorders has dramatically increased. Great news! According to the study, 82% of people would agree that an eating disorder is a physical OR mental illness. 78% of people believed that they would know if someone was suffering from an ED, and 95% said if they knew someone that was suffering from an ED, they would help the person seek the appropriate help.

That is definitely progress and encouraging news. : ) One area that the survey highlighted was the fact that overall, specific knowledge about eating disorders has not increased and that the incidence of eating disorders has not declined. Rather than being discouraged by this part of the survey's results, it just reminds me that there is still a need to continue to raise awareness and educate people about eating disorders. There has been a lot in the news this week about eating disorders... between Portia de Rossi sharing about her eating disorder (maybe too explicitly!) and Demi Lovato, who quit her tour to allegedly receive treatment for an eating disorder. An interesting comment that Lynn Grefe (NEDA President) made is that too often we focus on trying to de-stigmatize mental illness and eating disorders, which can sometimes reinforce the stigma. She went on to say that having an eating disorder is no different than having any other illness (breast cancer, etc) and that we need to spend more of our time focusing on educating people, especially in light of this recent data. Two thumbs up, Ms. Grefe.

To check out more of the data from this survey, keep checking back in:) The link is through MedScape Med News and technical difficulties are interfering with the link attaching. You can also google 'NEDA survey MedScape' to find it as well!