The Joy Project

Help those suffering from eating disorders by voting for the Joy Project in Pepsi's Refresh Project! Pepsi has organized this project as an opportunity for people, businesses and non-profits to share ideas that will make a positive impact on communities. Anyone can submit an idea, as well as vote! And, there are only 2 days left to vote before they start a new month over and , so if you are interested, you may want to check it out soon!! The Joy Project is currently ranked #64 and needs some more votes (quickly) if they are going to receive some funding!!

The Joy Project is seeking 25k to fund a program called Roots of Recovery- the money is being used to rent a meeting space to conduct their meetings and activities, as well as fund the activities and meetings! They are not providing therapy or nutrition services, and are not licensed clinicians. However, they are interested in providing support, education and research- all things that are needed in the field of eating disorders! If you are interested in finding out more about the Joy Project (or voting), follow this link. To check our the Joy Project's website, follow this link.

Athletes and Eating Disorders- Part 2

If you missed part 1 of Athletes and Eating Disorders, you can scroll down a little to read it, or you can click here! I had the honor of interviewing Nancy Matsumoto (co-author of The Parent's Guide to Eating Disorders and a free-lance writer in NYC--follow this link for more on Nancy!), who is working on completing Toolkits for NEDA (National Eating Disorders Association) that are geared towards coaches and trainers. Both disordered eating and eating disorders impact many athletes, and one of the ways to promote health amongst athletes is to educate coaches and trainers, who are in unique positions of influence to point athletes towards the proper treatment and care of their bodies. Nancy, in my previous post, mentioned a phenomenon called the Female Athlete Triad, that I wanted to expand on (courtesy of NEDA).

Below is NEDA's description of this term/phenomenon:

The Female Athlete Triad includes 1) disordered eating, 2) loss of menstrual periods and 3) osteoporosis (loss of calcium resulting in weak bones). The lack of nutrition resulting from disordered eating can cause the loss of several or more consecutive periods. This in turn leads to calcium and bone loss, putting the athlete at greatly increased risk for stress fractures of the bones. Each of these conditions is a medical concern. Together they create serious health risks that may be life-threatening. While any female athlete can develop the triad, adolescent girls are most at risk because of the active biological changes and growth spurts, peer and social pressures, and rapidly changing life circumstances that go along with the teenage years. Males may develop similar syndromes.

The Female Athlete Triad puts female athletes at risk, and also inhibits their athletic performance. I am glad Nancy mentioned this because it is something that not many people know about (even in the field of eating disorders!). Below are the last few questions/answers of my interview with Nancy- I hope that you will find this informative (like I have)!

Me: What are some things that you have been struck by or learned about eating disorders and athletes through this process?

Nancy: One thing I’ve learned about athletics and eating disorders is that for the coach, the line between encouraging athletes to achieve peak performance levels and promoting unhealthy eating and training behaviors is blurred. For this reason, when coaches and trainers, are told they need to be more vigilant in spotting and addressing dangerous behaviors it can sound to them like their ability to do their jobs is being questioned and curtailed. They want to create winning athletes, and the traits that create champions—perfectionism, the desire to please coaches, and strong drive to succeed—are those often associated with eating disorders. They may fear that in order to encourage healthier behaviors among their athletes, they will have to discourage the very traits that make their athletes excel. What we hope the Toolkit will do is show that the better nourished and healthier the athlete is, the better her or his performance will be, and that although eating-disordered behaviors may seem to improve performance in the short run, in the long run they do not support athletic excellence.
Me: For many elite athletes who are competing at world class levels (whether collegiately, professionally, in the Olympics, etc), particularly in sports that may encourage (implicitly or explicitly) a high degree of scrutiny over body composition and weight for performance purposes (gymnastics, ice skating, running, wrestling, etc), eating disorders and disordered eating are increasing. Do you have any thoughts about how we might work towards helping athletes approach their performance and bodies from a more healthy standpoint?

Nancy: Yes, education and support for both athletes and coaches is very important. Some coaches are still not fully aware of the risks for and dangers of eating disorders among their athletes. We hope that once they do understand the facts, they will be open to discussing these risks with the team, stop making negative comments about weight or size, establish a zero tolerance policy for eating disordered behaviors, and foster a climate in which an athlete feels she or he can discuss these issues without fear of reprisal. For athletes, it’s great to have a sports nutritionist speak to the team about the importance of adequate fueling and hydration in their sport, to go over the warning signs for problem eating and exercise behaviors, and to encourage them to seek help at the earliest signs of a problem.

A lot of these strategies are about de-stigmatizing eating disorders, making athletes understand that disordered eating and eating disorders are a common problem among athletes, and that they can and should be discussed. Athletes should also know where there is help available, and that these problems can be solved with the right professional treatment. In many athletic settings, lack of knowledge about eating problems creates a climate of fear among eating-disordered athletes that makes it very difficult for them to admit to this problem. This causes a lot of suffering in silence. All the recovered athletes I spoke to talked about the tremendous stress of having to perform while also sustaining their disorder in secret.

When the Toolkits are completed and available, I will be sure to post a link so that any of you who may be interested in passing this information on to a coach you know, an athlete that you know, or if you are a coach/athlete yourself that desires this information, that you will be able to access it! By raising more awareness and promoting education for coaches and trainers, we can hopefully provide more care and restore health to those who are suffering from eating disorders and disordered eating. For more information on eating disorders, follow this link to access the National Eating Disorders Association site.

Busting an Eating Disorder Myth..

We've all heard the saying "Don't judge a book by it's cover." When it comes to weight and eating disorders, I don't know if we have really operated this way. What I mean by this is represented in a commonly held myth about eating disorders-- which is that you can usually tell when someone has an eating disorder because of their size. Yes, when someone is very underweight, that is typically an obvious indicator that someone is anorexic. However, someone who struggles with either bulimia or an eating disorder not otherwise specified (also known as EDNOS- the third and only other current eating disorder (aside from anorexia and bulimia) recognized in the Diagnostic and Statistical Manual of Mental Disorders) is typically of average weight or overweight. In fact, you might be surprised to learn that you can't tell by looking at someone if they struggle with bulimia or not.

A recent article published on Newsweek.com addressed this myth. The article, entitled Finding A Healthy Medium: Eating Disorders Don't Discriminate Based on Size, by Kate Dailey, is one worth reading. It is so important to be aware of the facts and to know that eating disorders affect people of all shapes and sizes. This article also addresses BED (binge eating disorder). Follow this link to read the article.

I read a great blog entry a few days ago on parents, adolescents and body image-- topics that have been on my mind a lot lately due to the nature of my work! For parents who are trying to navigate the rough waters of a child or teenager who is struggling with an eating disorder and poor body image, it can be daunting and difficult to know how to respond. For this reason, I often recommend a great book to parents called The Parent's Guide to Eating Disorders, written by Marcia Herrin and Nancy Matsumoto. I had a chance to ask Dr. Herrin a few questions which I will share with you below; she happened to also write the blog entry that I mentioned. Whether or not you are a parent, I think this information can be helpful because you likely have parents yourself, or parental figures in your life, or maybe you know young adults, children or teenagers that you work with, mentor, teach, volunteer with, etc.. While some of this info may not apply directly, some of it can be adapted to encourage healthy attitudes with food. To access the blog that Dr. Herrin writes with Nancy Matsumoto (who is doing some exciting work with athletes and eating disorders that I look forward to sharing with you soon), follow this link- the blog entry is copy and pasted below as well.

Watch Dieting and Bad-Body Talk in front of your Kids

In brand-new, not yet published research, my friend and colleague Dianne Neumark-Sztainer and colleagues at the University of Minnesota and the University of California, San Diego have found that messages from parents about weight and body image have a significant effect on adolescent body image. I have worked with a number of families in which a child, usually a daughter, is all of a sudden worried about her weight triggered by a parent who is dieting and/or talking a lot about how much she (or he--dads can have an affect here too) doesn’t like her body. I tell parents that if they are going to diet, DON”T TALK ABOUT IT!! in front of the kids. Dianne’s group also found that when parents when parents eat well, overweight teens tend to follow their example. Watch for this study: Family Weight Talk and Dieting: How Much Do They Matter for Body Dissatisfaction and Disordered Eating Behaviors in Adolescent Girls? in next issue of the Journal of Adolescent Health.

I think that it is important to point out that parents are not to blame for eating disorders!- however, there are ways that a parent can impact her child for the better and support the child in such a way that is effective! I had the awesome opportunity to ask Marcia Herrin, a nutritionist specializing in working with eating disorders and weight issues, a few questions, and wanted to share some of the helpful tips that she suggests for parents. Dr. Herrin is very respected in the eating disorder field- she founded the Dartmouth College Eating Disorders Prevention, Education and Treatment Program. She has a masters in public health as well as a doctorate in nutrition education. She currently runs a private practice and works with children and adults struggling with eating disorders and weight issues. For more information on Marcia, follow this link.

Me: You and Nancy have partnered together in your book The Parent's Guide to Eating Disorders. This book provides a lot of very helpful information for parents who may be worried about their children's eating attitudes and behaviors. If you could share two or three helpful tips for parents raising children, what might you say to them to help them to encourage healthy attitudes about food?

Marcia: Do not comment on your child's weight. Eat together as a family as often as possible. Do not talk about dieting or weight issues (yours or anyone else's) in front of your child. Do make sure lunch and dinner meals include protein and dessert.

Me: If you are a parent who suspects that your child is struggling with food, whether an eating disorder or disordered eating, what steps might you encourage them to take to help their child?

Marcia: First call your child's doctor or your area's most respected expert for their assessment of the situation. Then talk directly (calmly and kindly) to your child about your concerns and observations. Let them know that you are worried but not mad. In our book we say if you are "open, receptive, curious, honest, tentative, and work hard at understanding your child's point of view... no matter what words you use, your chances of success will be greater."

Me: Chapter 8 in your book is wonderful. It touches on body image and the ways that our own body image affects the body image of our children (and by extension those around us). Can you share a little bit about how a parent's negative or unhealthy view of their body or food can affect a child? Do you have any advice for parents who struggle with their body image or self-esteem?

Marcia: "Keep it to yourself" is the advice I give parents about their own struggles with body image or self-esteem. One of the riskiest situations is when a child observes one parent teasing the other about their weight or eating habits. Parents, even if they struggle to believe it themselves, need to preach "it is not what you look like that matters; it is who you are as a person and what you do."

Me: You write about PAMS (Parent-Assisted Meals and Snacks) and appear to have much success with this model, which has been adapted slightly from the Maudsley method. Can you share the heart behind this method and the success that you have seen with teenagers that you have worked with?

Marcia: One strength of PAMS comes from "saving face." When parents take over responsibility for the eating disordered child's food, the child has to eat even if she doesn't want to. She doesn't have to give up her eating disorder. She can relax knowing her parents aren't going to let her starve to death. She doesn't have to agree to eat, she is made to eat. PAMS helps parents know what and how much to feed their child. Some parents can figure this out on their own, but PAMS helps parents who are stressed and overwhelmed by their child's eating disorder hit the ground running with an approach to food that works. I have been in the field of eating disorders for nearly 25 years and I have never seen any other technique turn an eating disorder around as dramatically as PAMS does.

For more information on PAMS and other related topics, check out The Parent's Guide to Eating Disorders. If you are a parent who struggles with body image or food, the most important thing that you can do for your child is to work towards being healthy yourself! Whether that means seeking out a nutritionist, a therapist, or a consultation with your doctor, it is critical for you to be the very best you that you can be, for you and for your children! When Marcia says 'keep it to yourself' regarding your struggles, she means do not talk to your children about it. But it is okay and vital to talk about it with professionals, friends and family members if you are dealing with these feelings and behaviors.

The FREED Act

There used to be a character on Saturday Night Live named Stuart Smalley, who was the host of a fake self-help show (pictured above-haha). I never really watched it because I was young when it was on, but I have seen highlights of it on different SNL highlight shows. Anyways, the character in this sketch is obsessed with twelve-step programs, and is involved in a number of them. He isn't a trained therapist, just someone who is trying to overcome his own addictions and help others on this same journey. His famous line, as you can see from the picture above, is something that he would look in the mirror and repeat to himself as a positive affirmation: "I'm good enough, I'm smart enough and doggone it, people like me!" He had many catchphrases that poked fun at 'psychobabble' and self-help lingo. He even turned this sketch into a movie called Stuart Saves His Family--I had to watch it for a class once and write a paper on it :-).

Anyways, in an ironic twist of fate, Al Franken, who played the role of Stuart Smalley, is known also for his political work- he is currently a senator in the state of Minnesota and is advocating for eating disorders! Amy Klobuchar, also a Minnesotan senator, and Tom Harkin, a senator from Iowa, have teamed up to introduce a new bill which Franken is sponsoring. This bill is called the FREED Act (Federal Response to Eliminate Eating Disorders) and it's goal is to "allocate research money to the National Institutes of Health to better investigate the causes of eating disorders and improve treatment methods. The research would also seek to improve public data on eating disorders, including morbidity and mortality rates." This quote was taken from an article published in The Minnesota Daily and the article in its entirety can be read here. The gist though is summarized in a quote Franken gave to the paper- he said, "We don't know nearly enough about diagnosing, treating and preventing these diseases. [This] legislation is a major step forward in understanding eating disorders and how to stop them from destroying lives."

To put things into perspective, the NIH (National Institutes of Health) allows $1.20 towards research per person with an eating disorder, contrasted with $159 towards research per person with someone who has schizophrenia (whose prevalence is significantly less). That is pretty staggering!! Last week was lobby day for the Eating Disorders Coalition, and this was an exciting day for eating disorder advocacy! I have no political agenda that I push when I write my blog- however, I think it is important for us to know the facts and to be educated, and to be able to act if we feel moved to do so! To read more on this act and what it aims to do, follow this link. If you are interested in finding out how YOU can advocate for increased eating disorder funding for research, prevention and treatment, follow this link to write to your Congressperson!