When Is It Time To Speak Up?

Nancy Matsumoto (a freelance journalist who has contributed to the New York Times, Newsweek, Time, etc..) and Marcia Herrin (a nutritionist specializing in eating disorders who founded the Dartmouth College Eating Disorders Prevention, Education and Treatment Program), have co-authored a great book called The Parent's Guide to Eating Disorders. They also have a blog called Eating Disorders and Nutritional News. To read a little more about Nancy and Marcia, follow this link! I wanted to share a recent blog post written by Nancy because I think it is a very authentic post that addresses a topic that people often ask and wonder about. The title of the post is 'Knowing When to Express Concern About a Friend's Eating Disorder.' Follow this link to read it, or you can read it below (copy and pasted).

In other fun news, I had the opportunity to ask both Nancy and Marcia some questions recently about some different eating disorder topics which I am excited to share with you soon! :) :) Follow this link to check out their website.

Knowing when to express concern about a friend's eating disorder

A recent experience reminded me that even when we know what the right thing to do is, it’s still hard to know when to do it. Over the course of the past year, I have become friends with a woman, I’ll call her Jane, in my Japanese language class. I recognized the telltale signs of anorexia in her right away: the hollow cheeks, the clothes hanging off her skeletal frame, the way she liked to bring food for others, but didn’t want to eat much herself.

Later, Jane told me that she did not see herself as too thin, she thought she looked normal, maybe even a little bit heavier than she wanted to be. This, too, is a classic symptom of the body dysmorphic disorder that often accompanies anorexia.

I wondered if I should say something, to express concern and find out if Jane was in treatment. Had I been just half as emaciated as Jane was, I would not have been able to think straight; I would have felt dizzy and probably fuzzy-headed from malnourishment. But Jane’s mind was razor sharp. She was an encyclopedia of kanjicharacters, devoured the finer points of grammar that made my eyes glaze over, and read the appendix of our dry text book for fun.

Although she was always the most prepared person in our class, Jane was also always late to class. I thought she had a job that she couldn’t leave early. Later, she told me that she had no job; the digestive problems caused by her anorexia meant that she simply had to wait until she felt well enough to leave her apartment. Often, she didn’t arrive until the last 20 or 30 minutes of our two-hour class.

Then Jane went away to Florida on vacation. It was sunny and warm there, but she returned with a wretched cold and looked thinner than ever. She looked terrible. “Feel my hands,” she told me and another classmate. Even though our classroom was overheated as usual, her hands were icy cold. Suddenly, she had entered crisis mode. Being in Florida surrounded by friends who were healthy, fit, and enjoyed active, outdoor lives had suddenly made her want those things for herself. She looked in the mirror and for a moment saw how different she looked, how starved and unhealthy the woman who stared back at her was. It was a moment of clarity that lasted long enough for Jane to realize she needed help.

For the first time, Jane also opened up to me and a few others in our class about her eating disorder. She was desperately seeking a treatment center, she told me. Even though all the doctors she spoke to felt she should be hospitalized, she hoped to stay at home and find outpatient treatment. I was scared for her life, and I could tell she was, too. I berated myself for not saying anything earlier. Maybe I could have prevented this sudden and horrible downturn. I knew what was happening to her and I didn’t say anything.

I thought that she would think me too pushy, or a know-it-all. I worried that I would be intruding. After Jane spoke openly about her worries, I was able to refer Jane to Marcia, who then recommended a good psychologist in New York for her to see. When I saw Jane at class yesterday, she told me she liked her therapist but was worried that she would not be able to afford many more treatments. She couldn’t afford to spend the $5,000 out-of-pocket minimum her insurance plan required before it would cover 50 percent of the therapist’s bills. Even paying for half of the treatments would be a stretch.

When I asked Jane today whether it would have offended her if I had spoken up, she told me, “I wouldn’t have reacted negatively, because I know what’s going on with me. I’m not sure that I would have done anything about it; you have to be ready.”

The kind of epiphany she had recently, when she recognized what she looked like and how sick she was, Jane told me, has happened before, although it never lasts. “I want to do something, and then I’ll go into hibernation again,” she said. Two weeks ago she had a phone interview with the Renfrew Center in Pennsylvania, but then decided not to go.

Jane said she wanted so much to be healthy and active but added, “I don’t know how to be active, to sleep and to squeeze food in. I can’t eat because it makes me feel bad, and I’m afraid I will get sick. I’m like a child; I want to be taught to eat again.” Then, she added, “I don’t know if I’m going to make it. If this can help someone else, please write about it.”

I asked Marcia if she thought I had done the wrong thing by waiting to voice my concerns to Jane. Marcia responded, “You have to trust your instincts on when to speak up, and it sounds like you did. I have reminded other concerned friends in similar situations that you can trust your instincts if your motives are pure. We all need to remember that we can't force another adult to take action (without taking legal action first). What Jane needs now is encouragement to hang in there long enough to benefit from treatment. Sometimes this is a good time to suggest or lend a book. Maybe Life Without Ed byJenni Schaefer or, Gaining: The Truth About Life After Eating Disorders, byAimee Liu. Good books can lead to good discussions, too. “

As a nutritionist who often sees eating disorders patients who cannot afford professional treatment and/or have difficulties with insurance issues, Marcia told me, “I have lots of thoughts about this.” The first is that Jane’s dilemma is typical of our insurance system, which slaps large deductibles on eating disorders treatment and follows with inadequate reimbursements. The patient goes without treatment and, in the worst cases, ends up hospitalized in an intensive care unit at upwards of $1,000 a day.

Marcia’s second thought was that it is often hard for patients make recovery their number one priority in life; everything else should be secondary. This is not easy in cases where the patient doesn’t have the complete support of loved ones, however.

Jane’s comment about feeling like a child who needs to learn how to eat again, Marcia noted, is a perfect description of what a good nutritionist can help an eating-disordered patient do, and why seeing a nutritionist or dietitian who specializes in eating disorders is so important.

“Another thing that can be inspiring,” Marcia said, “is to help the other person see that her life is important to others—children, spouses, families, friends, even pets, and to you!”

I will tell Jane that she is important to me, and to our class. I hope that if you are concerned about a loved who is in despair over an eating disorder, you will do the same thing.

Take care,

Nancy

Marcia Herrin and Nancy Matsumoto, co-authors, The Parent’s Guide to Eating Disorders, Gūrze Books, (www.childhoodeatingdisorders.com).

20 Ways to Love Your Body

I have been preparing for a presentation on eating disorders that I will be giving tomorrow at a local high school, so I have been scouring the NEDA website looking for cool ideas, stats and other things to make my presentation non-boring to high school students (who are probably going to think I'm old and boring anyways- JK!!). Anyways, while I was scanning some of NEDA's resources online, I came across a list of '20 Ways to Love Your Body' compiled by Margo Maine, PhD that I thought some of you might enjoy reading! I am just going to copy and paste it below (with my additions in italics:)), or, you can also follow this link and check it out on NEDA's site.

20 Ways to Love Your Body by Margo Maine

1. Think of your body as the vehicle to your dreams. Honor it. Respect it. Fuel it.

2. Create a list of all the things your body lets you do. Read it and add to it often.

3. Become aware of what your body can do each day. Remember it is the instrument of your life, not just an ornament.

4. Create a list of people you admire: people who have contributed to your life, your community, or the world. Consider whether their appearance was important to their success and accomplishments.

5. Walk with your head held high, supported by confidence in yourself as a person [who is made by God and created beautifully!].

6. Don't let your weight or shape keep you from activities that you enjoy.

7. Wear comfortable clothes that you like, that express your personal style, and that feel good to your body.

8. Count your blessings, not your blemishes.

9. Think about all the things you could accomplish with the time and energy you currently spend worrying about your body and appearance. Try one!

10. Be your body's friend and supporter, not its enemy.

11. Consider this: your skin replaces itself once a month, your stomach lining every five days, your liver ever six weeks, and your skeleton every three months. Your body is extraordinary--begin to respect and appreciate it.

12. Every morning when you wake up, thank your body for resting and rejuvenating itself so you can enjoy the day.

13. Every evening when you go to bed, tell your body how much you appreciate what it has allowed you to do throughout the day.

14. Find a method of exercise that you enjoy and do it regularly. Don't exercise to lose weight (or punish yourself because of what you have eaten) or to fight your body. Do it to make your body healthy and strong and because it makes you feel good. Exercise for the three F's: fun, fitness, and friendship.

15. Think back to a time when you felt good about your body. Tell yourself you can feel like that again, even in this body at this age.

16. Keep a list of 10 positive things about yourself (and look at it!)--without mentioning your appearance. Add to it!

17. Put a sign on each of your mirrors saying, "I'm beautiful inside and out."

18. Choose to find the beauty in the world and in yourself (because it is all around).

19. Start saying to yourself, "Life is too short to waste my time hating my body this way."

20. Eat when you are hungry. Rest when you are tired. Surround yourself with people that remind you of your inner strength and beauty.

Some of these may resonate with you more than others- I really appreciated number 4 and number 8. Gratitude is SO important; being thankful and having perspective can go a long way. Hopefully this list provides you with a few things to think about and some helpful pointers to start appreciating and loving your body! :)

Happy Independence Day!!

July 4th is one of my favorite holidays- I LOVE summer, fireworks, watermelon, and sunny days at the beach. I fully realize, however, that today is March 13 and we are not rapidly approaching July 4th at this point. Why do I even bring up July 4th?? Well, it is the day when we typically celebrate 'independence.' But I started thinking recently that while we celebrate independence collectively as a nation, it is not as common that we individually celebrate our personal independence from struggles or things that have held us back in the past-- or perhaps even from things that we are currently struggling with still that are holding us back. I'm not necessarily talking about making a big public declaration, or throwing a big party to celebrate your independence (if that is what you want to do though, go for it! haha). But personally acknowledging and having a fixed time set aside that exists to remind you and reflect on such a decision can provide great meaning and purpose. I have heard, as I'm sure many of you have, of people marking their days of sobriety- and that is surely a form of commemorating a momentous decision to turn from alcohol or another substance. While (like I said) I am not necessarily suggesting we release fireworks to mark our independence from something, I think that acknowledging the surrender that takes place with such a decision is important and worth remembering and reflecting on.

My intention in writing this post about independence, as weird as it might sound, is to encourage you to consider having an independence day for yourself. What exactly do I mean by this? Well, I think that we all go through things in our lives. I write a lot about body image and eating disorders, but there are certainly other struggles that exist out there as well that you may face!! Whether it is an eating disorder or body image issue, an unhealthy relationship that you find yourself struggling to get out of, an unhealthy habit that seems to control you, dependence on alcohol or an illicit substance, or something else, I think it is SO important to commemorate your decision to turn from whatever it is that is holding you back and is keeping you from being FREE so that you are able to use it as a means of pushing ahead. Of course, we don't all have a specific date or a specific time to commemorate moments like these and that is okay- because turning from an unhealthy behavior or a way of thinking can be a gradual process. The point is that having a specific date isn't necessary. What seems important (to me) is the heart behind this, which is that we are acknowledging a surrender of our will and are choosing to move forward from a certain point on. Surrender does not mean that we don't slip and sometimes fall back into old ways of thinking or acting- but surrender keeps us moving forward as we look ahead to a goal or a way of life that we strive to maintain.

Do you find that you stare at yourself in every reflection, mirror, store window, etc that you walk past, obsessively checking yourself out to make sure you look ok?? Do you feel like you need someone else (a friend, a boyfriend, a husband, a parent, your child, etc) to validate your worth?? Do you feel like you need to be a certain size or weight to be happy?? Do you feel that you need a certain food/drink/drug to feel alive or satisfied?? Are you constantly doubting yourself or being critical of yourself?? Any way of thinking or acting that keeps you from being free is a way of thinking or acting that is not only not helpful for you but serves to keep you in bondage. To start by simply acknowledging and becoming aware of such captivity is the first step. Making a decision to 'be free' is not as easy as it sounds, and requires diligence, faith and hard work!! For some of us, we need more support to experience freedom- whether that is with the help of a friend, a pastor, or a counselor, to walk through that process with.

I would encourage you to consider if anything (person, place, thing) is holding you back in your life and what may be keeping you from becoming the person you were created to be. There is no better way to live than in freedom!! Walter Conkrite said that "there is no such thing as a little freedom. Either you are all free, or you are not free." Sounds pretty obvious, right? Well, if that is the case... and if there is anything that is keeping you from being 'all free' than I would challenge you to take an action step forward- no matter how big or small.

**As an aside, I want to be clear that if you have an eating disorder, simply stating freedom from your ED does not usually make it go away-- and this is not what I am suggesting will happen if you declare a fight against your ED. An eating disorder is a mental illness, and as such, cannot just be wished away. However, your will in fighting your ED is soo important. Maybe your declaration of independence from your ED begins with pursuing professional help, or seeking the level of care that is appropriate and advised for you by a health professional. Or perhaps it means being committed to the recovery process. Whatever this action step may look like, I want to make sure that I am clear on this point! :)

Tanith Belbin: A Story of Hope

I recently wrote about eating disorders in the world of figure skating. (You can read that post by clicking here.) For those of you who did not see that post and don't feel like backtracking and reading it, I will give you the super quick summary. Jenny Kirk, a former competitive figure skater, did a two part interview with the Huffington Post that brought attention to the pervasive problem of eating disorders in figure skating. Kirk battled an eating disorder and is now in recovery, attending college and raising awareness about eating disorders. You can read more about her story by following the link above.

In her interview, Kirk said that based on her experience in the competitive, world class world of figure skating, nearly 85% of competitive figure skaters have eating disorders. That number is excruciatingly high. In spite of such discouraging statistics, the New York Times just wrote an article on ice dancer Tanith Belbin, an Olympic silver medalist (2006) who is currently competing in the Winter Olympics. Her story is a positive one that elicits hope and the possibility of change, and you don't always hear the uplifting side of some of these stories. For this reason, I want as many people to know about it as possible!

Belbin's story is one of disordered eating that put her at risk for losing her competitive edge on the ice due to her exceedingly thin stature. She was advised by her coach, Natalia Linichuk, to add some muscles and curves so that she would skate better. While the process was not always comfortable for her, Belbin learned to fuel her body and its needs in order to perform optimally at such an elite level. She is now at a healthier weight, and not only does she feel better physically, but her skating has benefitted immensely. Her ice dancing partner has even noticed that she is able to hold herself up better and has more strength. What I really love is that she states that she has become more adventurous and open to trying new things off the ice, like climbing. Belbin and her partner skate on Friday in the 2010 Olympics. To read more about her story, follow this link to read the NY Times article that was written on her this week.

Just as a quick aside, at the end of the article, Belbin says that the moral of the story is not that skaters need to necessarily seek out the professional help of nutritionists in order to eat right; she says instead that they should become educated about what is healthy and pursue this knowledge on their own. I think that for some, this can be effective; but for the majority, having a nutritionist is essential in becoming educated about portion sizes and what is appropriate and healthy. It is common for those with eating disorders to misjudge what they actually need, and not everyone can achieve health without additional support. If you know someone who needs support, don't be afraid to offer your help in finding what she/he needs!

Mixed Messages and Making Moves..

This morning, I read a really thought provoking blog entry on True/Slant (which is a blogazine--kind of like a magazine, but a blog... umm, i might have made up that word!!). The author, Katie Drummond, was discussing Katherine McPhee's recent bikini cover on Shape magazine. McPhee, who gained fame after appearing on American Idol, has publicly discussed her past struggles with bulimia, and her experience of being admitted to treatment for three months prior to going on the show in order to focus on getting healthy. Ms. Drummond takes aim at Shape Magazine for putting a recovered eating disorder patient clad in a bikini (and airbrushed!) on its cover, as well as at McPhee for posing in a bikini and perpetuating unrealistic images of beauty after struggling herself with feeling pressure as a result of viewing similar unrealistic images in the media. Ms. Drummond's article is entitled A Lesson in Health Hypocrisy and she explores the hypocrisy that exists in this scenario. Her blog entry is a little angsty, but I appreciate the passion with which she writes because I think that by posing in a bikini for a magazine which happens to advertise 'drop a pound by Friday' on its cover, McPhee- and Shape- are sending some pretty mixed messages.

I wonder if McPhee, or Shape, or the media in general realize the impact that they are having on women by sending such mixed messages. I am not pointing the finger at McPhee (well, maybe I am a little), but she says in the article that doing six different 'moves' changed her body. This sets an alarm off to me. It's not that exercising is wrong, or trying to be healthy or fit is wrong, but it concerns me that her happiness and acceptance of her body are a result of the changes she has made to her body. It just sends the wrong message to women about where our happiness comes from. Again, the point is not to bash McPhee. I just think it is important to raise awareness and discuss some of these things that we become numb to, because whether we know it or not, these images impact us! While there is not one single cause of eating disorders, and while seeing unrealistic images of women's bodies do not cause eating disorders, these images can be a precipitating factor, when combined with a genetic predisposition and certain environmental factors.

A month from now, NEDA (the National Eating Disorder Association) is sponsoring National Eating Disorders Awareness Week--- February 21-27. I will be posting more information as this week draws nearer, but I wanted to mention it in light of what I read this morning on True/Slant. Rather than just venting about the media and that magazine cover, or discussing how things could or should be different, it is helpful to think forwardly and focus on what we can do to make some changes! One simple thing that I have mentioned before is using GoodSearch! This is a search engine, just like google, that donates money to nonprofits of your choice before you perform each search. You can donate to eating disorder nonprofits, as well as a bunch of other great organizations. Follow this link to find out more. The second thing that I wanted to mention is something that I read on NEDA's website the other day. Marilyn Wann, author of Fat? So!, developed an art activity for people to participate in that deals with transforming the numbers on scales to adjectives! Confused? The Boulder Youth Body Alliance (BYBA), a nonprofit that seeks to encourage teens to change the world, rather than their bodies, has encouraged teens to participate in this activity by turning scales into art. I love this idea and think it must be really empowering for women of all ages to take part in something like this! Follow this link to view pictures/examples of scales as art, and to read more about what BYBA is doing!