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Posts from the ‘Emotional Wellness’ Category

Body Shaming Does Not Help People Live Healthier Lives. Period.

shutterstock_256857343Recently a viral You Tube video by an uncreative comedian brought some internet attention onto the concept of fat shaming. I won’t give the person’s name or details of the video, I’m sure most of you have an idea of the video I’m speaking about and I don’t want to encourage any more clicks to her website or contribute to any attention she is getting in the aftermath of this video. There is plenty to say about the myths about tough love and fat shaming without this poorly done video being attached to it.

There is a line of thought in mainstream culture that suggests that being “tough” on people who are overweight will lead to positive changes in their lifestyle (aka weight loss). Somehow society has taken on the responsibility of being truth-bomb-droppers for overweight and obese people, criticizing their body size under the guise of “helping”. This is exasperating to me on many levels and brings up a lot of discussion points (I could go on all day, but I’ll spare everyone the excess ranting and stick to my Top Three);

1) The idea that criticizing another person for their weight is somehow going to inspire them to lose weight is inaccurate and misguided. In the book “Health at Every Size”, Linda Bacon summarizes numerous research studies that show that people who are criticized for their weight tend to gain MORE weight and at a high risk for becoming obese. I’m not sure how the message got out there that people who are overweight are somehow unaware of their size and need this to be pointed out by another person. Who needs a “truth bomb” from a stranger on the internet when you are the one living in your body every day? If it doesn’t result in any positive lifestyle changes, then the point of this criticism is more beneficial to the person criticizing than the person receiving the so-called truth bomb. People who intend for this to be helpful call it “tough love”, but it is just plain old body shaming. The recipient tends to internalize all of the “tough” and none of the “love”.

2) In my professional experience as a therapist who specializes in the treatment of eating disorders, the presence of body shaming is a response to the collective fear we have of body acceptance. The idea that we can accept our bodies (Yes, even if we are not at our lowest, ideal weight. Stay with me.) is a tough pill for most people to swallow. Acceptance is not the same as giving up. Acceptance actually leads to more positive changes and is a powerful motivator. It is the thing that leads us to exercise for the good feeling it gives us, not as a punishment for “bad” eating. It leads to us choosing foods that make our bodies feel healthy and energized. There is a lot of fear that if a person fully accepts themselves, than they will become lazy and out of control. You know what sends people into a state of feeling and acting out of control? Anxiety. Shame. Trauma. All of these triggers are products of internalized criticism, not self-acceptance.

3) How do we know that weight loss is the secret to good health for others? How can we tell, just by looking at a person, that their weight is unhealthy? Only a doctor can make that conclusion about an individual. There is medical research (again, please consult the book, “Health at Every Size”) that states that people whose BMI lands in the “overweight” range actually live longer than people whose weight land in the “normal” range. Our bodies are designed to store fat as a survival mechanism, we don’t need to demonize this basic biological function, we need a more in-depth understanding of it. More medical information has been surfacing that shows that it’s healthy habits, not body size, that determines better health outcomes and longer lifespans. I encourage anyone interested in learning more to check out the the TED talk given by Sandra Aamodt, MD. There is a wealth of solid science out there that challenges this black and white idea that weight is a primary indicator of health. It is one fraction of a much more complex picture. We need to stop treating others like we have all the answers for them, just based on their body size.

I hope the conversation about fat shaming can move beyond the arena of who is offended, who is too sensitive, and who should or shouldn’t have opinions about being overweight. These are all part of the same smokescreen hiding the real issue; fat shaming is real, it is damaging and it isn’t inspiring anyone to make positive changes. Let’s do more to help people feel like they can trust themselves and make their own intuitive judgment calls about their health choices without being criticized. Let’s. Do. More.

What is Orthorexia? Is there really something wrong with “healthy eating”?

shutterstock_272048915There has been a lot of talk around the term “Orthorexia Nervosa”. It is defined by Steven Bratman, MD, as, “an unhealthy obsession with eating healthy food”. While this disorder is not officially part of the DSM-V as an official Eating Disorder, it still produces a great deal of pain for those who suffer from it and is worth the attention of the mental health community.

As a therapist who specializes in the treatment of Eating Disorders, this condition is not new to me. I have been seeing it for years, it only now has a name attached to it. I believe it is vital for our culture to start looking more critically at what it means to be “healthy”. Many people develop some kind of disordered eating habits or full-fledged eating disorders with the intention of being “healthy”. Somewhere along the way, things take a turn and these good intentions become harmful behaviors, but the intention is almost always coming from a place of wanting to be healthier or improve oneself. I want to look at Orthorexia through this compassionate lens.

The key to understanding what makes this a disorder different from “healthy eating” is a person’s rigidity of thinking and the level of distress that one experiences when deviations from that diet are made. Making solid efforts to eat healthy food is not what makes Orthorexia a disorder. One person could eat the exact same organic kale salad and it isn’t necessarily the food choice itself but the thoughts and anxiety behind it that make it a disorder. If a person is not able to be flexible with food choices, a serious red flag goes up for me in thinking that this person is at high risk for some kind of Eating Disorder. We deal with many unexpected events in the course of our lives, from life-changing, traumatic disruptions to smaller but still significant disruptions in our everyday routine. Allowing our brains to accept this uncertainty and be able to adapt to new circumstances is a huge part of being an emotionally healthy person. For a person with Orthorexia, deviations from his/her routine that are food related are met with intense guilt, anxiety, and self-criticism. Being at a party and being “forced” to eat outside of his/her comfort zone is not something that is acceptable to a person with Orthorexia. The focus of everyday life is about maintaining the “purity” of his/her diet and removes the person from fully being present. Planning meals for the day begins to take up more and more time. A person starts saying no to social engagements or travel because they are unsure of the food that will be available. When a person must deviate from the food plan, the level of anxiety that it triggers is painful. This is much more than a simple, “Oh wow, I think I overate at that party, I’ll just balance things out tomorrow”. The thoughts are more focused on personal weakness or “what damage has been done”.  Weight loss is not the main goal for the person with Orthorexia, the focus is on food purity.

What makes this such a difficult issue to address is the good intentions of the person suffering from the disorder and how difficult it is for others to understand why this is a problem. Maybe the person is focused on eliminating carcinogens to avoid cancer, or eliminate chemicals from their diets. These goals start off well, but the time involved to succeed at them becomes more than a person can realistically commit to. It also becomes tied to a person’s self-esteem. Food is important and it can bring up a lot of emotions for us, but it is not tied to our self-worth. A person with Orthorexia often judges him/herself based on their food choices. That organic kale salad goes from being a simple lunch choice becoming a source of personal validation. When the person “falls off the wagon”, the shame is so intense that it furthers a tendency to isolate and become disengaged with life outside of the world of Food. It can also have physical consequences, including nutritional deficiencies and illness.

When I read articles on Orthorexia on social media sites, I am often struck with the backlash that I read from people who are outraged that “healthy eating is now a disorder”. I hope we can expand our dialogue here. This is an opportunity to have an honest look at what “good health” means. I hope that we can acknowledge that we are allowed to choose how we spend our time. We are allowed to spend time fostering relationships, working on our careers and finding joy in our lives.  The purity of our food choices does not have to take priority over all of these other things. We are allowed to listen to our bodies and make intuitive food choices based on our healthy hunger cues. We are not “weak” or “bad” when we don’t execute these diets perfectly. There is a big difference between “eating perfectly” and having a balanced life that is focused on flourishing. I hope we can continue to strive for this and support others who are struggling to do so through their eating disorders.

For more information on Orthorexia, please visit:

National Eating Disorder Association: https://www.nationaleatingdisorders.org/orthorexia-nervosa

Steven Bratman, MD, MPH (the person who coined the term “Orthorexia”): http://www.orthorexia.com

Do We Need to Stop Fighting Against Emotional Eating?

By Erika Hirsch, MA, MFT, ATR

October 29, 2013

 

When people talk about changing their relationship to food or losing weight, I often hear the complaint, “I wish I wasn’t such an emotional eater”. If you look around on the Internet for articles or websites on emotional eating, even people that want to help negatively reinforce this. Oprah’s website lists the “Cure for Emotional Eating”. Other websites claim to show you “How to Gain Control of Emotional Eating” or “How to Overcome Emotional Eating” and of course, the ultimate, “The Trick to Staying Slim if You’re an Emotional Eater”. It has become very common in our culture to see emotional eating as an enemy, a disease, and a powerful force beyond our control that we need to trick in order to overcome. The images that come up in a Google search for emotional eating are an even bigger reinforcement of this; tortured looking women with messy hair and smeared chocolate all over their faces, hunched over piles of candy or cake frosting. Emotional eating has become an enemy that takes away all of our self control and leaves us powerless.

What if we approached emotional eating not as an enemy, but as a helpful source of information? Biologically, our brains are hard wired to make eating as rewarding as possible. The part of our brain that is focused on survival is also looking for information regarding potential food supply scarcities. If your cortisol levels go up because you are experiencing stress, your brain will probably think to itself, “Well, it looks like there is a chance that we need extra energy to deal with this, especially because whatever is going on might involve famine and we should just make sure we get enough to eat so we can survive it”. This part of the brain hasn’t received the memo that there is a grocery store or restaurant on every corner; it hasn’t fully caught up with our modern lives. When it comes to survival, the human brain doesn’t like to take any chances, it feels stress and it will link it to survival in some way. Instead of recognizing that biological function that we all have, we reject it and pretend that somehow there is a way for us to be Zen-like robots that just eat for fuel and don’t have any temptation to eat “unhealthy” foods that give us enjoyment. Somehow the love we have for kale should overthrow any love we might have had for cupcakes or cheese, and if that doesn’t happen then we have failed. We are weak for finding enjoyment in food. Does this seem unrealistic to anyone else? Why are we fighting so hard against our own brains? Certain foods give us a spike in serotonin, which makes us feel better when we are stressed out. This is not a crime; it is not a character flaw. We should understand it and be informed about it, but it is counterproductive to see it as a sign of failure.

Instead of condemning emotional eating immediately after we identify it, I believe that we need to observe it happening without judgment, and then ask ourselves a series of more in-depth and compassionate questions before we determine if the situation is a problem or not:

-Is my body legitimately deprived of something? Food, sleep, or something else? Many times we turn to food when we really are looking for a soothing routine at the end of a long day. This is not a reason to feel guilty, but it is informing us that we need extra support or comfort to deal with our everyday stress.

-The food I’m craving will make me feel better for a little while, but then what? What am I looking for in the long term? We often turn to food multiple times to chase that serotonin spike that comes when you first start eating that desired food. When we only use food to help ourselves emotionally, it never feels like enough. That is not because we are weak; it is because it is true. Food will never be enough to help us feel better, we need to look to more direct ways to deal with our feelings that will sustain us longer than food can.

-Do I need to get outside of my head? Is something causing me stress that I need to deal with? Maybe talk to a friend and vent it out? Keeping stressful thoughts locked up in our own heads often is not enough. Writing or talking out a problem utilizes different parts of our brain, making it more efficient in working through the problem.

-What else, besides eating, could help me feel better? Instead of focusing on the guilt associated with eating when stressed, move on and focus on what could be done next. Often our guilty feelings keep us focused on the “damage” done by the foods that we have indulged in and we then ignore the original emotions that still need care and attention.

-Do I need a break but am denying myself for some reason? Often food is what we turn to when we need a break but feel that it is more important to power through whatever is going on at the moment.  Even a short amount of time that is dedicated to taking a real break (not checking your phone, email, or watching TV) can be very helpful.

If we immediately tell ourselves that food is a “bad choice” in dealing with our feelings, then we start a cycle of negative thoughts about ourselves. We judge ourselves, feel guilty, and feel like food is now off limits and we can’t have it. This usually leads to some kind of emotional rebellion where we decide we will have the food anyway, and not just that, but keep eating more because damn it, we want to and nobody can tell us not to! Following the rebellion comes the guilt aftermath. We are rebelling against ourselves, and it isn’t helping. If we look at food as just one of many ways of coping, without intense negative judgment, then we can accept it and move on from it. It is much more productive to look at emotional eating for what it is, a temporary way to boost our mood. Sometimes it has a purpose; sometimes it is just a distraction from something bigger. If we can accept that, then asking ourselves what else could be done to help us feel better doesn’t have to feel like we are depriving ourselves. That mindset will decrease the urgency that the food craving has, and we are now able to look more directly at what we are really feeling in that moment and what can be done about it. The goal is to look at what we need, address it directly, and give us positive feedback for doing so. Only then can we start to create a more positive relationship with our emotions and with food.

Intuitive Eating and Creating Healthy Relationships with Food

March 14th is Registered Dietitian’s Day, and I wanted to support all the RD’s out there who are challenging harmful food myths and working to be true advocates for good health.   “Good health” is not defined by a number on the scale, or a clothing size, or on how well you can stay away from “bad” foods, or how many days a week you can get to the gym.   What is healthy for me may not be the same for you, we have to look at the biology of our own body and how to respect our bodies enough in order to give them the fuel that they need.  It is so common in our culture to be in a cycle of dieting, focusing on how our bodies look, and not what they can DO, and when there is a focus on what our bodies can do, it is often competitive.   That easily leads to feelings of guilt or self-judgment… and the cycle continues.

This is the work that RD’s do, they look at what your body needs and help you build a positive relationship with food.  I find that people who combine talk therapy (with an MFT, LCSW, clinical psychologist or psychiatrist) and nutritional counseling with an RD are able to create long lasting positive changes in their physical and emotional health.  If you are looking for an RD, I recommend a person who works with the Intuitive Eating Philosophy, created by Evelyn Tribole and Elyse Resch.  Intuitive Eating is described by Evelyn and Elyse in this way: “Intuitive eating is an approach that teaches you how to create a healthy relationship with your food, mind, and body–where you ultimately become the expert of your own body.   You learn how to distinguish between physical and emotional feelings, and gain a sense of body wisdom.   It’s also a process of making peace with food—so that you no longer have constant “food worry” thoughts.  It’s knowing that your health and your worth as a person do not change, because you ate a food that you had labeled as “bad” or “fattening”.”

There are 10 Principals to Intuitive Eating, which are as follows (from the Intuitive Eating Website)

1. Reject the Diet Mentality Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily, and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet stopped working and you gained back all of the weight. If you allow even one small hope to linger that a new and better diet might be lurking around the corner, it will prevent you from being free to rediscover Intuitive Eating.

2. Honor Your Hunger Keep your body biologically fed with adequate energy and carbohydrates. Otherwise you can trigger a primal drive to overeat. Once you reach the moment of excessive hunger, all intentions of moderate, conscious eating are fleeting and irrelevant. Learning to honor this first biological signal sets the stage for re-building trust with yourself and food.

3. Make Peace with Food Call a truce, stop the food fight! Give yourself unconditional permission to eat. If you tell yourself that you can’t or shouldn’t have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, bingeing When you finally “give-in” to your forbidden food, eating will be experienced with such intensity, it usually results in Last Supper overeating, and overwhelming guilt.

4. Challenge the Food Police .Scream a loud “NO” to thoughts in your head that declare you’re “good” for eating under 1000 calories or “bad” because you ate a piece of chocolate cake. The Food Police monitor the unreasonable rules that dieting has created . The police station is housed deep in your psyche, and its loud speaker shouts negative barbs, hopeless phrases, and guilt-provoking indictments. Chasing the Food Police away is a critical step in returning to Intuitive Eating.

5. Respect Your Fullness Listen for the body signals that tell you that you are no longer hungry. Observe the signs that show that you’re comfortably full. Pause in the middle of a meal or food and ask yourself how the food tastes, and what is your current fullness level?

6. Discover the Satisfaction Factor The Japanese have the wisdom to promote pleasure as one of their goals of healthy living In our fury to be thin and healthy, we often overlook one of the most basic gifts of existence–the pleasure and satisfaction that can be found in the eating experience. When you eat what you really want, in an environment that is inviting and conducive, the pleasure you derive will be a powerful force in helping you feel satisfied and content. By providing this experience for yourself, you will find that it takes much less food to decide you’ve had “enough”.

7. Honor Your Feelings Without Using Food Find ways to comfort , nurture, distract, and resolve your issues without using food. Anxiety, loneliness, boredom, anger are emotions we all experience throughout life. Each has its own trigger, and each has its own appeasement. Food won’t fix any of these feelings. It may comfort for the short term, distract from the pain, or even numb you into a food hangover. But food won’t solve the problem. If anything, eating for an emotional hunger will only make you feel worse in the long run. You’ll ultimately have to deal with the source of the emotion, as well as the discomfort of overeating.

8. Respect Your Body Accept your genetic blueprint. Just as a person with a shoe size of eight would not expect to realistically squeeze into a size six, it is equally as futile (and uncomfortable) to have the same expectation with body size. But mostly, respect your body, so you can feel better about who you are. It’s hard to reject the diet mentality if you are unrealistic and overly critical about your body shape.

9. Exercise–Feel the Difference Forget militant exercise. Just get active and feel the difference. Shift your focus to how it feels to move your body, rather than the calorie burning effect of exercise. If you focus on how you feel from working out, such as energized, it can make the difference between rolling out of bed for a brisk morning walk or hitting the snooze alarm. If when you wake up, your only goal is to lose weight, it’s usually not a motivating factor in that moment of time.

10 Honor Your Health–Gentle Nutrition Make food choices that honor your health and tastebuds while making you feel well. Remember that you don’t have to eat a perfect diet to be healthy. You will not suddenly get a nutrient deficiency or gain weight from one snack, one meal, or one day of eating. It’s what you eat consistently over time that matters, progress not perfection is what counts.

You can find more information about Intuitive Eating at http://www.intuitiveeating.org/.

Do yourself a favor, if you are motivated to make a positive change in your health, consult with a Registered Dietitian instead of researching the latest diet trends online.  It will be time well spent!

Emotional Eating and the Holidays – Looking at Emotional Eating and Stress Management in a Different Way

The holidays can often sneak up on us, and so can holiday stress.  On top of the stress of making travel plans, coping with family tension, and the financial strains of holiday shopping we also worry a lot about holiday foods.  There are a lot of “helpful” websites out there that give advice about emotional eating during the holidays, but most of them are aimed at ways to maintain your diet and not gain weight.  In my experience as a therapist specializing in the treatment of Eating Disorders, focusing just on emotional eating in terms of weight gain or weight loss is not enough.  We need to look at what emotional eating really is and how it functions during the holidays.  Understanding it can help us feel like emotional eating is more manageable and not such a scary, powerful thing.

 

1.  ACKNOWLEDGE THE REASON WHY EMOTIONAL EATING EXISTS:  Emotional eating happens for a reason, and it is a good reason.  We all have emotional needs.  It is part of being human.  We come across stressful situations in our lives and we look for ways to meet those needs and cope with stress.  Finding ways to meet those needs in healthy ways is much harder than it sounds.   It is more common to look for ways to cope that make us feel good physically, which often involves using food.  That is not necessarily a bad thing, but often it just is not enough.  Filling an emotional need with a physical feeling often only helps in the short term.

2.  LET GO OF BLAMING YOURSELF: After acknowledging that food is being used to fill an emotional need, the second and most important step is to have compassion for yourself.  You are not a “bad person” for wanting to feel better.  In the dieting world, it is seen as “bad” to “go off track” and eat “bad foods”.  Let go of the idea that certain foods are bad and that you should feel guilty for breaking the “rules” of your diet.  Instead, contemplate the reason why you are reaching for the foods you are craving.  For most people, the holidays are a mixture of comforting, happy memories, stressful, difficult memories (especially if you have lost a loved one) and high expectations for a “perfect holiday”.  Those are not easy things to deal with.  Let yourself off the hook and try to let go of any unrealistic expectations that are causing you stress.

3. TAKE CARE OF YOUR STRESS DIRECTLY, NOT INDIRECTLY:  If you are having a hard time during the holiday season, let yourself make your emotional needs a priority.   Ways to directly deal with your stress is to talk about it, spend time with people who do not add to your stress levels, and schedule some time just for yourself.  Sometimes just having a few brief moments of quiet time in a peaceful place can make a world of difference. The holidays can become so hectic and busy that we often put our own needs last.  The less we directly deal with our own stress levels, the more we rely on indirect ways to cope, which can lead to using food, alcohol, or other ways to “escape”.  Trying to escape our stress does not provide an adequate outlet for us to process our emotions.   If you are having a hard time grieving the loss of a loved one around the holidays, it can be useful to look at the positive side of emotional eating.  If a certain food reminds you of the person you have lost, let yourself enjoy those foods and remember your loved one.  Combine this ritual with writing a letter to your loved one, writing in a journal, or talking with someone who understands how much you miss that person.  Taking care of yourself is just as important as your other obligations this holiday season.

4.  MAYBE I NEED MORE SUPPORT?  For approximately eleven million Americans, emotional eating is part of an eating disorder (National Eating Disorder Association, www.nationaleatingdisorders.org).  Eating disorders can range in severity levels and unfortunately eating disorders can be misunderstood and many people do not seek out the help that they need.  If you feel like emotional eating is truly out of control or if food and weight is dominating your thoughts throughout the day, it is worth your time to talk to a professional who specializes in helping people with Eating Disorders.  You can find an Eating Disorder specialist in your area through the website www.EDreferral.com.