The beginning of college and freshman year can trigger eating disorders due to all the vast changes and added stress. For the first time, many of the students are responsible for budgeting their money, completing their own errands, and managing their time. They are also spending a great deal of time with a new group of people and are adjusting to having nearly complete independence. While this may seem like a dream come true for most teens, all of these components together can cause a great deal of anxiety for some.
Almost all students discuss the dreaded term “freshman fifteen”, and while some may experience weight gain, the concept is a myth, although the thought of it can be the cause of even more stress and anxiety. In an effort to avoid these unwanted pounds, many students will engage in risky behaviors, such as crash dieting or excessive exercising, both of which are slippery slopes into an eating disorder.
Other students may have engaged in disordered eating behaviors before starting college, but have been living under the watchful eye of parents and unable to fully partake in their undesirable behaviors. Newfound freedom can offer the perfect opportunity for an eating disorder to fully develop. This, coupled with peers who may be engaging in, and/or even encouraging these behaviors, can be an unpleasant combination.
Although Anorexia Nervosa and Bulimia Nervosa are the most common eating disorders, and what usually comes to mind when you think of eating disorders, Binge Eating Disorder may also be triggered at this time. Binge Eating Disorder is characterized by the uncontrolled eating of large amounts of food in a short period of time. These individuals experience discomfort, but do not purge. This causes weight gain, which is often upsetting, and sometimes for emotional comfort, they will turn to food, thus leading to another binge. The cycle can be very difficult to break, especially while dealing with all of these new stressors.
Eating disorders are a true physiological disease, with a biological predisposition, which is why not all college students develop eating disorders and why not all diets lead to eating disorders. Of the 90% of college females on a diet, which may be considered disordered eating, approximately 20-25% progress to eating disorders. And, of those who do develop eating disorders, 1/10th of them are males.
Common signs of an eating disorder are:
It is important to get help if you need it, and it is equally as important to offer help to someone in your life who may be battling an eating disorder. Eating disorders are very serious, and can lead to long-term health problems if left untreated. If you, or someone you know, experiences any of these signs, get help from a therapist and dietitian. Most college campuses have counseling centers with professional who can help or get you the information you need to get help. It is also important to remember that eating disorders can be triggered by other things and during different times in one’s life as well. For example, marriage, pregnancy, and post-partum are all times when there are new stressors in a person’s life. Remember, it is never too late to develop an eating disorder, and it is never too soon to get help.
“Lecturing people on how to live a healthy lifestyle can be counterproductive, unless individuals can be persuaded to change their behavior.”
It is no surprise that Jamie Oliver’s plan to eliminate childhood obesity did not go exactly as he intended. His main goals on the show “Food Revolution” were to change school meals, to teach cooking classes, and to encourage people to eat more meals at home. These goals may be desirable for a few families, but seem completely impractical for most people I know. First of all, changing school lunches would require a lot of government funding and may cause an increase in prices of lunches for students. Currently, many families rely on the inexpensive (sometimes free) meals and snacks that schools provide for their children.
Secondly, these families probably do not need cooking classes. I would imagine that they are choosing not to cook because of their busy schedules, lack of time, or simply because it is not enjoyable for them; not because they need to learn how to do it. Each of these goals seems more like preaching and less like dealing with the root of the problem, which may be the reason why there was a drastic decrease in the number of children eating cafeteria lunches in the particular schools that were targeted. I do not think this was the outcome that Oliver hoped for.
More importantly, none of these changes address the relationship with food. In order for a change to withstand the test of time, it must be behavioral. By telling children (and adults) that certain foods are good and others are bad, it sets up a negative dichotomy. Children are told, or forced, to restrict certain foods, which will cause them to inherently sneak, hide, and binge these forbidden foods.
Another problem that is not addressed regarding school lunches is the short amount of time that students are given to eat. When they are rushed, they tend to eat everything on their plate, without taking the time to notice if they are even still hungry or if they are already full. This causes children to overeat, which can be considered a major cause of childhood obesity, not the types of food that the children are eating.
So what should be done to manage childhood obesity?
How many of these people have an eating disorder? (photo by cesarastudillo)
How can you find a solution to a problem without really knowing the problem? This is the question plaguing physicians, psychologists, therapists, dietitians, and other professionals who treat patients with disordered eating. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a book that lists and defines all psychiatric disorders, patients can be classified as having anorexia, bulimia, or an Eating Disorder-Not Otherwise Specified (EDNOS).
The clinical definitions for anorexia and bulimia are so rigid, that over half of the patients with eating disorders cannot be diagnosed as one of those and instead are diagnosed with EDNOS. There is a wide range of patients who are given this diagnosis, but as researchers point out, conditions vary greatly and many patients can identify more with the symptoms and criteria of anorexia or bulimia.
This leads to several problems. First and foremost, there is little research that discusses how clinicians should treat EDNOS patients. From a patient perspective, some insurance companies will not cover medical expenses related to this diagnosis.
I have a problem with how the term “not otherwise specified” can be misinterpreted as a less serious eating disorder, or not quite an eating disorder yet. This notion may cause patients to be less motivated in participating in their own treatment, or cause loved ones to dismiss it. Even though all psychiatric disorders include a not otherwise specified diagnosis, the percentage of patients with this diagnosis is far less than the astonishing 50% of EDNOS diagnoses.
So what can be done? And why? Many professionals believe that reducing the stringency of the anorexia and bulimia definitions would allow more patients to be diagnosed as one or the other, and maybe even both. Experts also see a need for a defined binge eating disorder and a separate purging disorder for patients who purge but do not binge.
Why is it important to have these clear diagnostic criteria available?
These changes may seem small, but once a psychiatric condition is listed in the DSM, there is an increase in research of the condition, as well as an increase in the general awareness. As a result, clinicians will be able to better treat patients with disordered eating, and patients will take their diagnosis more seriously and will be more accountable for their recovery. Additionally, Insurance companies may reimburse for more diagnoses, and there could be an increase in the coordination of care among health care professionals because there will be a standardized language for the various diagnoses. With these changes, patients will definitely see an improvement in the level and quality of their care.
Post by Brittany Gowland
Just like so many of my fellow Americans, I partake in the guilty pleasure of reality TV, usually with a smile on my face, but I can’t stop myself from becoming saddened by the television shows that chronicle the weight and body image struggles of celebrities like Carnie Wilson and Kirstie Alley. Many people can relate to these women and feel relieved knowing that even when you’re famous, you can fall victim to a fad diet and experience yoyo-like weight loss and weight gain.
Carnie Wilson underwent gastric bypass surgery to “solve” her weight problem, only to have gained weight in the end, and is now struggling (in front of millions of people) to try to figure out what to do.
Kirstie Alley has been in the spotlight for years, always because of her weight. After losing 75 pounds and becoming the spokesperson for Jenny Craig, she regained that weight plus some. Recently, Kirstie Alley has vowed “to lose 100 pounds again!” which I suppose she will attempt to do with the help of a weight loss product that she is currently endorsing.
The missing element in both Wilson and Alley’s solution is that they do not address their underlying relationships with food, weight, and body image. This portrays the message to all individuals watching that they too can ignore their own food issues. Newsflash: No weight loss plan/diet/exercise regimen, etc will ever be successful without first resolving other issues.
Carla Wolper, a researcher at St. Luke’s Roosevelt Hospital in New York, states exactly what I’m thinking when she says, “It would be nice if there was somebody out there doing it the right way”. But then again, I guess that wouldn’t make for a very interesting TV show.
On the contrary, I commend actor and comedian Jeff Garlin who wrote about his struggles with food in his new book “My Footprint”. It is not very often that a male, especially a famous one, speaks out about his insecurities. I applaud his honestly as he discusses his compulsiveness with food and his never-ending diet plan. It is comforting to those suffering to know that anyone, regardless of gender, can face these issues that he has identified, and will hopefully overcome.
I just watched Geneen Roth on Oprah, discussing her new book Women, Food and God. Bravo to Oprah for addressing the real reason people struggle with weight and eating. Finally she is getting off the diet roller coaster and getting to the source of the problem.
I just read this book last week. It was a very enjoyable read. I’ve long loved Geneen Roth’s work, as she has written many books on the topic of overeating. She declares this book to be the culmination of the message she has been trying to convey for years.
While she does not address her ‘guidelines’ throughout the book, she slips them in at the back of the book for reference. The meat of the book is really looking at why we use food. Food is the drug of choice for many people in this country, largely due to the fact that it is not actually an illegal substance, so we can easily get away with using it to alter consciousness.
She doesn’t discuss how food makes us feel better, but anyone who has used it for reasons other than hunger knows its effectiveness all too well. There is an actual neurological response to food that promotes feelings of calm and pleasure. It can activate Serotonin in the brain (just like Prozac), as well as endorphins, etc. So it actually is an effective tool for soothing ourselves. Except when it becomes the primary method of doing so, which often leads to weight gain and self-loathing.
Her guidelines are as follows:
Someone commented on my last post that I just seem to bash all healthy eating advice, but offer no solutions. Actually, I have written extensively on my main website, linked to this blog, about the non-diet approach I use with my clients and in my own life. I do bash typical healthy eating advice since it does not seem to be helping anyone. In fact, as the traditional healthy eating chatter has grown louder, there has been a steady increase in obesity as well as eating disorders of all kinds. That makes it pretty bash-worthy in my book, and to do otherwise would be unethical.
Ms. Roth is one of many voices of the non-diet movement. Early adopters included Jane Hirshmann and Carol Munter in Overcoming Overeating and Elyse Resch and Evelyn Tribole in Intuitive Eating. This approach is the only effective treatment of eating issues I have seen either in research or in practice. This method allows people to normalize their relationship with food, which greatly decreases binges, overeating, and non-hunger eating. This can allow the gradual process of the body moving toward its set-point weight. Weight loss is not the focus or the goal, but rather it is the relationship with food that is the problem to be solved.
I can tell you that there are many days where I still marvel at the fact that I can (and do) eat whatever I want, and my body maintains a stable, natural set-point weight. I do not have to think about food, weight or my body. I can enjoy the pleasure of eating, but it does not rule my world. In the past I was certain (because of the pervasive message in our society) that I would have to actively manage my weight for my entire life. I thought my body was some untamed beast ready to spring out of control with exponential weight gain if I lost vigilance for even a moment.
I didn’t know this was a problem, and I lost many years to this belief. Those years were lost because all thoughts were about food and body. I couldn’t enjoy being present in my world. It was only when I woke up to the idea I could trust my body that I found the freedom to really live again. I am constantly grateful for this liberation, and I work passionately to help others liberate themselves. So a great big, juicy Thank You to Geneen Roth and the power of Oprah to spread this word to the masses.
Most people will tell you that ‘diets’ are not good for you. Those same people, though, will tell you that ‘healthy eating’ and ‘lifestyle change’ are the real ways to manage weight. Those terms are often just new cover-ups for what they all have in common: food restriction.
On pretty much any plan you find, there is some limitation of calories as the goal. This is either done with counting points (like Weight Watchers), calories, or grams of fat or carbs. Whatever the details, the methods are all basically the same: You are not going to get to eat what you want. The message is: What you like is making you fat. Sorry. Good luck!
I was discussing a research study during my Intuitive Eating 101 group today. The very famous experiment was done by a researcher named Ancel Keys during WWII, using conscientious objectors as human subjects. It was called a starvation study. I think you might find the results, well…very interesting.
After sorting through 100’s of volunteers, and subjecting them to psychological and medical screenings, he chose 36 mentally and physically healthy college-educated males. He began with a 3-month standardization phase of feeding them approximately 3200 cals/day, followed by a 6-month semi-starvation period, and completed with a 3-month refeeding phase.
The men were supposed to lose 2.5lbs./week, to a total of a 25% of body weight lost. Initially the men were pretty upbeat about the experiment. Soon, though, they were struggling with temptation. After one participant broke the diet and was dismissed from the study, they implemented a ‘buddy system’ to keep participants on track (sounds like Weight Watchers or AA).
One participant was so tempted by the smell of a bakery, he ran inside, bought a dozen donuts and passed them out to children just to watch them eat. There was one man who purchased over 100 cookbooks during his time in the experiment. Another participant was chewing up to 40 packs of gum a day. The inability of one participant to tolerate the starvation led him to cut off several of his fingers to get out of the study.
Some of the symptoms the men experienced were:
One man’s experience:
I don’t know many other things in my life that I looked forward to being over with anymore than this experiment. And it wasn’t so much…because of the physical discomfort, but because it made food the most important thing in one’s life…food became the one central and only thing really in one’s life. And life is pretty dull if that’s the only thing. I mean, if you went to a movie, you weren’t particularly interested in the love scenes, but you noticed every time they ate and what they ate.
Keys found the recovery period to be surprisingly difficult. He found he needed to double the calories in order to really repair the damaged tissues; otherwise protein, vitamins and minerals were ‘of little value’. Many found this period to be the most difficult of all because they were so slow to recover. After initially adding only 400 cals to some of the men, Keys found he had to increase it substantially because they showed no improvement. Issues like tiredness, loss of sex drive and weakness were slow to improve even given further increases in calories.
Upon refeeding the men complained of eating to the point of making themselves sick. One man stated he had a ‘year-long cavity’ that needed to be filled. There were many men who reported continuing to eat excessively even after the experiment was over, with recovery ranging from 2 months to a full 2 years. One man said he “simply couldn’t satisfy [his] craving for food by filling up [his] stomach”.
If you haven’t connected the dots to the common symptoms and sentiments the majority of dieters experience, then maybe you’ve never restricted yourself. It is awful. What these men experienced is common to what people experience all the time on restrictive plans. This study shows us that these symptoms are predictable patterns which are biologically associated with restriction.
Maybe you are thinking, “Well, they were starving those guys, of course they felt that way and had those issues.” Guess what…the semi-starvation period was a daily intake of 1600-1800 calories. This is at or above the recommended intake for the majority of the weight management plans available today. Remember, the next time you are being enticed by the lure of a diet…the damage will follow.
Sometimes you have to lose 10 lbs. or 200 lbs. to realize the skinny dream is nothing but a fantasy. Much like its cousin, the rich dream, skinny doesn’t equal happiness. For those who are below a healthy weight, there are often behaviors in place that make them down-right miserable. But that is another story.
The focus of this article is looking at the reality of weight loss. Many people hold off on life until they ‘lose the weight’. This provides a protection, in many ways, from taking risks in life. If you have an excuse (I’m too fat, my nose is too big, etc.), you do not have to do all the big things you wish you could do.
If only I could bottle the hope and excitement of the person who declares “I’m going on a diet!” The wistfulness is palpable as you see them drift off into the fantasy of what will be. They will likely find Mr. Right, get their dream job, and on and on. Oprah was brave enough to do all of the things she wanted to do despite her weight (thank goodness she didn’t put things off until she was skinny). The sad part is, you can almost feel she is still resting true happiness on the hopes that one day her body will be different than it is.
This level of enthusiasm for the Next Great Diet is only there for the first few tries, though. After that it is almost a joke as you reach for more of whatever it is you will not allow yourself to eat on the diet. At some point even just the thought of dieting leads right into a binge.
For those few people (2% of all dieters) who actually keep the weight off over time, the reality is harsh. Often there is a hyper vigilance with food that is all consuming. Life is not so much fun. But worse than that, all of those promises of what it would be like to be thin (the sky opening up to angels singing from the heavens) are not fulfilled.
Now you don’t have your fall back excuse for not having the life you want. Now it is all on the real you–not the facade. It always was about the real you, but now you cannot deny it anymore.
What if you pretend your body is not going to be different. Assume your body will be as it is today for the rest of your life. Nothing you eat (or don’t eat) and no amount of exercise will change your body. Now, what do you want to do? Love your body as it is (every single part) and get on with your real life.
In a recent study, researchers found a significant bias in healthcare professionals who treat overweight and obese patients. This includes, but is not limited to, nurses, doctors, dietitians, and physical educators. Weight-based discrimination among healthcare providers has increased 66% over the past decade. This type of prejudice has a significant impact in the care that may be provided to the patient.
Lead author Dr Kerry O’Brien, from The University of Manchester, UK, said: “One reason for the high levels of obesity prejudice is that people only hear that obesity is due to poor diet and lack of exercise, which implies that obese people are just lazy and gluttonous, and therefore deserve criticism. But, uncontrollable factors, such as genes, the environment and neurophysiology, play an important role.
“Weight status is, to a great extent, inherited. It’s crucial that health professionals, such as nurses, doctors, dieticians and physical educators, are aware of these other influences, as well as their own potential prejudices, and don’t just blame the individual for their weight status.
“Those tasked with providing health services to obese people may become frustrated with patients when they do not lose weight following counselling and treatment, but the research shows that weight loss is extremely difficult to maintain long term. Obese people are constantly fighting their physiology and the environment. If professionals keep this in mind it may help in not stigmatising their clients.”
Researchers found that by administering a tutorial about additional factors in weight status, they could effect a 27% decrease in the bias. The tutorial focused on causes beyond the control of the patient that contribute to weight. When only given training regarding the influence of eating and exercise on weight, the bias increased 27%.
Obviously this fatism is not limited to those in the healthcare field. This is a widespread issue in our culture. People assume those who have weights outside of ‘normal’ (67% of the population) lack the will to control themselves. This is despite the obvious success and achievement in all other areas of the individual’s life (ie. Oprah).
The assumption that the entire issue is how a person eats and moves actually contributes to increased rates of overweight/obese as well as eating disorders. There is obviously a strong genetic factor in set point weights, and there is also the issue of disordered eating or binge eating disorder. Advising people who struggle with these issues to simply ‘diet and exercise‘ does a tremendous disservice to them.
Moreover, the CDC has found the category of ‘overweight’ actually has the lowest mortality rate. Only those in the morbidly obese category experience a potentially shorter life, but actually to a lesser degree as those who fall in the underweight category. In fact, research has shown it is the losing and regaining of weight that may cause many of the medical issues such as high blood pressure, diabetes, etc.
Based on those figures, the net U.S. death toll from excess weight is 26,000 per year. By contrast, researchers found that being underweight results in 34,000 deaths per year
Think there will be a bias on being underweight? Or maybe even a national War on Underweight? Probably not–the bias is widespread and not subject to being swayed by logic.
I recently wrote an article for a site promoting the end of fat talk. I’m pretty sure you know what talk I’m talking about. Whether out loud or just inside your head, fat talk is going on for millions of people.
My two main issues with fat talk are:
It doesn’t really work in the way you think it will. It largely backfires on you. It makes you eat more to avoid your feelings. It makes you eat more also because now you are so upset about your body (and for a second felt deprived when you thought about going on a diet–ack!).
In the article I asked people to ask themselves three questions:
Please check out the full article on the Reflections: Body Image Program, created by the Tri Delta sorority.
Demi Moore recently discussed the end of her lifelong struggle with her body image. She stated she has come to realize externals do not bring happiness. I am so encouraged to have famous women discussing their real thoughts about their bodies. This further emphasizes the point that body image has nothing to do with how you look. It is a mental state.
It would be hard to argue that Demi Moore is unattractive. Yet she felt that way. I’m pretty sure you feel that way sometimes too. But in your case, you think it is justified. Well, she did too. Body Image is a mental state often used to distract you from real feelings under the surface.
You see, if you just focus on your body (instead of work or boyfriend or finances, etc.), it feels like something you can control. You will just get to the gym everyday and eat less. Voila! That should make you happy–to have the body you always wanted.
Have you ever said, “When I get to X number of pounds, then I will LOVE my body”? If you actually got there with your methods, I’m pretty sure you found what everyone, including Demi, finds: you are still not happy. Well, maybe you haven’t lost enough–there are still some trouble areas. Wrong. It will never be enough, because changing your body is not the solution. You need to change your attitude about your body. You need to see body image thoughts for the emotional cover-up they are.
So Kate Beckinsale has also recently stepped out discussing her previous battle with anorexia. She decided she was either going to die or be a real person. Not everyone is faced with such a straightforward decision because not everyone is on the brink of death with their disordered eating. However, if you have a bad relationship with food, you are not really living. You would benefit from choosing to be a real person as well.
Portia de Rossi is releasing a memoir chronicling her struggle with an eating disorder. Every time a celebrity comes out of the closet about their eating disorder, my heart leaps in my chest. I am just so grateful that women and girls who try to look like celebs can see it is not healthy or realistic. Even celebrities cannot do it–because that is not how people are really ’supposed to look’.
Next time you turn on the TV or open up a magazine, remind yourself of two things. First, all of those pictures have been retouched. Those people do not look like that–you certainly shouldn’t try to. Second, many of those people are struggling with eating disorders and body image issues. That’s right, the people you want to look like don’t even like the way they look. Love the real you–honor your genes, not your jeans.
Search engine optimization by SEO Design Solutions
