Wednesday, November 26, 2008

Thanksgiving and eating disorders

Thanksgiving has been said to be the most challenging holiday for people living with eating disorders. If you are looking to create a plan to navigate this difficult day The Center For Change has some ideas. Good luck and hopefully you can find something in the day to be thankful for.

Twelve Ideas to Help those with Eating Disorders Negotiate Thanksgiving and Christmas - Center for Change Inpatient Treatment Team; Compiled by Michael E. Berrett, Ph.D.

For most people, the Thanksgiving and Christmas holiday season is a wonderful time of year. It is often a time of family reunion and celebration, when families, friends, and co-workers come together to share good will and good food. The season is to be bright, happy, and full of the best parts of relationships. Yet, for women who suffer with eating disorders, this is the worst time of the year. For these people, trapped in the private hell of anorexia or severe bulimia, Thanksgiving and Christmas magnify all of their personal demons, causing them great internal pain and turmoil.

  1. Eat regularly and in some kind of reasonable pattern. Avoid "preparing for the last supper." Don’t skip meals and starve in attempt to make up for what you recently ate or are about to eat. Keep a regular and moderate pattern.

  2. Worry more about the size of your heart than the size of your hips! It is the holiday season, a great time to reflect, enjoy relationships with loved ones, and most importantly a time to feel gratitude for blessings received and a time to give back through loving service to others.

  3. Discuss your anticipations of the holidays with your therapist, physician, dietitian, or other members of your treatment team so that they can help you predict, prepare for, and get through any uncomfortable family interactions without self destructive coping attempts.

  4. Have a well thought out game plan before you go home or invite others into your home. Know "where the exits are," where your support persons are, and how you’ll know when it’s time to make a brief exit and get connected with needed support.

  5. Talk with loved ones about important issues: decisions, victories, challenges, fears, concerns, dreams, goals, special moments, spirituality, relationships and your feelings about them. Allow important themes to be present and allow yourself to have fun rather than rigidly focusing on food or body concerns.

  6. Choose, ahead of time, someone to call if you are struggling with addictive behaviors, or with negative thoughts, or difficult emotions. Call them ahead of time and let them know of your concerns, needs, and the possibility of them receiving a call from you.

  7. If it would be a support or help to you, consider choosing one loved one to be your "reality check" with food, to either help plate up food for you, or to give you a reality check on the food portions which you dish up for yourself.

  8. Write down your vision of where you would like your mind and heart to be during this holiday time with loved ones. Take time, several times per day, to find a quiet place to become in tune again with your vision, to remember, to nurture, and to center yourself into those thoughts, feelings, and actions which are congruent with your vision for yourself.

  9. If you have personal goals for your time with loved ones during the holidays, focus the goals around what you would like to do. Make your goals about "doing something" rather than about trying to prevent something. If you have food goals, then make sure you also add personal emotional, spiritual, and relationship goals as well.

  10. Work on being flexible in your thoughts. Learn to be flexible in guidelines for yourself, and in expectations of yourself and others. Strive to be flexible in what you can eat during the holidays. Take a holiday from self imposed criticism, rigidity, and perfectionism.

  11. Stay active in your support group, or begin activity if you are currently not involved. Many support groups can be helpful. 12-step group, co-dependency group, eating disorder therapy group, neighborhood "Bunco" game group, and religious or spiritually oriented groups are examples of groups which may give real support. Isolation and withdrawal from positive support is not the right answer for getting through trying times.

  12. Avoid "overstressing" and "overbooking" yourself and avoid the temptation and pattern of becoming "too busy." A lower sense of stress can decrease a felt need to go to eating disorder behaviors or other unhelpful coping strategies. Cut down on unnecessary events and obligations and leave time for relaxation, contemplation, reflection, spiritual renewal, simple service, and enjoying the small yet most important things in life. This will help you experience and enjoy a sense of gratitude and peace.

Center for Change Inpatient Treatment Team; Compiled by Michael E. Berrett, Ph.D.

Saturday, November 22, 2008

eating disorders and other addictions

According to Dr. Russel Marx, Princeton HealthCare System: Those with eating disorders at higher risk for substance abuse. In an article on Friday, November 21, 2008 1:21 PM EST he states, "Risk factors for eating disorders and substance abuse are strikingly similar". Not great news for parents who have a child living with an eating disorder. As parents living with this constant worry and fear that eating disorders bring on we all know, there usually isn't much good news. But, at least we can have a heads up from this information.

Dr Marx asks us to consider these statistics from a groundbreaking study released in 2003 by The National Center on Addiction and Substance Abuse at Columbia University:

• Individuals with eating disorders are up to five times more likely to abuse alcohol or illicit drugs.
• Those who abuse alcohol or illicit drugs are up to 11 times more likely to have eating disorders.

• Eating disorders occur in 5 to 10 million Americans, mostly girls and young women.

So, as parents or people who care about someone with an eating disorder what do we do with this information? Please share your ideas here. I cannot think of much besides:
1. Continue to practice "letting go with love"
2. Let your loved one's care providers know these stats
3. Have a conversation with your loved one stating that you are concerned

We would all like to hear if you have more suggestions for those of us who care about someone who has multiple addictions. I know Al-Anon is a great comfort to a lot of people, worth checking out if you are feeling consumed by worry about your loved one.

Dr. Russell Marx is a board-certified psychiatrist and medical director of the Eating Disorders Program at University Medical Center at Princeton. He also is the author of the book “It’s Not Your Fault: Overcoming Anorexia and Bulimia.”

Next week: how to handle Thanksgiving with your loved one who is living with an eating, my best advice...move to Canada,they already had theirs. Humor is essential.

Tuesday, November 11, 2008

Holiday Survival for People with eating disorders

My google alerts today brought an early holiday gift! The gift came in the form of some of the best tips I've seen so far for people who find the holiday season extremely challenging due to their eating disorders. These great tips come courtesy of; Cynthia Bulik, Ph.D., the William and Jeanne Jordan Distinguished Professor of Eating Disorders in the UNC School of Medicine’s department of psychiatry and director of the UNC Eating Disorders Program. I have heard people say that Thanksgiving is the worst holiday of all due to the main focus on food. So, the best thing to do with a gift is to share it, so here you go! Thank you Cynthia and best of luck with your latest book, “Crave: Why you binge eat and how to stop”.

Many people equate the holidays with food – big meals equals big times. Americans, especially, attach a lot of social and personal value to what, and how, we eat, often through family rituals or attitudes. For many, family gatherings are positive events, but for the 9 million men, women or young people who have an eating disorder, the holidays, without proper planning, can feel like nightmares.

Three out of four American women have “disordered eating” behavior, and 10 percent have an eating disorder such as anorexia or bulimia nervosa or binge eating disorder, says Cynthia Bulik, Ph.D., the William and Jeanne Jordan Distinguished Professor of Eating Disorders in the UNC School of Medicine’s department of psychiatry and director of the UNC Eating Disorders Program. Her latest book, “Crave: Why you binge eat and how to stop,” is due out in early 2009.

If you have an eating disorder, plan ahead. Bulik and the UNC Eating Disorders team offer the following suggestions to navigate the food minefields of the holidays:

• Have a “wing man” – someone you trust to help run interference at family get-togethers or office parties. This should be someone who knows your triggers and can help distract you from temptations (or someone pushing your buttons), change the subject or assist you while you handle the stress.

• Make up a code signal or phrase with the wingman before going to the holiday party. If you start to feel overwhelmed give your friend the signal so that you can both step out of the room and they can offer you some support.

• Keep your support team on speed dial and call them at any time during or after a party. Talking relieves the pressure. You're not overburdening them. They will undoubtedly have stories to share, too.

• Potlucks are your friends. Don’t hesitate to take a food you prepared that feels safe enough to you so that you will have at least one manageable entrĂ©e.

• Lavish holiday spreads don’t have to be the enemy. If faced with one, channel your inner Boy Scout or Girl Scout skills and be prepared! Before stepping in line, and before getting a plate, evaluate the options. Mindfully consider which foods you'll sample, portion sizes and whether you feel comfortable trying a “feared food.” Make a decision and stick with it!

• If your treatment team has given you a meal plan stay on track so you aren't starving when you get there.The gift

• Listen with your heart, not your head. Hear the happiness and caring in a person’s tone when they tell you that you look “so much better.” They are saying they care about you. Don’t let the eating disorder lead you to misinterpret those words in a way that deprives you of hearing that people really care about you.

• Get Real! People too often have a fantasy about how “perfect” the holidays are going to be. When family members fail to live up to unrealistic expectations, it might be tempting to restrict or overeat in an effort to feel better temporarily. Try to anticipate some of the possible emotional traps in advance so you can cope (and maybe even laugh) when you encounter them.

• The well-known HALT slogan works for any type of recovery. Don't let yourself get too hungry, angry, lonely or tired. This is especially important over the holidays.

• 'Tis the Season to Forgive, so forgive yourself if you have an eating slip.

• Try your best not to skip appointments with your treatment team. It’s an important time to stay in touch with people who can help.

If you think you might have an eating disorder, the best first step is a comprehensive evaluation. For more information, call the UNC Eating Disorders Program at (919) 966-7012 or visit

Thursday, November 6, 2008

NEDA Charter Launch

Here it is November In MN, getting cold and rainy and time to get to work for the NEDA (National Eating Disorders Association) Charter Launch that will happen on February 22nd at the State Capitol.

As a volunteer for the National Eating Disorder’s Association’s (NEDA) STAR program, (States for Treatment, Access and Research) I am working on a campaign to help launch the Worldwide Charter for Action on Eating Disorders, a patient’s bill of rights, in every state over the next year!

Today I am writing to ask for your help in connecting us with those;
parents, support people and interested public, who may welcome an opportunity to participate in a brainstorming to share opinions and give us feedback on what they believe would be relevant issues to focus on... do they believe that we should focus on awareness, prevention and education? In MN we are fortunate that we already had parity before the National Bill was signed, so we find this a great opportunity to use this launch to support the most pressing aspects of eating disorders.

The Charter will serve as a tool to assist people with eating disorders and their loved ones in identifying high quality, appropriate services and practices, and to guide them in challenging unhelpful, outdated, and anti-therapeutic practices. This Charter will provide service planners and providers with the basic building blocks for quality program and service development.

Real people — individuals and families — are the strongest advocates for championing our cause. Together we hope to increase access to treatment for eating disorders by expanding insurance coverage, advocating for quality treatment, increasing public understanding of eating disorders and urging more funding for research.

If you or someone you know would like to share your feedback please send an email to and we'll get your opinions.

Happy Thanksgiving!