Author - admin

Body image and shame

Fat Shaming, Low Body Esteem & Body Positivity

The topic of girls and women’s perception of their bodies, as well as how this topic is portrayed by the society, has long been a subject of discussion. An individual’s perception of her (or his) body has long played a critical role in understanding how to treat eating disorders. Much of this understanding is increasingly looking at the role of media and societal pressures on people’s perceptions. Popular media and the fashion industry appear to actually encourage a culture of fat-shaming and weight stigma. This history of shame and stigma has created devastating consequences.

Low Body Esteem:

According to studies performed by the Dove (Unilever Corporation), feelings of low body esteem impact the majority of both women and girls. The report states that 85% of women and 79% of girls say that they purposely skip major life activities and events due to the fact that they do not feel good about the way they look. Shockingly, 69% of Women and 65% of girls state that pressure from advertising and mass media pushes them to reach an unrealistic standard of beauty. On a worldwide scale, the report states that out of the 13 countries in the study, Japan ranked lowest, with only 8% body confidence among respondents, followed by the UK and Canada at 20%, the US at 24%, and South Africa topping the list at a modest 64% of women who feel confident in their bodies.

The Body Positivity Movement:

Reports like these have inspired a growing empowerment trend known as body positivity movement. This movement is quickly gaining popularity on the internet and in mass media. The concept of body positivity evolved as a way to counteract feelings of poor body image in society at large. Generally, body positivity asserts that all bodies are good bodies. How people’s bodies physically appear should not determine their worth as a person. “In Western society, this idea fights against long-held valuations of physical appearance, primarily as portrayed (or conspicuously not portrayed) in the media. Body positivity proponents across social media, therefore, seek to make diverse body types more visible, partly as a reminder to rethink our cultural conceptions of what it means to be beautiful, and that such concepts are not fixed.”

Fat Shaming as Entertainment:

Whether the body positivity movement able to create permeant societal change is still unclear. The entertainment industry still produces shows that seem to send the opposite message. For example, for the last few months controversy has been swirling around the new Netflix show Insatiable. Described as a dark comedy set in the Southern world of beauty pageants, the show is labeled as a “coming of rage” story. The series follows the actions of a vengeful teenager who was called “Fatty Patty” by school bullies. However, this character loses a substantial amount of weight, after having her jaw wired shut; and then teams up with a disgraced pageant coach in order to seek revenge against the people who once tormented her. The show’s creator argues that the Netflix series draws from her own experiences dealing with bullies and an eating disorder while growing up in the suburbs. Critics have called the show “an offensive mess,” “almost unwatchable” and “obscenely cruel” for perceived fat shaming.

One of the actors from the series, Alyssa Milano, defended the series arguing that the show is not engaging in fat-shaming behavior. “We are addressing (through comedy) the damage that occurs from fat shaming.” Milano explains that she hopes the show is a conversation starter, since the series explores body images issues, rather than sweeping it “under the carpet.” Insatiable’s main star Debby Ryan agreed with Milano and argues that the subject matter is difficult, but she hopes that the show serves a purpose by “stirring conversation” about fat shaming and low body esteem.

Critics of the show have not agreed with Ryan and Milano’s analysis. As of August 31st, 2018, a Change.org petition has garnered more than 200,000 signatures to have the show canceled. The originators of the petition state that the shows central plot is not an isolated case, but part of a much larger problem every single woman has faced in her life. The Netflix series “perpetuates not only the toxicity of diet culture but the objectification of women’s bodies.”

Other critics have agreed with this analysis and have called the show dangerous. Behavioral health professionals have noted that the U.S. society has made significant improvements in advancing the body positivity movement. However, fat-shaming and body weight stigmas are still a problem. Netflix’s show Insatiable only proves there’s still a lot about the way body image is portrayed in the media that needs to improve. The show’s core premise displays a plotline that is based on some ugly body image ideas. Body Positivity activists have pointed out that series shows that “a fat girl could never stand up for herself while fat and of course she has to be assaulted and have her mouth wired shut before she becomes her best self, her skinny self.” Other news sources have raised the question that perhaps the series is just misunderstood.

Whether the show is deemed offensive or is actually secretly progressive, the judgment that people feel about their physical appearance will continue. As a social trend and topic of conversation, River Centre Clinic will monitor this story as it unfolds. Our trained staff understands the complexity and sensitivity surrounding these issues. For additional questions or comments about this or other related topics – please contact us.

The River Centre Clinic’s primary purpose is to provide high quality, cost-effective, specialized care for patients with eating disorders in a state-of-the-art treatment environment. The clinic follows a treatment philosophy designed to provide an affordable treatment alternative to inpatient care. Our innovative approach to treatment is designed to reduce costs without compromising our high quality of care. The River Centre Clinic provides state-of-the-art treatment located in a modern, spacious and tranquil setting in Sylvania, Ohio — an historic suburb of Toledo, Ohio. The facility was designed to provide an attractive, and safe alternative to hospital or hospital-based programs. Living facilities are located in the main building to comfortably accommodate adults and adolescents in separate units.

Follow on Twitter:  @River_Centre

Body positivity, Body Image, Weight Stigma, Low Body Esteem

Read more...
Women eating sweets

What is Emotional Eating and How to Stop It?

The occasional food craving is a normal behavior for many people. But when these cravings become something more, they could suggest larger underlying problems. This is where the term emotional eating enters the conversation. Emotional eating is not initial harmful, due to the fact that it satisfies a person’s immediate emotional impulse. However, a regular pattern of emotional eating can create various health problems.

What is emotional eating?

This eating behavior is a way for people to suppress negative feelings like stress, anger, fear, boredom, sadness or even loneliness. Major life events can trigger emotional eating such as problems with personal relationships, work, health or even financial pressures. When some people are in emotional distress, their food consumption patterns may become more impulsive and began to resemble binge eating behavior. The act of eating serves as a distraction with the focus on eating a “comfort food” providing momentary relief, versus dealing with a serious problem or painful situation.

In other words, consuming comfort food during times of stress can provide temporary gratification. But, this food consumption will not fulfill a person’s actual emotional needs or solve ongoing problems.

 

Why do people engage in emotional eating?

The reasons as to why people may engage in emotional eating are complex. Part of this behavior is likely due to our evolutionary roots. In ancient hunting and gathering societies, stress was a signal to the body to consume more calories for survival purposes. This behavior may have helped 100,000 years ago, but is now ill-suited to our sedentary lifestyle.

The physical sensation of hunger is based on how the human body reacts to stress by telling the adrenal glands to release a burst of adrenaline. This in turn increases the heart rate and supplies energy that is intended to be used for fight or flight situations. Next, the adrenal glands release cortisol, which instructs the body to replenish energy by stimulating an appetite for high-energy (calorie) foods. Cortisol can stay in the body for many hours, which will create hunger pains. Oddly, this same hormone also tells the body to store any unburned calories as fat. Again, this evolutionary and physical response to stress, as well as the associated storage of body fat, is not healthy in the modern age.

 

Ways to control emotional eating?

Here are 4 influencers that tend to encourage emotional eating behaviors.

[1] Food as a main pleasure:

People experience a real soothing effect when they eat certain foods like ice cream, potato chips or cookie dough. Consumption of certain comfort foods delivers a burst of short-term pleasure. These foods are addictive, so not eating them when the urge strikes is a challenge. A possible solution is for people to discover other ways to soothe their emotions besides eating food. They need to explore other (non-destructive) behaviors that bring them pleasure.

[2] Not aware of the behavior:

Sometimes people are not aware that they are eating. This is sometimes known as unconscious eating by therapists. In these cases, individuals seem to almost operate as if they are in a trance. In many ways, this behavior may resemble binge eating. Mindlessly eating or grazing while watching television or movies can easily encourage this behavior. A solution is for people to stop putting food into their mouth simply because it is available. The best prevention is to always be mindful of what and when they are eating.

[3] Difficulty Coping with Negative Feelings:

It is human nature to avoid thoughts and experiences that make a person feel bad. Sometimes this is tough, so the only way some people can avoid negative feelings is to engage in self-destructive eating behaviors. In the short-term, this will distract a person from feeling negative thoughts. However, this not a healthy long-term solution. Ideally, individuals should learn to let themselves experience negative or difficult feelings. A trained, certified and experienced behavioral health professional is helpful in this situation.

[4] Negative Body Image

People hating their own physical body and possessing an overall negative body image is a critical factor for triggering emotional eating. A downward spiral of negativity and shame makes it challenging for people to implement long-lasting healthy eating changes. Again, a skilled mental health specialist is helpful in this situation. People need to stop hating their own body before they can successfully stop their self-destructive emotional eating behaviors – and this is tough to do alone.

 

When should an individual seek professional help?

If individuals have tried to use self-help options but they still have no control over their emotional eating behavior, they should consider seeking help from an eating disorder specialist. An experienced mental health professional can help a person understand the origins of this behavior, whether it is an eating disorder as well as acquire coping skills.

For additional information or questions about emotional eating, please contact the staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The clinic’s main phone number is 1.877.212.5457.

The River Centre Clinic is located in a modern, spacious and tranquil setting in Sylvania, Ohio – a suburb of Toledo, OH.

Follow on Twitter:  @River_Centre

Emotional Eating, Eating Disorders,

 

Contributor: ABCS RCM

Read more...
Child looking at partial cupcake - River Centre Clinic

Childhood Eating Problems & Adolescents Eating Disorders

Many parents are familiar with children who are picky eaters. In fact, for babies, this is often a normal eating behavior. As children age, they start to develop their own personal food preferences. However, as children grow older an overly selective eating behavior could be a sign of deeper health concerns. Many people are not aware that eating disorders are the third most common chronic illness in adolescents according to the American Academy of Pediatrics (AAP). Since the 1950s, there has been a steady increase in the incidence and prevalence of anorexia nervosa, bulimia nervosa as well as other eating disorders in both children and adolescents.

Data from the National Institute of Mental Health (NIMH) estimates that out of 800 public high school students, approximately 20-22 students will be impacted by eating disorders and even more will experience subclinical (not detectable) symptoms of the disease. Adolescents who have suffered from eating disorders are more likely to experience medical co-morbidities such as depression, anxiety, substance abuse and suicide.

During a person’s adolescence is when many of these diseases first occur. Adolescence is a time in people’s life when a great deal of change is occurring. Body changes, confusion, social anxiety only accelerate feelings of self-consciousness and low self-esteem. The onset of eating disorders often appears during this period, but these diseases can develop at a later time in a person’s life.

Not all of these eating disorders directly develop due to body image issues. Among children, they may struggle to eat certain foods because they feel physically nauseous. This can create a lack of appetite for food, which will make it more difficult to eat. A fear of vomiting or choking makes a child avoid certain foods, which can gradually become more restrictive over time. According to the National Eating Disorder Association, this restrictive eating behavior is a possible sign of what was previously identified as selective eating disorder, but is now referred to as ARFID or Avoidant Restrictive Food Intake Disorder.

ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness. Although many children go through phases of picky or selective eating, a person with ARFID does not consume enough calories to grow and develop properly. In children, this results in stalled weight gain and vertical growth. ARFID can also result in problems at school, due to difficulties eating with others and extended times needed to eat. As with all eating disorders, the risk factors for ARFID involve a range of biological, psychological, and sociocultural issues. These factors may interact differently with different people, which means two individuals with the same eating disorder can have very diverse perspectives, experiences, and symptoms.  

Eating disturbances are considered problematic when it causes the child to become upset or worry and when he or she is not eating enough to sustain proper nutrition and facilitate proper growth. Complications around eating can take many forms including but not limited to:

  • Trouble with food textures/sensory issues
  • Temper tantrums during meals
  • Refusing to eat
  • Limiting food groups
  • Choking, gagging, or vomiting after eating
  • Body image concerns
  • Anxiety/OCD

Due to the concern over the growth of eating disorders among children and adolescents, the Centers for Disease Control and Prevention (CDC) has researched this modern health concern. The CDC made the following recommendations during their 2008 national initiative. Their screening of high school students for eating disorders found that almost 15% of girls and 4% of boys scored at or above the threshold of 20 on the EAT-26, which indicated the possible existence of an eating disorder. The CDC recommended regular health screenings for high school students in order to identify at-risk students who could benefit from early intervention. Early identification and treatment of disordered eating and weight control behaviors can prevent progression of the disease and reduce the overall chronic health risk. To complicate matters, pedestrians have pointed out that some obesity prevention efforts may actually encourage the development of an eating disorder. The majority of adolescents who develop these disorders were not previously obese, but some teenagers, in a mistaken attempt to lose weight, can develop an eating disorder.

For additional information about childhood and adolescent eating disorders, please contact River Centre Clinic. Their Childhood Eating Problems Program director is Anna Lippisch, MSW, LSW. She can be reached at 419-885-8800 or by email. The EAT-26 (Eating Attitudes Test) assessment provides anonymous and instant feedback for a variety of eating-related health conditions.

Follow on Twitter:  @River_Centre

Childhood eating problems, Adolescents eating disorders, ARFID

Read more...
Outside Yoga Class (River Centre Clinic)

Can Yoga Help Treat Eating Disorders?

Yoga, Eating Disorders,

Are there links between body image, physical activity and eating disorders? Stories and research from decades ago have shown that competitive sports can encourage the development of eating disorders. In the 1990s, Sports Illustrated articles openly discussed the deadly impact of anorexia on women athletes. Yet, roughly twenty years later, this problem still exists in U.S. culture. As of 2011, according to the Huffington Post and the National Eating Disorder Association, approximately 33 percent of male athletes are affected by eating disorders who participate in aesthetic sports and weight-class sports. But what if some physical activities actually decreased the occurrence or actually provided effective treatment for eating disorders?

Newer research is studying whether certain physical activities such as yoga, provide effective treatment for eating disorder related illnesses. Yoga, originally a Hindu spiritual and ascetic discipline from India, as an activity is increasingly popular around the world. Yoga is popular in the United States as a hobby that promotes health and relaxation. The activity incorporates movement, body postures, breath control as well as meditation. The popularity of yoga has raised questions as to whether different styles of yoga can provide complementary therapy for patients who are receiving treatment for eating disorders.

A randomized controlled clinical trial study in 2009 attempted to discover what effects individualized yoga practice had on adolescent patients. These individuals were receiving outpatient treatment for diagnosed eating disorders (anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified). In this randomized study, out of 50 girls and 4 boys, the group that was participating in yoga experienced a greater decrease in eating disorders. The participates who were receiving non-yoga activities showed some initial decline, but then returned to baseline levels after 12 weeks. In this study, the yoga treatment did not have a negative effect on BMI, but the overall therapeutic approach was seen as holding promise as an adjunctive therapy to standard care.

Research in 2016 also asked the question as to whether the practice of yoga provided positive results in an outpatient setting. Specifically, in treating anxiety, depression and body image disturbances among adolescents with eating disorders. In this study, researchers concluded that outpatients eating disorder therapies combined with yoga practice showed decrease levels of anxiety, depression, and body image disturbances. Like the earlier 2009 study, the practice of yoga was seen as a beneficial treatment strategy when blended with multidisciplinary care. However, researchers did add that further study was needed on treatments approaches that presented yoga as a standard element of outpatient eating disorder therapy.

More recent studies from 2018 are continuing to research the application of yoga as a treatment strategy.  A small randomized control trial investigated the impact of an 11- week yoga program for women who were diagnosed with bulimia nervosa or other not specified eating disorders. Interestingly, this small study found that the women experienced benefits from yoga for months after the original research. A more detailed and larger study is planned in collaboration with the University of Buffalo. Like earlier research, this study will document the impact of regular yoga practice as a viable eating disorder treatment. Researchers in this study did note that examining eating disorders is challenging due to the fact that most yoga-eating disorder studies have few participants, short duration window as well as other design challenges. This two-year study will provide eating disorder researchers with an opportunity to collect data on an established, manualized yoga program that serves hundreds of individuals in community, educational and medical settings.

For additional questions about the use of yoga practice to supplement the treatment of eating disorders, please contact the staff at River Centre Clinic. The clinic’s mission is to provide specialized and cost-effective treatment for individuals suffering from eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder, and other eating disorders). An innovative approach to treatment is designed to reduce costs without compromising a high quality of care. They follow a well-established therapy model for treating eating disorders that integrates individual, group, and family therapy. For real-time feedback, their EAT-26 (Eating Attitudes Test) assessment provides anonymous and instant feedback about a variety of eating-related health conditions.

Follow on Twitter:  @River_Centre

Yoga, Eating Disorders

Read more...
image - military helmet - Eating Disorders Among Active-Duty Military Personnel

Eating Disorders Among Active Duty Military Personnel

The United States has one of the best militaries in the world, with just over 1.34 million active-duty troops in 2015. They are prepared to meet any threat or challenge facing the country. However, many Americans are unaware of the personal and mental health challenges facing members of the nation’s armed forces. One of these challenges is the prevention and treatment of eating disorders among the ranks of U.S. military service personnel. Recent studies by the U.S. military indicate that eating disorder diagnoses for members of the armed forces have increased by 26 percent over a period of five years. The same study hints that the actual incidence of these illnesses is likely even greater.

According to research, it is estimated that roughly 30 million Americans will experience some type of eating disorder. Similar studies have shown that there are elevated rates of this disease among the nation’s active duty military members. In particular, the disease appears at higher proportions for women who are enlisted for active duty in the military. This data is not a new phenomenon. Back in 1999, researchers at the Mayo Clinic studied the eating behaviors of 423 women on active duty at Madigan Army Medical Center in Fort Lewis, Washington. This study reported that 8 percent of the women were diagnosed with an eating disorder. For comparison, the incidence of this disease for non-military women is estimated at only 1 to 3 percent of the total population. Active duty service members, including West Point graduates, reported that they feeling pressure from family, school and peers to “make the uniform look good.” This pressure can create a cycle of binging and purging with soldiers feeling like they can never be thin or in shape enough. The same disease also occurs among male active duty service members.

In all of the armed forces, more women than men are diagnosed with diseases like anorexia, bulimia and binge eating. More than two-thirds of cases involved female troops and the overall incidence rate among women, at 11.9 cases per 10,000, was more than 11 times that of males. Interestingly, the overall incidence rate of eating disorders among female Marine Corps members was nearly twice the amount when compared to women Army members. For male active duty service members, the rates were highest in the Army and Marines. Potential reasons for the increased risk for developing an eating disorder while in the military is likely due to exposure to trauma, as well as the need to routinely meet physical fitness and body weight requirements. These factors likely elevate the risk of eating disorders developing among both women and men. Children of military families also reported similar conditions at a significantly higher rate than the civilian population.

Research published in the U.S. Military’s Defense Health Agency’s Medical Surveillance Monthly Report found that incidence rates had risen steadily from 2013 to 2016 before decreasing slightly in 2017. Diagnoses for eating disorders increased from 2.3 per 10,000 to 3 per 10,000 in 2016, before dropping to 2.9 per 10,000 in 2017. “Results of the current study suggest that service members likely experience eating disorders at rates that are comparable to rates in the general population, and that rates of these disorders are potentially rising among service members,” the report states. “These findings underscore the need for appropriate prevention and treatment efforts in this population.”

The need for prevention and treatment of military members and their families suffering eating disorders has not been unnoticed. The U.S. Department of Defense’s (DOD) Peer Reviewed Medical Research Program (PRMRP) has allocated funding for eating disorders research, intervention and treatment programs. Congress first made the topic of eating disorders eligible for funding in 2017. In 2018 Congress is expected to allocate $5 million towards the prevention and treatment of eating disorders. However, federal funding for research on eating disorders is limited, with only $0.93 per person affected by eating disorders compared to other diseases such as autism receiving $44 per person affected.

To complicate matters, there is still a stigma surrounding the reporting of diseases such as eating disorders. Members of the Armed Forces are less likely to seek treatment, making prevention programs and access to treatment an imperative need across all branches. The occurrence of these diseases may, in fact, be much greater among active duty military members.

For additional questions about this topic, contact the staff at River Centre Clinic. Their programs provide a full range of treatment options for women and men with a primary diagnosis of an eating disorder. For immediate and confidential feedback, take River Centre Clinic’s EAT-26 (Eating Attitudes Test) assessment.

Follow us on Twitter:  @River_Centre

Active-Duty Military Personnel, Eating Disorders

Read more...
Scale and tape (RCC)

Body Weight and the Diet Cycle

According to research from Harvard Medical School, eating disorders such as anorexia, bulimia and binge eating, afflict more than 30 million Americans, while millions more experience disordered eating and weight control behaviors. This statistic is even more sobering when one considers the fact that eating disorders have the highest mortality rate of any psychiatric disorder in the United States. Numbers like these have real consequences on people’s health and overall quality of life. Often people are trapped in a vicious cycle of weight gain and severe dieting. In many instances, dieting does not produce permanent weight loss. Instead, it creates an unhealthy diet cycle where a person’s body weight quickly cycles up and down. What is needed is a holistic understanding of health that does not stigmatize body weight. People should focus on healthy behaviors and physical well-being instead of body weight.

The central idea behind the act of dieting tends to create problems. Extreme diets can actually damage people’s metabolism as well as their mental perception of food and eating. This means that individuals can end up in a worse place versus when they started the diet. The diet cycle can start here, with people’s weight gain and loss having a yo-yo appearance. The rise and fall of body weight creates the appearance that people are actually at war with their food (and weight). What is more beneficial for people is an active and healthy lifestyle, as well as an acceptance of their physical appearance and body weight.

When people are informed that they are overweight, there are unintended consequences. This information can reduce people’s satisfaction with their body and create other negative emotions and behavior. This is due to the fact that modern society tends to reinforce the message that “thin” is beautiful and good. People who struggle with their weight tend to also have lower self-esteem. The stigma of being overweight can help to set up a cycle for additional weight gain or the development of eating disorders like bulimia or anorexia. Individuals at all body weights often respond to stress and anxiety by eating. This emotional-induced eating will likely only encourage more weight gain. An increase in body weight can create a feeling of lower self-esteem and anxiety in a person. People quickly become trapped in an unhealthy feed back loop of weight gain and dieting.

More has to be done in order to make it safe to be a larger-bodied person. Most eating disorders are often accompanied by trauma, but body shaming and fat loathing only make these diseases worse. Actions from the fashion and food industry, as well as pop culture, almost seem to encourage eating disorders. However, attempts have been made to address the issues surrounding perceptions of physical imperfections, body weight and fat shaming. A few examples from fashion and marketing are from lingerie retailer Aerie and the increasing popularity of plus-size models. Since 2014, the ad campaigns of lingerie retailer Aerie (American Eagle) reportedly uses non-airbrushed photos of women of various body shapes and colors. Successful Fashion designer Chris Siriano has stated that there have “always been customers of different sizes since day one.” Currently, one half of Siriano’s fashion collection is made in extended sizes. These are positive steps in the right direction, but body weight fears and stigma surrounding fat is still a common occurrence.

For additional questions about the connection between body image, body weight and the diet cycle, contact the staff at River Centre Clinic. Their programs provide a full range of treatment options for children and adults with a primary diagnosis of an eating disorder. For immediate and confidential feedback, take River Centre Clinic’s EAT-26 (Eating Attitudes Test) assessment.

Follow us on Twitter:  @River_Centre

Body Weight, Diet Cycle

Read more...
Pride Flag image - LGBTQ-River Centre Clinic

LGBTQ+ and Advice to Eating Disorder Treatment Providers

Guest contributor:  Lee R.

When asked to write this blog post, I turned immediately to my good friend Google to look up some statistics and check out the latest research. What I found, or what I did not find, was revealing, albeit not entirely surprising to me. Google Scholar turned up 1,360 results for the search “LGBT eating disorder” in the last 10 years, whereas simply “eating disorder” racked up over 59,000 hits for the same time period.

It is not clear whether or not the LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, etc.) community is underrepresented in eating disorder research, but it certainly is not prominent, appearing in only 2.3% of the research references. But that should not be interpreted as meaning that the disease does not impact the LGBTQ+ community. In fact, it’s quite the opposite.

The Trevor Project and NEDA (National Eating Disorder Association) came together in 2018 to research the prevalence of eating disorders in LGBTQ+ youth1 and the results were staggering. About 54% of the sample had been diagnosed with an eating disorder, and an additional 21% suspected they had an eating disorder due to disordered eating habits. In another study2, it was found that nearly 16% of transgender college students had been diagnosed with an eating disorder in the past year, as opposed to approximately 2.5% of their straight, cisgender counterparts.

Though the research on LGBTQ+ eating disorders is scarce, what does exist speaks volumes. Eating disorders run rampant through this community, yet it is rarely spoken about in the LGBTQ+ community itself, and even less frequently in the mainstream eating disorder treatment community. Where there is currently silence, there needs to grow a discussion on how LGBTQ+ eating disorders develop and progress, how they present, and the best treatment modalities to help sufferers receive the best care possible.

That is not to say that mainstream providers cannot appropriately serve the LGBTQ+ community. However, if providers were educated specifically on how eating disorders impact the LGBTQ+ community, there may be an even greater success rate for recovery. As a start, here are 5 things I, and a few others in the community, wish treatment providers were more aware of:

  1. Gender dysphoria exists and can make it difficult for a person to live in their own body. Gender dysphoria is the feeling of distress that occurs when someone’s gender does not match the one they were assigned at birth. It can often focus on specific parts of the body that society reads as one sex or another. It can result in restriction of food, compensatory behaviors, or binge eating. Providers need to be aware of gender dysphoria, because of the added complications to recovery. Poor body image or body dysmorphia is not the only physical hurdles in those who experience gender dysphoria. Additionally, gender dysphoria is not necessarily due to poor body image, though one may trigger the other.
  2. Internalized homophobia is also a thing that exists. Internalized homophobia refers to the prejudices that members of the LGBTQ+ community turn inward after seeing and hearing the prejudices in society. This can lead to negative views and even shame of their own sexuality. This shame and negativity can then lead to further flawed thinking and disordered eating habits.
  3. Language is important. Using my pronouns is not just a suggestion. While I’ll probably present it as a timid request and tell you “it’s fine” when you mess them up, my pronouns are actually very important to me. They help me feel more at peace with who I am, especially in such a tumultuous time as the beginning stages of eating disorder recovery. By using the correct pronouns for me, you not only convey that you respect who I am, you also help me build trust and rapport. Additionally, using gender-neutral language is imperative. People of all genders can have eating disorders, using female-centric language is outdated. Help everyone feel at home by neutralizing your language.
  4. Do not assume we are just confused. I identify as a queer non-binary person. I am not confused about who I love or what gender I am; I am completely confident in both aspects. And it is quite possible your clients will be too. When they do come out to you, know that this means they trust you. Do not insist that it’s “a phase” or that it’s due to their eating disorder. In fact, it’s likely the other way around: eating disorders often develop and progress due to minority stress, internalized homophobia, and gender dysphoria. If your client is in the beginning stages of exploring their gender and/or sexuality, do not diminish their journey by crediting the eating disorder.
  5. Having culturally sensitive resources available to us is so important. Whether it’s an LGBTQ+ process group, a therapist who is a member of the LGBTQ+ community, or even something as simple as gender-inclusive bathrooms, having resources readily available to us helps us feel included and heard. Knowing that a treatment team is culturally competent can be a great relief for LGBTQ+ people who may otherwise have felt like they needed to keep their identity a secret.

This list is by no means extensive; it really is just a beginning. Every client is unique, and the best way to get to know what they want you to know is to open an honest conversation with them.

I have found in my experience that the staff at the River Centre Clinic is willing to have those honest conversations with their patients. When I first arrived at RCC in 2014, I was unsure if I wanted to come out as genderqueer. I began by talking about it with several of the other patients who then encouraged me to tell the staff. Once I did come out to everyone, the support I received from the staff and my peers did not waver. The staff was willing to learn more about my identity and use the pronouns I chose. Even when I returned in 2016, they remembered my identity and treated me with the same respect and compassion with which they treated everyone else. I believe that the acceptance I received was a vital component in making my recovery as strong as it is today.

Follow us on Twitter:  @River_Centre

 

1 – National Eating Disorder Association. (2018). Eating Disorders Among LGBTQ Youth [Press release]. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/nedaw18/NEDA -Trevor Project 2018 Survey – Full Results.pdf

2 – Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D., & Duncan, A. E. (2015). Gender identity, sexual orientation, and eating-related pathology in a national sample of college students. Journal of Adolescent Health, 57(2), 144-149.

Read more...
River Centre Clinic

Muscle Dysmorphia, Eating Disorders & Males

The term eating disorder is commonly associated with younger women, even though research has shown that eating disorder symptoms and behaviors also occur in women over 50. However, this stereotype that eating disorders only appear in females is a misconception. Studies have shown that eating disorders do not discriminate, with males also suffering from this potentially lethal disease. Some studies have shown that males account for an estimated 5 to 15 percent of patients with anorexia or bulimia. Symptoms of binge-eating disorder are displayed in 35 percent of males. In males, especially boys and young men, these illnesses create a distorted sense of body image. For males, this distortion is often in the form of muscle dysmorphia, a type of disorder characterized by an extreme concern with becoming more muscular.

For boys and young men with muscle dysmorphia and related disorders, they want to lose weight or gain weight in order to “bulk up.” Young men who believe they are physically too small may actually start using anabolic steroids or other dangerous substances in an attempt to increase their body’s muscle mass. Eating disorders and muscle dysmorphia are listed separately in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. However, the occurrence of these disorders is often seen as a collection of related behaviors. Both are the direct result of over-evaluating an idealized body type, which fuels either a drive for leanness, muscle mass or both. These eating disorders and body image distortions can give rise to disordered eating behaviors in boys, young males or even older men. Yet, in pop culture and society at large, muscular bodies are encouraged for boys. In American sports, being lean and muscular is seen as a beneficial attribute for nearly all sports. In fact, in certain athletic activities such as wrestling and gymnastics, severe weight and eating control is almost encouraged. So how do parents and loved one identify what is healthy versus unhealthy eating in boys and young men?

One question to ask is whether the person with the potential eating disorder is prone to anxiety, depression and perfectionistic tendencies. Other warning signs include people who have been bullied, felt too skinny or have struggled with their weight. These are all contributing factors for boys to develop some type of eating disorder. People should also consider their family’s personal history when considering whether or not a loved one is struggling with some form of muscle dysmorphia or related eating disorder. Risks are increased if there is a family history of eating disorder behaviors or anxiety issues. What are the family norms surrounding food and body image? Adults in a family are often the role models for their children. If discussions of weight and body shaming are frequent topics, kids will notice. From a mental health standpoint, the goal is to have a healthy sense of self and body. Excessive behaviors are usually a sign of a deeper issue. With this in mind, here are four warning signs to watch for in boys and young males:

  • Engaging in extreme dieting.
  • Quickly losing or gaining body weight.
  • Obsessing over dieting.
  • Binge eating and vomiting.

The presence of these behaviors could indicate that an eating disorder is developing. If this is the case, it is better for an individual to receive treatment as soon as possible. Earlier treatment has a better likelihood of success since these disordered behaviors will have less time to become entrenched habits. The concern is not only for the boy’s emotional health, but also for his physical health. Good physical fitness is great, but obsessive behaviors and perfectionism are not. If all signs point to a problematic body image and the existence of an eating disorder, it is beneficial to see a mental health professional who specializes in treating these conditions. Sadly, this topic is rarely talked about among young males. There is still a stigma surrounding publicly discussing mental illness. An additional stigma exists due to the fact that eating disorders are still seen as a women’s issue.

For additional questions about eating disorders in boys and young men, contact the staff at River Centre Clinic. Their programs provide a full range of treatment options for children and adults with a primary diagnosis of an eating disorder. For immediate and confidential feedback, take River Centre Clinic’s EAT-26 (Eating Attitudes Test) assessment. It is a widely cited standardized self-report screening measure that can help determine whether an individual has an eating disorder that requires professional treatment.

Follow us on Twitter:  @River_Centre

Read more...
social media-smartphone

Social Media and Orthorexia

Social media’s pervasiveness throughout society is well-established. Individuals from a variety of backgrounds read and actively use some type of social media channel. The mass adoption of this new communication form is starting to generate questions and concerns. One of these questions ask as to whether the use of social media makes people more susceptible to developing an eating disorder? A new study suggests that specific social media channels might actually lead to unhealthy obsessions with healthy eating.

Incidents of depression have been linked to heavy social media use. For example, there is an increasing amount of evidence that connects the amount of time spent on Facebook with the occurrence of depression. Other studies have also suggested that the extensive use of social media by young adults has a negative impact on body image, depression, social comparison, and disordered eating. Beyond these negatives, social media sites that offer the newest superfood or latest diet fad may be just as damaging. Studies are beginning to see a correlation between disordered eating – particularly orthorexia, or an obsession with eating healthy foods that can lead to unhealthy consequences like nutrient deficiencies, social isolation and anxiety.

Although not formally recognized in the Diagnostic and Statistical Manual, awareness about orthorexia is on the rise. Being concerned with the nutritional quality of the food is not a problem and is actually a good habit to develop. However, individuals with orthorexia become so fixated on what is considered healthy eating that they actually start to damage their own well-being. Studies have shown that many individuals with orthorexia also have obsessive-compulsive disorder. High orthorexia nervosa prevalence has been found in populations who take an active interest in their health and body and is frequently comorbid with anorexia nervosa. In particular, there seems to be a link between Instagram users and signs of orthorexia symptoms.

In 2017, a study in Eating and Weight Disorders found that a whopping 49 percent of people who followed health food accounts on Instagram had orthorexia. By contrast, less than 1 percent of the general population has the “condition,” which, by the way, isn’t an official diagnosis or classified eating disorder. The correlation between Instagram users and the increased symptoms of orthorexia nervosa is surprising. Especially, due to the fact that higher Instagram use was associated with a greater tendency towards orthorexia, but no other social media channels had this effect. Additional analysis indicated that Twitter showed a small positive association with orthorexia symptoms. Other features such as Body mass index (BMI) and age had no association with orthorexia. As a reminder, the prevalence of orthorexia nervosa among the study population was 49 percent, which is substantially higher than the general population which is less than 1 percent.

Understandably, people use social media to discover healthy eating tips or to stay accountable to a fitness plan. But the pursuit of nutritious eating can become an unhealthy preoccupation. The pursuit of the perfect diet can lead to self-punishment and interfere with social activities. Eating disorders and disordered eating behaviors do not discriminate; they can affect women, men, girls and boys. For some people, especially women, healthy eating becomes practically synonymous with deprivation. This means that the typical warning signs for eating disorders, distressing thoughts, compulsive behaviors and self-created rules around food, often go unnoticed or are even praised. This is despite the fact that restrictive diets are sometimes precursors to clinical eating disorders. According to the National Eating Disorders Association (NEDA), food inflexibility can lead to guilt or self-loathing if a “bad” food is consumed, as well as anxiety about food planning and isolation from social events with food and drinks.

The signs of orthorexia include compulsively checking nutrition labels, an inability to eat any food that is not designated pure, obsessively following healthy lifestyle bloggers or social media figures, and showing an unusual interest in what kind of food others are eating. Naturally, people can read nutrition labels and follow fitness experts on Instagram without being orthorexic. But, when the action becomes compulsive and obsessive, this may indicate something beyond following a healthy food plan is occurring. Does the individual feel required to check labels, perhaps even multiple times, even though they have purchased this item in the past and already know the nutritional content? When eating food, does the person feel anxious about eating in general? These are perhaps symptoms of an eating disorder like orthorexia. If untreated, orthorexia can lead to anorexia nervosa, since eating disorders are rooted in compulsivity and obsession surrounding food. According to NEDA, orthorexia is characterized by being consumed with good vs. bad or healthy vs. unhealthy food, while anorexia is characterized by obsessive caloric restriction and weight loss.

Orthorexia is not yet officially recognized by the DSM-5. However, Healthcare practitioners skilled at recognizing eating disorders will know the signs of orthorexia and can connect patients with the appropriate therapists and medical doctors. Doctors and therapists who specialize in eating disorders and mental health, such as those at the River Centre Clinic (RCC) in Ohio, are aware of orthorexia’s prevalence and risks. For additional questions about this topic or other behavioral health issues – please contact us.

 

Eating Attitudes Test (EAT-26)

The EAT-26 is the most widely cited standardized self-report screening measure that may be able to help you determine if you have an eating disorder that needs professional attention. Take the EAT-26 now and get immediate and anonymous feedback.

Follow us on Twitter:  @River_Centre

 

Read more...
Image of singers

Eating disorders: From Pop Stars to Everyday People

From famous entertainers to the average person on the street, eating disorders are the silent battle that many people fight alone. Recently, pop stars like Demi Lovato and Kesha have both disclosed their struggles with eating disorders. Lovato told Insider that she is open about the challenges she faces with weight control and maintaining a positive body image. In a recent article in Cosmopolitan, Kesha shared a similar story but spoke of her success with overcoming body issues. However, there are numerous other people who do not have the spotlight of a pop star to share their pain and triumphs. They are not as well-known, but their everyday struggles with eating disorders are just as real.

Currently, there are over 30 million people who suffer from some type of eating disorder. There are still stigmas around mental illness, and this is true for eating disorders. Whether in Michigan, Iowa, or Ohio; the stories are very similar. These are stories of individuals confronting the pain of this affliction. In a story from Michigan, one woman reflects back on high school and remembers feeling proud that she “hadn’t eaten anything that day.” Eventually, she realized that something had to change. A mother in Iowa shares a similar story about her battles with and recovering from anorexia. “Eating disorders are a lot about control, and there was a lot in my life that was out of control. This was something I could control. And I grew up feeling like I wasn’t good enough or really worthy.”

In Ohio, an anorexia survivor has even created a short film that documents the doubt and isolation that is part of this mental illness. In this instance, the individual who has struggled with anorexia is a male, even though the disease is mistakenly thought of as a women’s disorder. He remembers thinking that “I could never tell people what I was going through because they never would believe me, or maybe it wasn’t even real.” His short film is intended to raise awareness and remind people that they are not alone and help is available. Recovery is possible. On a side note, males make up about 25 percent of eating disorder diagnoses.

Across the nation, eating disorders plague a wide variety of people. Yet, treatment options are available that can bring hope to those who are suffering in silence. For additional information, or if you have questions about eating disorders and recovery solutions, please contact the staff at River Centre Clinic (RCC). With decades of experience, their Eating Disorders Programs provide a full range of treatment options for adolescents and adults with a primary diagnosis of an eating disorder. The levels of care provided at the RCC are designed to meet the needs of most patients with eating disorders, but it is important to note that treatment is individualized for each case. We follow a well-established therapy model for treating eating disorders that integrates individual, group, and family therapy. The River Centre Clinic is located in a modern, spacious and tranquil setting in Sylvania, Ohio.

Eating Attitudes Test (EAT-26)

The EAT-26 is the most widely cited standardized self-report screening measure that may be able to help you determine if you have an eating disorder that needs professional attention. Take the EAT-26 now and get immediate and anonymous feedback.

Follow us on Twitter:  @River_Centre

Read more...