Tag - Eating Disorders

Outside Yoga Class (River Centre Clinic)

Can Yoga Help Treat 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 1990’s, 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. Today the National Eating Disorder Association reports that over one-third of Division 1 NCAA athletes have symptoms that place them at risk for anorexia. Most people think that only female athletes are at risk for an eating disorder, however, male athletes are also at risk—especially those participating in sports where diet, appearance, size, and weight are of importance such as wrestling, bodybuilding, crew, and running. (more…)

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Orthorexia Nervosa versus Anorexia Nervosa?

Anorexia nervosa is a well-known eating disorder that afflicts both women and men. The disease creates an extreme fear of weight gain in people who suffer from it. Symptoms include not eating, binge eating and purging, also known as bulimia. However, there is a lesser known eating disorder that shares similarities to anorexia, but is still different. This disorder is known as orthorexia nervosa and was first described in 1998.

Orthorexia means an obsession with proper or healthy eating. Having a concern with the nutritional quality of the food is a healthy behavior, but problems occur when this concern becomes excessive, damaging and disruptive. Individuals with orthorexia become so fixated on what they perceive as healthy eating that they actually damage their own physical and emotional well-being.

Is Orthorexia Nervosa the same as Anorexia Nervosa?

Many of the symptoms and behaviors surrounding orthorexia tend to overlap with anorexia. Yet, in cases of anorexia, people tend to focus more on severely restricting the quantity of food (calorie count). There is a clear and forceful desire to not gain weight. This, in turn, creates behavior that focuses on excessive exercising in order to lose unwanted weight. However, these are separate inflictions.

Since orthorexia is a newer diagnosis, it still possesses varying levels of acceptance among eating disorder treatment professionals. Some eating disorder specialists regard orthorexia as a discrete diagnosis like anorexia nervosa or bulimia nervosa. There are reports that signs of orthorexia are perhaps increasing due to the use of social media to popularize extreme diets and other food-related behavior. Other health professionals, believe that patients with orthorexia symptoms are actually suffering from anorexia nervosa. The symptoms for orthorexia and anorexia have similarities such as:

  • A desire to maintain control of life by severely controlling daily food consumption.
  • Seeking self-esteem and fulfillment through controlling food intake.
  • Citing undiagnosed food allergies as a rationale for avoiding food.
  • Co-occurring disorders such as OCD or obsessive-compulsive personality disorder.
  • Elaborate rituals about food that may result in social isolation

What Is Orthorexia Nervosa?

There are still very few studies on the Orthorexia, but theories suggest that it is based on anxiety and/or depression much like other eating disorders. It is for this reason that the occurrence of orthorexia is typically accompanied by other eating disorders such as anorexia, bulimia, or binge eating disorder (BED). Which means a person’s orthorexia can co-exist with a bulimia disorder. This means an individual could binge on seemingly healthy foods (vegetables) and then purge the food in order to get rid of the calories.

Unlike bulimia though, people with orthorexia can hide their disease by displaying their symptoms in plain sight. At initial glance, people suffering from orthorexia appear to be simply taking care of their physical body. Individuals with orthorexia may even talk about how they are about their eating habits. But, this healthiness is an illusion. There is a difference between conscious, healthy eating and having orthorexia nervosa. Orthorexia is similar to obsessive-compulsive disorder (OCD), in the fact that people must create rules and engage in specific rituals around food.

Some trendy or extreme diets can trigger behavior that resembles orthorexia. However, simply adopting an alternative diet, whether based on science or pseudoscience, does not mean someone has orthorexia. For example, some people adopt a trendy diet that restricts certain food groups: Vegan, gluten-free, Paleo diets, etc. The adoption of these diets does not automatically create an orthorexia diagnosis.

Orthorexia turns eating into a pathological activity that becomes entangled with obsessive thinking, compulsive and ritualistic behavior and self-punishment. Individuals with orthorexia often use a diet to achieve a feeling of perfection, purity or superiority. They may feel judgmental towards people who do not follow their perfect, healthful diet. This means they often spend excessive amounts of time planning and researching “pure” foods, which interferes with participation in normal social activities and interactions. These symptoms are what turns a trendy diet into orthorexia nervosa.

How are Orthorexia Nervosa and Anorexia Nervosa Different?

Obsession with weight is one of the primary signs of anorexia, bulimia, and other eating disorders. But this is not a symptom of orthorexia. Instead, the focus for people with orthorexia is an excessive obsession with the health implications of their dietary choices.

People with anorexia will severely restrict their food intake in order to lose weight. People with orthorexia, however, strive to feel pure, healthy and natural. The focus is on quality of foods consumed instead of the quantity. In the end, it is critical that people with eating disorder signs and symptoms seek appropriate clinical advice from a professional with experience treating orthorexia, anorexia as well as other conditions. The obsessive tendencies associated with orthorexia can indicate a co-occurring disorder that should be diagnosed and treated by a psychiatrist.

There are definite similarities as well as differences between anorexia and orthorexia. Both of these eating disorders tend to provide a sense of control and stability around the consumption of food. Again, both eating disorders are dangerous mental illnesses that require professional treatment from a skilled clinician.

For additional information or questions about anorexia and orthorexia, please contact the experienced staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The 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 on Twitter:  @River_Centre

Orthorexia Nervosa, Anorexia Nervosa,

Contributor: ABCS RCM

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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

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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

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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.

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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

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Six Tips to Prevent Relapse

A residential treatment program can become a safe space for many patients. It may feel scary going back to your home, job, or school. While in treatment, you have invested time working on your recovery and hopefully whatever environment you are returning to can foster a pro-recovery environment. Despite the environment, many patients have a few slips during the recovery process post-treatment. River Centre Clinic’s hope is that you have learned strategies to prevent those slips from becoming a relapse. These five tips are not all-inclusive, but they are some of the best strategies to ensure recovery.

Meal plan.

While in treatment you have learned how to meal plan and it most likely began to feel like a normal process towards the end of your stay. However, directly after treatment, meal planning may feel inflexible. It may be tempting to not follow your plan precisely or to completely stop planning. Rest assured that you will not have to meal plan forever to maintain your recovery. While the timeline differs for each individual as to when they can stop meal planning, patients who stick to their meal plan as ordered are less likely to relapse. Be open and honest with your outpatient therapist regarding your concerns with meal planning and create a strategy that works for both of you.

Connect with your outpatient treatment team regularly.

Before you leave residential treatment, you will have hopefully connected with an outpatient therapist and set up your first appointment post-treatment. Talk to your therapist to determine who else you should connect with to create a team of health professionals that advocate for your recovery. Often a team including a therapist, dietitian and primary care physician, all skilled in treating eating disorders, are highly beneficial for post-treatment care.

Utilize your team.

Connecting with a team of skilled health care professionals post-treatment is a vital part of recovery. Just as important, is connecting with a team of friends and family. Your tribe should include people that you feel comfortable talking to about your eating disorder, meal plan and urges. Take time to talk to these special individuals about the type of support you need. Ask your therapist if you can schedule a designated appointment for your tribe to help them understand your recovery
process and how they can help.

Define one self-care ritual and stick to it!

Stress is inevitable and it can make recovery more difficult. But you can combat stress by taking care of yourself and incorporating self-care into your daily routine. Self-care can look different depending on the individual. Do you enjoy reading, a nice hot bath, journaling, listening to music, meditation? These types of activities can be incorporated into your routine to help manage stress.

Know the difference between a slip and relapse.

A slip usually happens suddenly and may take you by surprise. Maybe you were having a particularly busy day and realized at 4:00 p.m. that you missed your afternoon snack. If you’re able to get right back to your planned meals and squeeze in the missed calories, consider that a slip. While a slip is still a setback, it’s much more minor than relapse. Relapse is when a slip turns into consistent eating disorder behaviors. To prevent this from happening, acknowledge a slip if it occurs. Call someone in your tribe or your therapist, if you are able to, so that they can help prevent guilt and shame that you may feel from your slip. These feelings will only exacerbate the problem. Focus on the progress you have made and brainstorm
solutions to prevent a future slip.

Make your own stoplight list.

How will you know when you are falling back into old eating disordered habits? By creating a personalized red, yellow and green flag list with the help of your therapist, you will have a written set of guidelines which will help you to recognize when you need to reach out for assistance. Look specifically at your own personal relapse cues and recovery behaviors and create a comprehensive list. Being sure to identify high-risk indicators that you are doing poorly (red flags), warning signs that you are slipping back into old habits (yellow flags), and signs that you are living a recovered lifestyle (green flags) is integral to keeping on track. Be sure to include both physical and emotional indicators of each.

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