Heavy Hearts: Subtle Shifts to Cope When The World Feels Too Scary

Heavy Hearts: Subtle Shifts to Cope When The World Feels Too Scary

Angie Viets, LCP, CEDS

Photo by Cathal Mac an Bheatha

This article has originally been published on Psychology Today.

Friday morning in between sessions with clients a colleague called. A teenager at a high school nearby had committed suicide after arriving at school that morning. My heart sank. She informed me that the school had released all of the students for the day and that they’d canceled the football game scheduled that evening. 

The remainder of the day it looked as though it was business as usual for me. Meeting with clients, picking up my kids from school and ordering in pizza—our Friday night ritual, yet, I couldn’t shake the sadness of the seventeen-year-old girl who ended her life that morning. I carried her around with me wondering how we might have spared her from suffering so intensely. My thoughts drifted to the trauma for the teens entering the building that morning, worried they weren’t fully prepared for a chemistry exam or frustrated about some drama amongst their peers, and then the unimaginable happens, and everyone is shuffled back onto buses and into worried parents’ cars. The faculty, I imagine, remain to deal with the aftermath. Oh, but the family—my heart drops further—how do they go on when their sweet girl is no longer? 

Still asleep, my five-year-old rushed in on Saturday morning, “Momma, it’s a home day!” Yes, today is a home day (i.e., a non-school day) and with the sun shining brightly through proclaimed black-out curtains I thought of the family who didn’t have the gift of a very typical Saturday. 

I’ve trained myself in times like these to send love to those hurting in my mind’s eye and to bring myself back into the present moment—the list I need to make for the grocery store, the laundry that must be started, and the endless errands I need to run. Present moment attention helps those of us highly sensitive creatures not to get caught so profoundly in a web of sadness. Dwelling on the news of another’s tragedy is just as unhealthy as ignoring it altogether. 

Sunday morning as I sit in a driveway, waiting—as mothers endlessly do—for my thirteen-year-old to gather his things from a sleepover I check Facebook. I’ve barely begun the mindless scrolling and then the headline from my local newspaper takes my breath away, “Three Murdered on Mass Street.”

Interrupted by my oldest, the one I’m attempting to allow a little more freedom, he hops into the car with bedhead and big news, “Mom, last night was insane. Lil Yachty was seriously like five feet away from me.” 

He’d gone to Late Night at Allen Fieldhouse the night before, the celebratory kick off for the University of Kansas’s basketball season and they’d brought in one of my son’s favorite rappers to “hype everyone up.” Later, while my son and his buds played X-Box until wee hours of the morning, three kids in their early twenties were murdered after leaving the bars in our sweet little college town.          

My brain couldn’t fathom the scene. Mass Street, the same street where we spend countless hours at quaint restaurants, shopping at locally owned stores, and hanging out at coffee shops while writing my first book was a crime scene only hours before. For years, I too wandered out of bars on that same street as a college kid, eager to make plans for the afterparty as I imagine they were also until shots were fired and the scattering ensued. The fear, terror and grief others experienced nagged at me. How could we have intervened? How could this happen? I spin out. I’m missing the excitement of my son as he tells the story of his favorite basketball players. Present moment, I think. Be here. Right now. First, pause, send love to those hurting today.

Monday morning I groggily make my way into the kitchen to pour the elixir into my favorite coffee cup. My husband, already busy packing lunches for the kids, nods at the tv, “You’re never going to believe what’s on CNN this morning.”

I walked into the living room where images of the Mandalay Bay in Las Vegas, the same Las Vegas my dad said he and my step-mom are headed to this week, flashed on the screen. Blurred images of a stampede of people fleeing in the dark, beneath it the words scrolled across, “Deadliest Mass Shooting in US History.” At the time it was believed fifty were dead and over two hundred injured.         

Horrified and aware of the time I started the shower, woke up sleeping children and began the usual routine of getting ready for work and rushing kids off to school. I thought of my son’s excitement to see a performer he loved on Saturday night. I imagined that same level of excitement of all the fans enjoying an outdoor concert of one of their favorite country musicians, and then, in what initially seemed like fireworks to enhance the performance, the utter terror of somehow comprehending the bullets pouring from the sky and penetrating innocent friends and family members without warning. How on earth can we live in a place where this happens? 

The toll from the teen’s suicide on Friday, the three college-age kids dead from a shooting just a short distance away while I slept, and the largest mass shooting in our country's history settled in. I felt myself shifting from sadness into fear. Without realizing it I unconsciously began creating a mental list of all the things we wouldn’t do or would change in an effort to keep safe. 

1. No outdoor concerts. (I recall the outdoor concert I took my son and his friends to this Summer. The joy in their faces as their idols hit the stage). Nope, don’t think about that. We won’t be going anymore. Too unsafe.

2.  Do my kid’s need to attend private schools so they don’t witness a classmates suicide while in high school? That’s absurd; I know the stats, suicide is rampant, the second leading cause of death among those ages 10-24, suicide doesn’t care what school you attend. 

I shifted into a place of helplessness and hopelessness. I can’t protect them, those I love most, from tragedy. I shift to Glennon Doyle, my favorite author saying, in a talk while I sat in the front row, “We are going to lose each other.” She too, a yellow canary, a highly sensitive soul couldn’t bear the pain of this life for many years, and she hid out in an eating disorder and substance dependence. She shared in her book, Carry On Warrior, that addiction was a safe place to numb out and protect herself. She recognized, as she sat with a positive pregnancy test, that such self-destructive behaviors had to end. Becoming a mother was her invitation to find a new way of being. She realized, as she sat in one hospital holding her newborn niece on the same day that in another hospital she said goodbye to her beloved grandmother that life is ‘brutiful.” Glennon encourages us to embrace both the beautiful and brutal parts of life. “We can’t have one without the other.”

Resistance.

My brain fights against this notion as the death toll rises in Vegas. I recall a conversation, not so long ago when I learned of several untimely deaths of people around my age, with my therapist (yes, therapists have therapists!). Nearing forty I was bumping up against my mortality, and I wasn’t too happy about it. At all. Not one part of it. I looked at her, the same way I remember looking at my mom when I was in labor for the first time, my eyes pleading, “I can’t do this. And PS: Why the hell didn’t you tell me it was going to be this painful?” 

“You know those documentaries about the inhumane treatment of animals?” I say. “I just keep thinking of us, much like all the cows that are crammed up against each other while being herded towards the slaughter area. I feel like we are the cows, all just crammed together waiting to die.” (I know this is morbid and dark, but this is how it felt in the moment). 

She looked at me, more reasonable, more comfortable with the truth, that yes, in fact, we all are going to die. “What would it be like for you, instead of being trapped in terror, to look at those who are shoulder to shoulder with you and find some comfort that at least we are all in this together.”?

Ah, yes. There’s that. I felt some relief as I recalled my favorite quote, “We are all just walking each other home.” Together.

Although today is not an ordinary day for many who are suffering, I think the best any of us can do is be present to each other and our lives when we do have the extraordinary gift of a typical day. To extend ourselves to those who are most in need in whatever form that takes for you—a donation of your time, a monetary contribution towards efforts to relieve those suffering in some small way, or simply sending healing energy to those in pain. 

As I walked past my coffee table on Monday evening, weighted and worried, I saw the title of a book a dear friend sent me, Only Love Today. What would I do right now, this very second if I was only to give love today? My golden retriever, eager for my attention, was my answer. If I focused on love instead of fear I would turn off the news for awhile. Mosley and I took a long walk and as we tiredly made our way up the hill back home, I stopped as at least fifty geese flew by in their hallmark V-shaped formation. I felt a sense of wonder as it seemed the number of geese flying overhead would never end. They poured endlessly, effortlessly from the sky. I heard a little girl down the block excitedly saying, “Daddy, daddy! Do you see all of the birds?” 

When the last of them had passed Mosley and I found our way back home. My heart was softened. Only love today. Only. Love. Today.

Angie Viets, LCP, CEDS is a clinical psychotherapist and certified eating disorders specialist in private practice. She specializes in the treatment of eating disorders, body image, and overeating. Angie is dedicated to empowering others to nurture their body, mend their relationship with food, and to embody their most authentic self. Her passion for the field was born out of her own hard-won battle with an eating disorder. She believes that full recovery is possible!

Angie has a thriving website that offers resources for people in recovery and was voted #1 on Healthline's list of the Best Eating Disorders Blogs of 2017. She is currently in the process of writing her first book, where she will demystify eating disorder recovery and offer inspiration and guidance to those suffering in silence. Her writing is featured in Huffington Post and recognized eating disorder treatment centers throughout the country.

Be Careful What You Tell Your Brain

Be Careful What You Tell Your Brain

Karen R. Koenig, M.Ed., LCSW

You are not only what you eat, but what you tell yourself. Nearly every week, a client comes into my office and tells me how “overwhelmed” she is. She’ll say it multiple times: “I’m so overwhelmed” or “I’m really overwhelmed” or “Boy, am I overwhelmed.” Although I encourage clients to connect to their emotions, I don’t encourage them to keep reminding themselves of feelings they don’t need to be having.

Our brain more or less understands only commands and translates more complex ideas into them. It hears our self-talk and does what it thinks we want it to do. So that, “I’m overwhelmed” tells the brain to feel pressured, “I’m miserable” instructs it to be unhappy, and “I’m scared” signals it to feel fear. This is, of course, the exact opposite of what you want to be telling your brain when you’re overwhelmed, miserable or scared. 

Try an experiment. Set a timer and for one minute repeat to yourself that you’re overwhelmed, scared, miserable, sad, fatigued, or some other “negative” emotion. Make sure to say it as if you really mean it, the way you would when you actually feel it. When one minute is up, check your feelings. Notice your bodily sensations and posture and what you’re thinking about. Generally, people end up feeling what they’ve been saying. If you don’t, continue the experiment for five minutes and check in with yourself again.

Then, follow this procedure and this time tell yourself that you’re happy, proud, joyful or glad to be alive. Again, notice your bodily sensations and emotional state. Extend the experiment to five minutes if needed and do another assessment.

I’m not telling you to deny your emotions. You just want to be careful that you’re not causing an emotion to happen because you keep repeating that you feel a certain way. Obviously, if you’re feeling hurt or mistreated by someone, you don’t want to brush that off or turn it into a positive feeling because this is crucial information for your happiness. But, there’s a big difference between self-talk that allows you to explore, say, feeling hurt, betrayed, or invalidated and directing your brain to make you unhappy.

If you tend toward focusing on negative emotions, just be careful what you tell yourself and aren’t reinforcing them. Rather, tell yourself how you wish to be feeling, not how you currently feel. Turn “I can’t stand this” into “I can manage this” and “I’m overwhelmed” into “I’m really busy.” There’s even a big difference between calling yourself “overwhelmed” and “busy.” Use the past tense to describe how you don’t want to feel—“I’ve been unhappy”—and the present tense to direct your brain how you wish to feel—“I’m feeling better and better every day.”

Karen R. Koenig, M.Ed., LCSW, is an international, award-winning author of seven books on eating, weight and body image, a psychotherapist with 30 years of experience, a health educator, and a popular blogger. Her expertise is in eating psychology and helping over-eaters and binge-eaters improve their self-care and become “normal” eaters. She lives and practices in Sarasota, Florida.
Visit her website

Expert Tips: When You Want To Give Up On Recovery (+ Journaling Prompts)

Expert Tips: When You Want To Give Up On Recovery (+ Journaling Prompts)

Josée Sovinsky, RD

Photo Credit: Shutterstock

Recovery from an eating disorder (or any other mental illness) is a journey. With my clients, I celebrate many recovery wins, but I also support them through difficult moments. Let's get real here: Recovery is HARD. It requires a lot of work, patience and dedication. Because we are human, this can sometimes become very overwhelming.

To help get you through those moments, I connected with colleagues in order to put together a list of tips for when you feel like giving up on recovery. For those who find journaling helpful, I also included some prompts. 

1. Remember Why You Want To Recover

Somewhere in your initial struggle, you decided it was time to heal. There is a reason why you started this journey. In those difficult moments, think of what makes recovery important to you. Will it allow you to spend more time on your hobbies and passions? Will it make you more available for connection?

Blair Mize, MS, RDN, CSSD, LDN, owner of Memphis Nutrition Group says : "Before giving up on recovery, take some time to think about and write down why you started pursuing recovery in the first place. By taking a look at where you started and noting milestones along the way, you may begin to see how far you've come and why making a full recovery still feels worthwhile."

Journaling Prompt: Why did you start your recovery/healing process?

2. Consider How Recovery Fits Into Your Goals and Values

A very powerful tool when working on recovery is thinking about your goals and values. Once you have established your values, you can think about how these are connected to recovery. For example, you may value family. Recovery is then in line with your values since it might allow you to spend more quality time with your family. 

Before giving up on recovery, Paige Smathers, RDN, CD encourages you to take a step back and look at the big picture of your life. What do you want? As in, what do you REALLY want? Then, ask yourself how you get there. Check in with yourself by recognizing when your thoughts and desires for life are coming from a place of trust, respect, and fulfillment and when your desires might be coming from a space of bullying yourself and/or punishing yourself. 

As Poonam Sahasrabudhe MSW, LSW reminds us, giving up on recovery and giving in to the eating disorder can be very tempting. Going back to what is known can be comforting. Try to remember how you felt in the eating disorder and ask yourself: Will going back to the eating disorder get you to your values? Will it help you feel more authentic and fulfilled? Will it help you feel more connected in relationships? Will it launch you toward your goals? Remember that you are amazing for your awareness and even considering changing what isn't working for you. 

Journaling Prompt: What are your 3 most important values? How does working on recovery relate to these values?

3. Remember This: Recovery Isn't Linear

Recovery is a journey with many twists and turns. Annina Schmid (M.A., CCPA, OACCPP, CACCF) shares that recovery isn't a linear process, and a so-called "relapse" won't take you back to the place that you started from. It is important to acknowledge the good and the difficult days. Don't act on impulse, think about your choice today as a long-term investment in your future. 

Journaling Prompt: What are 3 things you have learned in your healing process?

4. Be Kind With Yourself

I'll say it again: Recovery takes hard work. When we are being hard on ourselves in the process, it adds an extra layer of difficulty. I recognize it's easier said than done but do your best to approach yourself with kindness and compassion.

Remember you are doing the best you can with the tools you have. 

I couldn't agree more with Edith Shreckengast, MS, RDN, CSSD who shares, "You are a warrior and recovery is sincerely and utterly allowing yourself to live again. Take a deep breath and ask yourself what your truest desire out of recovery is? There is no right or wrong way of recovery, but there is your way. That way is beautiful and unique in which no one else can replicate."

Dr. Maria Paredes, LPCS, CEDS, Licensed Professional Counselor, Clinical Supervisor, Certified Eating Disorders Specialist and owner of Three Birds Counseling reminds us that unlike the diet industry's messaging of "just do these 5 steps" or "take this silver bullet pill" or "30 days of this and you'll be happy," the recovery road is long and windy and complicated and often exhausting. But, it's worth it. YOU are worth it. The best advice she has is just to be kind to yourself. No matter what *steps back* or *wagons* you think you've fallen off or *mistakes* you feel you've made, still. Even then, be kind to yourself. 

Journaling Prompt: What are 3 ways you can show yourself compassion?

The Bottom Line

There will be many ups and downs during recovery. This is normal. In those moments of despair, remembers why you want to recover and how recovery aligns with your values. Approach the situation which as much self-compassion as possible and as Dory said, "Just keep swimming". 

You've got this, recovery warrior!

Josée Sovinsky is a passionate Registered Dietitian working in a community setting in Toronto, Ontario. After facing her own struggles with disordered eating during her degree, she developed a strong interest in helping those affected by eating disorders and mental illness. She decided to learn more about intuitive and mindful eating, body acceptance and Health at Every Size®, which now strongly guide her work. She dreams of a world free from mental health stigma, body shaming, and disordered eating. When she is not helping others make peace with food, she enjoys baking, photography and doing yoga in her living room. Visit Josée's website and connect with her on social media.

Can You Have Too Much Compassion for Others?

Can You Have Too Much Compassion for Others?

Karen R. Koenig, M.Ed., LCSW

Photo by Dayne Topkin

I love the kind of days when the same themes keep re-appearing from one client to the other. Sometimes the theme is realizing that the most important approval comes from ourselves. Or that detachment is far superior than wanting to change someone. Or the theme that echoed through practically every session one particular Monday in late May.

Most of my clients learn about self-compassion from me and we have long discussions about it how they never learned it from their parents who didn’t possess it or why they never received much of it growing up. They understand that self-compassion—meeting suffering with kindness—is missing in them and generally do quite well in healing their eating and other problems by generated greater care and concern toward themselves. They find it quite amazing how a little self-compassion can go such a long way toward helping them have a better attitude and a better life.

On this particular Monday, the theme was not self-compassion, but compassion toward others and how having too much it can easily get in the way of seeing mistreatment—abuse or neglect—and stopping it dead in its tracks. Specifically, what came up talking with so many clients that day was how they could be so blinded by compassion, caring so much for others, or wanting desperately not to cause them pain, that they would willingly hurt themselves instead.

This may have happened to you. Someone tells you a sob story about their life and you feel so terrible for them that all you can think about is how to help them stop hurting. You’ll do almost anything to stop their pain, even ignore your own or the pain they’re inflicting on you. You’ll pay half their rent, feed them, buy them expensive toys, or lie for them. You’ll literally give them the shirt off your back and happily walk around without one because at least you could something for them.

Having compassion for others is a positive, humane quality, but it must be balanced out with compassion for self: I don’t want you to hurt and I don’t want to hurt either. It also must be balanced out with good judgment. I can’t tell you how many times clients tell me they’ve done inappropriate things for others all because “I felt badly for them.” What is missing in this reasoning is what any particular act will do to you. Sometimes it will harm you outwardly and sometimes it will take its toll inwardly, making you feel like a fool when you think you should have known better.

So, yes, show those who are suffering compassion, but watch that you don’t go overboard and end up hurting yourself.

Karen R. Koenig, M.Ed., LCSW, is an international, award-winning author of seven books on eating, weight and body image, a psychotherapist with 30 years of experience, a health educator, and a popular blogger. Her expertise is in eating psychology and helping over-eaters and binge-eaters improve their self-care and become “normal” eaters. She lives and practices in Sarasota, Florida.
Visit her website

Transforming Self-Criticism: Stop Comparing Yourself to Others

Transforming Self-Criticism: Stop Comparing Yourself to Others

Rebecca McConville, MS, RD, LD, CSSD

Photo by Carly Rae Hobbins

If comparison is the thief of Joy, why hand it over to thieves? In a world filled with: books, blogs, podcasts on how to get joy back into your life shouldn't we start with avoiding comparisons?

This seems most prevalent in the world of sport. Impressionable young athletes are quick to jump on the hottest bandwagon even if it is ludacris. Case in point when Tom Brady decided to go on the no nightshade diet. This diet had absolutely no scientific evidence to back it up yet athletes everywhere started inquiring about it. Was it the diet or was it Tom Brady who is a freak of nature athlete? Why can’t we acknowledge that some people are genetically gifted athletically just as others are naturally smart or have a quick wit to them that can make anyone laugh? In the world of sports, you truly are only competing against yourself and if today is going to be your day, it will be your day!

Do we suffer from the cruelness of comparisons or is it the culture in which we live in? Just as we see cultures within the world, they are even more prevalent within the world of sport. One of my dear friends has been an avid runner for 30+ years and talks about when runners showed up in cotton shirts/socks, old-school running shorts and their sports food of choice was mini-snickers. Now at races, people are fully decked in the trendiest running gear, full on makeup and accessories meanwhile huddling around their running clique discussing their pace splits (#nowatchme), clean eating efforts and what races they plan to do this month.

Cars used to have bumper stickers bragging about their child on honor roll or making fun of the child that beat up the honor roll student. Now cars are full of 13.1, 26.2, 50, 150-mile bumper stickers. Waiting for the moment we see the 1,000 numbers. My husband proudly jokes he wants a 0.0 bumper sticker!

Criticisms come as part of sport whether we want it or not, but we must consider the reason for why it is generated: constructive or jealousy? Ron Thompson shared a story at the Eating Disorder in Sports conference about when he was working with a runner who felt uncomfortable that her uniform would expose her when she was running. Ron replied, “Well if they're staring at your butt it has to be because you're in the lead!” I think most athletes agree they will take the fear of wedgie if it means winning.

Many times criticisms are internalized as self-criticism when it is meant towards their performance. I fell victim to this in college after making a horrible mistake picking up the ball once crossing half-court then double teamed resulting in a jump ball. The opposing team won the jump ball and came down to score the winning shot of the game. As I went to the locker room feeling completely defeated one of my teammates put her hand on my shoulder and said “It’s ok Bec, I know you won’t ever make that mistake again. “

You see when we aren’t busy comparing, or criticizing we have the power to change the culture and build one another up!

Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.

Trying Not to Try: The Wild Mind Workings of a Recovering Perfectionist

Trying Not to Try: The Wild Mind Workings of a Recovering Perfectionist

Andrea Wachter, LMFT

Photo by Erol Ahmed

“You’re imperfect and you’re wired for struggle but you are worthy of love and belonging.”

— Brené Brown

If you are someone who has struggled with eating and body image, there’s a good chance you have also struggled with perfectionism. If this is the case for you, you’re likely no stranger to the concept of trying.

Back in the days of my eating disorder, my trying looked something like this:

• Trying to lose weight
• Trying a new diet
• Trying to recover from a binge
• Trying to work out
• Trying to work out more (Pull up a chair, this could take a while!)
• Trying to improve my looks
• Trying to get a boyfriend
• Trying to look good
• Trying to fit in
• Trying to do well in school
• Trying to be cool
• Trying to be perfect

Next up were my early years in recovery:

• Trying to listen to my body
• Trying to eat intuitively
• Trying to get it right
• Trying to let go of being perfect
• Trying to be perfect
• Trying to be balanced
• Trying to be healthy
• Trying to be a good person
• Trying not to beat myself up
• Trying to get a career
• Trying to get “likes”
• Trying to let go of caring about “likes”
• Trying to keep up with the daily grind
• Trying to do the right thing
• Trying to know what the right thing was
• Trying to look good
• Trying not to care how I looked

These days it’s more like:

• Trying to be more present
• Trying to surrender
• Trying to live in acceptance
• Trying not to get injured
• Trying to be kinder to myself
• Trying to find my glasses
• Trying to have a balanced life
• Trying to be peaceful
• Trying to welcome all emotions
• Trying to age well
• Trying to surrender to aging
• Trying to practice gratitude
• Trying not to lose my keys
• Trying to practice mindfulness
• Trying not to beat myself up
• Trying not to try so hard (I told you this could take a while!)

Recently, while on a lovely walk in the redwood forest, (my personal place of worship), I started thinking about all this trying. How for as long as I can remember, I have been trying, and then more recently, trying not to try so hard. I’d set out to take a lovely, quiet walk and commune with nature, yet that day, my mind was as busy as ever. I decided to call order in the court.

Hey! Can we give it a rest? Can we just stop trying? Can we stop trying to stop trying? Can we admit that the only reason we ever try to get or get rid of anything is because we think we will feel better if we did? Can we cut out the middle man and just cut to the chase?

And then, perhaps being witnessed by the majestic trees, the swaying ferns and the glistening creek, or perhaps because I made a conscious decision to drop trying (the new stop, drop and roll), something inside me gave way. My little tryer said, “Uncle,” and I began to steer my mind to the breeze, my feet on the ground, my arms moving in time, my breathing, a bird song. Much like pointing a tantruming child back to something soothing in the present moment, I steered my busy mind back home, back to reality.

The promises of attainment, achievement, and accomplishment will pop up again and again, I’m sure. Many of us have been raised on way too much Disney and happily-ever-afters. But I’m onto it now. I am onto my mind’s seductive nature. Our minds seduce us into thinking that if we just got this fill-in-the-blank, we would be happy, but all we have to do is remember the last several hundred things we were convinced would bring us happy-ever-after-ness to see that it’s not the case. If it were, we would have just lived happily-ever-after.

So, if you struggle with a busy little tryer inside of you, see if you can reel it back in now and then. Notice the simplicity of the moment. Remind your mind that anything you acquire will have pro’s and con’s and ups and downs so there really is nowhere to get. This is the best news of all.

In any given moment, we all have a feast of temptations to take us away from this moment. And then we have this moment. Reality. Right here. Right now. We get to choose… fantasies and fears or that which is actually, factually here. This breath. This surface. This sensation. This sound. I’m willing to give it a whirl if you are.

Andrea Wachter, LMFT is a Licensed Marriage and Family Therapist and co-author of Mirror, Mirror on the Wall: Breaking the “I Feel Fat” Spell as well as The Don’t Diet, Live-It Workbook. She is also the author of Getting Over Overeating for Teens. Andrea is an inspirational counselor, author and speaker who uses professional expertise, humor and her personal recovery to help others. For more information on her books, blogs and other services, please visit her website.

No, Carbs Aren’t Bad for You And Here Are 5 Reasons Why

No, Carbs Aren’t Bad for You And Here Are 5 Reasons Why

Katy Harvey, RD

Photo by Ben Neale

At least once a day I’ll hear someone say something like:

“Carbs make you fat.”
“I shouldn’t eat that because it’s too high in carbs.”
“Sugar is so bad for you.”

“Carbs are the current dietary scapegoat in our culture.”

Scientists used to tell people that dietary fat was bad, so we started cutting fat out of our food supply. Then we realized that was terrible advice, and that there were many unfortunate health consequences of telling people to avoid it.

So now we’ve jumped to carbs being the food group that is demonized. And we’re seeing the same thing—that telling people to avoid an entire food group is making things worse, not better.

What happens when you tell yourself you shouldn’t eat something? Your brain immediately perceives the threat of deprivation and makes you want it even more. Ever heard of the “Don’t think about purple elephants” thing? (Now try not to think about purple elephants. I bet you can’t do it!)

It’s common for clients to tell me that they try to avoid carbs, only to find themselves eventually overeating or bingeing on high-carbohydrate foods.

Turns out your body is trying to tell you something in its desperation for carbs.

Reality is, no single food or nutrient is “bad” for us. In fact, by definition, a nutrient is something your body has to have. Too little or too much of any given nutrient can lead to symptoms of deficiency or excess - but the problem is the “too little” or “too much” - not the nutrient itself.

Let’s stop hating on carbs and embrace them instead!

Here are my top 5 reasons to love carbs

1. Carbs are your body’s favorite source of energy

For most people, consuming about 45-65% of your daily calories from carbs is ideal. Your body prefers to use carbs for energy (via your blood sugar - a type of carb!). Your blood sugar is the circulating energy delivered to cells. In the absence of enough carbs, your body can use protein or fat for energy, but it prefers not to because it has other priorities for those nutrients.

2. Your brain can only use glucose for energy

Glucose (your blood sugar) is the only type of energy that can cross the blood-brain barrier. Therefore, your brain can’t use protein or fat for energy. The brain alone burns about 400-500 calories (of carbohydrate) per day - that’s amazing!

3. Carbs taste good

There’s a reason we crave carbs – they taste good! This is a primitive way that our body is telling us we need them. Part of healthful eating is enjoying food that tastes good.

4. Carbohydrate-based foods contain other essential nutrients

Avoiding carbs means missing out on the other nutrients in those foods. For example, bread and cereals are an excellent source carbs, along with B vitamins (thiamin, riboflavin, niacin) and folate - things we don’t get in many other foods. Carbs can also provide a lot of fiber and potassium (especially starchy veggies like potatoes, and fruit).

5. Avoiding carbs makes you crave them more

Back to the purple elephant thing. Telling yourself you can’t or shouldn’t have something only enhances the desire for it. It also perpetuates the shame when you do eat those foods, and the distrust of yourself to be able to handle them.

Bottom line:

Carbs = energy = fuel = good for you

How can that be “bad?”

Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City.  She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.

Try These Powerful Tools to Stop Emotional Eating

Try These Powerful Tips to Stop Emotional Eating

Emily Fonnesbeck, RD

Food is social, it holds memories, and we feel comfort, satisfaction and pleasure from it. In that way, we all are emotional eaters to a certain extent. Emotional Eating only becomes an issue when we use food as the only way to consistently distract from or numb uncomfortable emotions.

It’s much more common than some realize, and can feel absolutely overwhelming to the person trying to make sense of it. It’s really easy to blame the food and become rigid and restrictive with what foods are allowed in the house or on a diet plan.

Unfortunately, this only works to increase emotional distress, feelings of deprivation and cravings for the very foods that may be felt to be problematic. Restriction breeds rebellion.

In my experience there are two ways to work effectively with emotional eating. They complement and support each other while also being their own unique skill or tool.

1. Feel the emotion

Imagine that a 2-year-old is trying to get your attention. She may start by saying your name or tapping you on the leg. What happens if you don’t answer? If you have experience with 2-year- olds, you know that she gets louder and louder and more obnoxious until you answer. However, if you had responded the first time, it’s likely she just needed to be listened to, validated, helped and then sent on her way.

The same could be said for your feelings and emotions. The more you ignore them, the bigger they get. The middle part of your brain, called the limbic system, is responsible for processing emotions.

In his book “Mindsight”, Dr. Dan Siegel, a professor of clinical psychiatry at the UCLA School of Medicine and executive director of the Mindsight Institute, teaches the reader about a technique called “name it to tame it.”

Neuroscience has found that naming the emotion like “I feel sad” can actually decrease the stress response in the brain. When you name it, your brain increases soothing neurotransmitters that are sent to your limbic system to calm it down. The very act of moving toward the emotion, naming it and aiming to understand it decreases its power over you.

A big hurdle to doing this is the common propensity of judging yourself for how you feel. Maybe you feel like you shouldn’t feel frustrated so you avoid acknowledging it. Maybe you feel like you should feel happy so you avoid acknowledging your true emotion. Separate who you are from what you feel.

Please note that in our “name it to tame it” example above, we used the phrase “I feel sad” not “I am sad.” Feelings, thoughts, and emotions are only activity of the mind, not who you are. Acknowledging them gives you a chance to be transparent, honest and authentic and move toward growth and healing.

Another hurdle is identifying how you truly feel. If you say “I am angry” and don’t feel the calming neurotransmitters doing their job, it may be because you didn’t identify the true emotion.

Maybe you feel hurt, which is making you feel angry. Aim to understand and validate rather than judge and react.

Why is feeling the emotion important? Because if you can move toward the emotion, then you won’t need to move way from it — and toward food.

2. Avoid emotional reactivity

The second technique may seem to be at odds with the first. We aren’t trying to avoid emotions, just avoid letting them get to a point where they feel unmanageable. In working with clients I find there are very specific triggers for emotional reactivity.

First, you don’t stand a chance against emotional eating if you aren’t eating consistently, regularly and adequately. It’s very difficult to think cohesively, rationally and clearly when you are overly hungry. Our brains only burn glucose for energy, so if blood sugar levels are dropping, you can expect that not much fuel is getting to your brain. If you are prone to emotional eating already, feeling overly hungry just creates the perfect storm.

Eat balanced meals (carbohydrate, protein, fat, fruit and/or vegetable) three times a day, adding snacks between if meals are longer than three to four hours apart. I am certain that you will feel more level-headed in many areas, including with food. Skipping meals might make you feel like you are saving time, but I assure you it’s only backfiring.

Second, establish clear work-life boundaries. If life feels out of balance, it’s easy to become burned out, drained and reactive. If you are strung out in all other areas of your life, it's easy to let food become the place where you throw caution to the wind and unwind. Set clear work-life boundaries and be sure to include time for your own personal hobbies and passions. Be realistic and appropriate in setting those boundaries, but do set them.

I would also recommend setting a clear boundary that establishes body autonomy. This would mean letting loved ones know that you prefer them to refrain from making comments about your food or your weight (and ideally theirs too). Too often those comments can feel triggering, elicit feelings of shame and often send individuals toward food and emotional eating behaviors. Keep yourself safe by setting appropriate boundaries.

Third, find ways to be proactive in self-care to avoid “crisis mode.” You can handle what life throws at you if you cultivate resilience regularly. This will mean different things to different people, but some good examples might include taking regular breaks during the day to get up and stretch, turning on music while you work.

Put a project aside for a bit to work on something less draining (but that lets you still feel productive), practice time management by planning your day ahead of time, start your day with meditation and/or prayer to feel connected and grounded, eat meals away from your desk, set regular sleep patterns and make time for physical activities you enjoy.

Your emotions, feelings and well-being matter. Being too busy for them or pretending they don’t matter is likely manifesting in emotional eating. See it as a sign that coping strategies and self- care behaviors are inadequate and take steps to support yourself.

Emily Fonnesbeck, RD is a Registered Dietitian who owns her own private practice in southern Utah. Her nutrition passion consists of helping individuals free themselves from diets, disordered eating, food anxiety, poor body image and obsessive exercise. She has a non-diet, weight-neutral, client-centered approach to help people make peace with food and live confident, healthy and satisfying lives.
Visit her website. 

Suicide: A Senseless Tragedy

Suicide:
A Senseless Tragedy

Angie Viets, LCP, CEDS

This article has originally been published on Psychology Today

As humans, we are hardwired to make sense of things. To analyze, formulate, and reason. We’re perpetually mining for meaning—especially when there’s chaos. Unconsciously we ask ourselves, “What does it mean?” And yet, there are situations where our logical brains fail us. Suicide is the epitome of such complexity.

Despite our most valiant efforts, to resolve what may be unresolvable, we sort and sift through the remains of a life robbed by suicide. Our bodies are programmed for survival, especially in dire circumstances. It’s a seemingly impossible endeavor to comprehend a person choosing to end their life. 

Many of us can identify fleeting thoughts in which we experience passive thoughts like “Wouldn’t it be nice to fall asleep and never wake up?” The intrusive thought of running your car off the side of the road flashes in your mind. We swiftly discard such notions when we are of sound mind. Able in those moments to call to mind simple reassurances, such as, “This too shall pass.” Often we’re able to conjure up past struggles, where yes, in fact, the plight passed.

But what if every way we turned we were met with the darkest, driest dirt—impenetrable despite our maneuvering? Intuitively, we know that worming our way out is where we finally find relief. With broken fingernails and dust-filled lungs, eventually, even the strongest soldier would grow weary. What if that endured for many seasons; no sign of the rain we prayed for to offer a lubricant to ease us out from dark tunnels into the light? Defeat and hopelessness would set in.

What if while we were in the cramped, suffocating space, we could make out, in audible laughter or soft whispers, the sounds of others, our beloved people (should we be so fortunate) above us? In spite of their best, most determined efforts, their passion and persistence to pry us out of the vice were unsuccessful, or only seemed to work for a short time, and then, without warning there we were again buried by the burden of our ailment. Desperate for their suggestions and solutions to work, yet also deeply resentful of how effortlessly they appear to twirl and tiptoe above. “What’s wrong with me?” we’d wonder.

Eventually, we would no longer be able to fight off the weariness and fatigue. The enormity of our guilt and our inability to simply “shake this” or “snap out of it” is added to our already failing lungs. Every possible solution—therapy, meds, meditation, more exercise, and sunlight—unsuccessful. In the stillness, we would ask ourselves, “Would they all just be better off without me?” Paralyzed by our powerlessness, our failure to thrive is cemented as we sink even further into the darkness. 

When all sound is gone, our ears caked with dirt, is likely, in my mind, when the tortured truth takes flight: If going up has failed innumerable times, then perhaps, with the gravity of a despairing and desperate heart, we decide that possibly the only way out is to surrender to what’s below. 

I’ve recalled my moments of deepest despair, prolonged pain, and silent suffering. In all of those trials there were—sometimes after agonizing searching—always, I repeat, always soft crevices where little by little I could inch my way back to the surface. I don’t believe it’s because I “tried harder,” or “wanted it more” that I was “successful,” any more than one who battles cancer is blessed to be in remission, while the friend she made while receiving all of those IV infusions learns the cancer has metastasized and no viable treatment option remains. Would we view that person as weak, failing in some way, or cowardly? Or would we find ways to accept the unacceptable and love him so hard it hurt until he took his last breath? We want so much for there to be another way. Trial drugs, a healer from a foreign land, something, anything. The hardest truth is hearing, “We’ve tried everything, we’re out of options.”

I will forever remember, as the kids swam in the pool, splashing and laughing, the sons, daughters, and husband of my beloved mother-in-law sat at the nearby table on the deck. The same deck where glasses of wine and stories were shared for years as the aroma of tender meat was seasoned on the grill. We listened, with tears streaming down our faces, as she told us she and my father-in-law had decided to discontinue the treatment for the tumor that invaded her brain only months before. 

My brain fought against this decision. “Surely there’s another way. Another specialist. Something, please God, something else we could try.” It was an agonizing process to surrender to her choice. I accepted this was her decision to make and my job, my one critical job, was to love her as much as I could, for as long I could. Over the course of those painful remaining months, as I curled up with her in her bed, she told me she was completely at peace with her decision, although unbearably sad about all that she would miss out on with her children and rapidly growing number of grandchildren. 

The stark contrast of my mother, a junior in high school at the time, who, as she turned into her cul-de-sac, sweetly known as “Candy Cane Lane,” after an evening shift at her part-time job was blinded by sirens flashing in front of her childhood home. Her adored father, the one she and her sisters lovingly refer to as “Daddy” and “Buzz” had—despite many years battling severe, intractable depression—ended his life mere days before Thanksgiving. There was no long goodbye. Perhaps he made his decision in an instant, or over the course of a year. 

They too wrestled with unanswered questions while cloaked in grief, “Surely there was another way. Something else we could have tried. Dear God, what did we miss?” And yet, as years passed, the acceptance of the unacceptable settles in. 

As a therapist, I offer my clients antidotes to ease the isolation, a soft space to land their weary souls, and the willingness to hold hope for them when they’ve lost all hope. Maybe, if there’s enough of us helping to scoop away the dirt carefully, perhaps some sunlight and fresh air will greet those trapped below. 

I know for sure, as I stand up here, desperate to make sense of the senselessness of suicide that we long to ease your suffering—to break the spell and bring you home. My belief and my experience are grounded in the knowledge that to suffer alone is not what was intended for us. We need to lean hard and deep into each other. To offer meals to the depressed the same way we would bring casseroles to the sick. The willingness to get close to the sufferer and say, “You are not alone in this, my dear. Whatever it takes, I’m here for you. For however long you need me.” We must call in the troops if there’s any hope of freedom from such despair. 

It alarms me when people negatively describe those who express suicidal thoughts as “attention seeking.” Yes, if someone tells you they’re suicidal, they are in fact seeking your attention. It’s a cry for help and requires a call to action. It likely took tremendous courage to say out loud what has haunted them inside for some time. Believe them the first time. During quiet evening porch swing talks, my mom has shared with me regret from all of those years ago, even though she was merely a teenager at the time, “We should have listened to him. Believed him when he said he no longer wanted to live in such pain. Instead, we tried to block it out and hoped it would pass.” 

With September being National Suicide Prevention Awareness month, I’m extending my heartfelt and sincere condolences to those who’ve lost someone they love to suicide. For those suffering with thoughts of suicide, please consider the following resources:

Informational Resources

• Know the Warning Signs and Risk of Suicide
• Preventing Suicide as a Family Member or Caregiver
• Being Prepared for a Crisis
• Need more information, referrals or support? Contact the NAMI HelpLine.

Crisis Resources

• If you or someone you know is in an emergency, call 911 immediately.
• If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255)
• If you’re uncomfortable talking on the phone, you can also text NAMI to 741-741 to be connected to a free, trained crisis counselor on the Crisis Text Line.

Visit NAMI's website for more resources and to get involved.

Angie Viets, LCP, CEDS is a clinical psychotherapist and certified eating disorders specialist in private practice. She specializes in the treatment of eating disorders, body image, and overeating. Angie is dedicated to empowering others to nurture their body, mend their relationship with food, and to embody their most authentic self. Her passion for the field was born out of her own hard-won battle with an eating disorder. She believes that full recovery is possible!

Angie has a thriving website that offers resources for people in recovery and was voted #1 on Healthline's list of the Best Eating Disorders Blogs of 2017. She is currently in the process of writing her first book, where she will demystify eating disorder recovery and offer inspiration and guidance to those suffering in silence. Her writing is featured in Huffington Post and recognized eating disorder treatment centers throughout the country.

Spotted: A Diet in Disguise

Spotted: A Diet in Disguise

Dr. Colleen Reichmann

I’m just going to come right out and say it- I hate the term “clean eating.” Never has a diet used such obviously guilt-ridden vernacular. The message behind clean eating is clear, isn’t it? Certain food is “clean” (i.e. moral, pure), and other food is “dirty” (impure, bad, amoral).

Clean eating culture is dangerous because it is not super transparent. Advocates of clean eating like to assert that it is not a diet, but a lifestyle change.” Sounds pretty doesn’t it? Lifestyle change. The small font not included by most clean eating advocates is that this lifestyle change includes a series of food rules and restrictions. Or, in other words, it is a change of your style of life into one that includes dieting.

Clean eating is a dressed up term for diet. Plain and simple. Where did this euphemism come from? Well, the idea of dieting seems to have gotten a little bit of a bad rap over the past ten years or so. Maybe that is because the public was catching on that diets don’t work. Maybe it coincides with the influx of militarized fitness fads. Whatever the reason, one thing is for sure—the food industry and media have capitalized and continue to capitalize on the idea that we no longer need to diet—we just need to change. The worst part? We, the public, eat it up (pun intended).

We charge out to buy spiralizers and denounce fruit as too sugary. We load smoothies with vegetables (seriously come up—let’s call a spade a spade—smoothies made mainly from vegetables suck) and whip up bone broth soup because of collagen.  We are attracted like magnets to food products listed as organic. Milk chocolate? Processed crap, we mutter to ourselves. Cacao bits? Load ‘em up.

I do not actually have any problem with wanting to incorporate healthy food into one’s diet. However, anything taken to the extreme is problematic. It is just as bad to eat just kale three meals a day as it is to eat pop tarts three meals a day.  And the problem is, the concept of clean eating becomes extreme so easily. Think about it. The term “clean” denotes a morality of the food that we consume. Some foods are good, clean, or pure. Others are bad, dirty, or amoral. We humans tend to become activated by messages about morality. Hence, the judgement-laden undertones of the term “clean eating” affect our psyche in undeniable ways.

The good news? There have been a spattering of articles over the past year or so that question the benefits of “clean eating,” hence it is reasonable to assume that the term will be defunct in the next five years. The bad news? Be aware: fad diets are shapeshifters. When one wears thin, the wellness industry tends to catch on and coins a brand new name for said diet. Hence the only way to truly shut down diet culture is to educate ourselves about those roses-by-other-names (i.e. diets in disguise).

So the next time you hear about the newest wellness fad involving food, be sure to ask yourself:

1. Does it encourage restriction?

Is this food fad suggesting that eating less is important? Is fullness considered a negative? Is the message “eat less to be happy” pushed at all?

2. Does it subtly or blatantly include the message that thinner=healthier or better?

Is the message behind the food fad, “eat this way and you will look like him/her?” Does it promote the idea that weight loss is the golden fountain of health?

3. Does it suggest cutting out certain food groups?

Does the food fad promote the message that certain foods should be completely banned from your energy intake? Is the word toxic used at all?

4. Does it promote mistrust of your body?

Does the message suggest that our bodies need to be outsmarted? Does it suggest that certain foods are the equivalent of drugs to our minds?  

Summarily, when it comes to food fads, a good rule of thumb is—if it promises salvation through eating—it is a fad diet. So call out the wellness industry every time they shape-shift. Protect your emotional well-being by shouting back at diet and “wellness” culture. Food freedom and overall happiness will be worth the effort-I promise!

Dr. Colleen Reichmann is a licensed clinical psychologist, practicing in Williamsburg, Virginia. She works in her private practice, Wildflower Therapy and is a staff psychologist at the College of William and Mary. She is recovered from an eating disorder, and this experience sparked her passion for spreading knowledge and awareness that full recovery is possible. She is now an eating disorders specialist, and has worked at various treatment facilities including University Medical Center of Princeton at Plainsboro Center for Eating Disorder Care, and The Center for Eating Disorders at Sheppard Pratt. She is an advocate for feminism, body positivity, health at every size, and FULL recovery. She writes about body image and eating disorders for morelove.org, Project Heal, Recovery Warriors, and The Mighty. 
Visit her website.

You’re All Wrong About Anxiety

We Are All Wrong About Anxiety

Karen R. Koenig, M.Ed., LCSW

Most of my clients are anxious, whether they have dysregulated eating or not. They fret incessantly about how they’re doing in life compared to others, whether they’re making enough “right” decisions, and how they’ll manage if life doesn’t go exactly as they’ve planned. They’re so used to believing that it’s their worries and fears that keep the sky from crashing down upon them, that they never stop and think that anxiety is no more powerful than the Wizard of Oz or protective than the Emperor’s new clothes.

This realization dawned up on me while talking with a client one day. She grew up very anxious with a strict mother who brooked little dissent and made my client think there was a right way—and, of course, a wrong way—to do everything. Hence, my client’s worry about whether she should leave a job that she (more or less) hated or stick around because it produced a pretty decent paycheck. The way she figured it, her anxiety kept her constantly thinking about what was right and wrong and that’s what had contributed to her success at her job. Therefore, she was having a deuce of a time giving it up, even when it made her miserable.

However, when we delved into whether or not her anxiety was the real power behind her success at work, my client was surprised to realize that this was hardly the case. Without much prodding, she recognized that she was conscientious and tried to do her best, not just for approval, but because she valued how it felt when she did. She acknowledged that she was an excellent planner and, in spite of not liking her job, a superb problem solver. She had a gift of being tuned into others (she had learned to be, in order to not rile her mother’s ire) and turned out to be an award-winning salesperson.

She had no idea that it was these attributes, not her constant anxiety, that made her successful in her career. Here, all along she’d thought it was because she thought so carefully about what was “right” and “wrong.” She’d attributed her success to her constant hypervigilance, when it turns out that she had some stellar life and work skills.

Do you credit anxiety for things going well in your life? Do you fear that if you give it up, you stop succeeding? Anxiety might have been useful long ago, and it may have actually made you do as well as you do, but its teaching days are long over. If it taught you to plan well and consider consequences, good for it. If it made you have a bit of self-doubt and the ability to see two sides of an issue, bravo. If it pushed you to go slowly and assess your options, hurray. Now that you’ve honed these qualities, it’s time to enjoy what they do for you and let your useless anxiety go.

Having compassion for others is a positive, humane quality, but it must be balanced out with compassion for self: I don’t want you to hurt and I don’t want to hurt either. It also must be balanced out with good judgment. I can’t tell you how many times clients tell me they’ve done inappropriate things for others all because “I felt badly for them.” What is missing in this reasoning is what any particular act will do to you. Sometimes it will harm you outwardly and sometimes it will take its toll inwardly, making you feel like a fool when you think you should have known better.

So, yes, show those who are suffering compassion, but watch that you don’t go overboard and end up hurting yourself.

Karen R. Koenig, M.Ed., LCSW, is an international, award-winning author of seven books on eating, weight and body image, a psychotherapist with 30 years of experience, a health educator, and a popular blogger. Her expertise is in eating psychology and helping over-eaters and binge-eaters improve their self-care and become “normal” eaters. She lives and practices in Sarasota, Florida.
Visit her website

What Genetics Have to Do With Eating Disorders

Are you one of those that feel like you must go to a thousand stores to find the perfect “jeans” without taking into consideration whether it fits your “genes”?  What we generally fail to recognize is that thousands of years of genetic makeup cannot be altered by “perfect” eating, supplement taking or hours spent exercising so you can fit into your ideal “jeans”.  However, you can either: change your jeans, rock your Mom jeans (click here for a good laugh) or accept how your “genes” look in any pair of “jeans”!

A case in point was the unfortunate news when Bob Harper suffered a heart attack while exercising at his New York gym. Bob Harper has been the face of “perfectionism” with his gospel preaching of clean eating and fitness. Harper reported during his interview on Fox News, "I fainted one time in the gym, I started having these dizzy spells and I just kind of overlooked them. I just adapted which was one of the dumbest things to do. I kicked myself over and over again about that.” In another interview, it was revealed that Bob’s mother had a heart attack around the same age and upon genetic testing was found to have high levels of lipoprotein A.

When I compare genetics and how they associate with health, strangely my mind wanders to a Ron White skit at Thanksgiving dinner with his siblings (now before you panic where I am going with this-HOLD ON). While I have no siblings of my own, my husband does. His sister is a geneticist, his brother is a judge, and my husband is the funeral director. These siblings share genetics (DNA) but are vastly different in their personalities, looks, and careers, yet each brings different lenses on how to view life and health.

Brandi, my sister-in-law (geneticist) studies how genes evolve over time and has a great understanding of what the likelihood you will have a health risk is or the probability that you'll be diagnosed with a health condition. My brother-in-law, Jim (judge), is a judge in a true sense. He excells in listening to both sides of a story as to what is uncontrollable (genetics) and what can be controlled (environment/behavior). Last but not least, my husband, the funeral director, probably has the most valuable lesson of all….. I will save that for the end!

Just as Bob Harper could not eat and exercise his way out of a heart attack, individuals cannot “willpower” their way out of an eating disorder, “eat clean” enough to control their cholesterol, think enough “positive thoughts” to overcome panic/anxiety, or simply “count their blessings” to overcome addictions. For people to accept living in the body given to them, they must consider their genetics (DNA). 

A person inherits genes from each parent, as well as the cultural /socioeconomic experiences from his/her family. Inherited genetic variation within families clearly contributes both directly and indirectly to the pathogenesis of a disease.

Here are a few examples of genetic influences:

• The University of Iowa and the University of Texas Southwestern Medical Center studied single families in which eating disorders were common across generations. They found that people with mutations in two different genes – ESRRA and HDAC4 – had a 90 percent and 85 percent chance of developing an eating disorder, respectively.

• A study published in the June 2013 issue of the Journal of Anxiety Disorders underscored that certain anxiety traits correlated with panic disorder are evident by the age of 8.

• Many other health conditions have strong genetic links: obesity “thrifty” gene; alcoholism, breast cancer, & heart health.

So why does my husband, the funeral director, have the most to learn from? While you can’t control or change your genes, you can control how you choose to live your life. At funerals, you will hear stories of those with longevity and prosperous lives and how they didn't sweat the small stuff and accepted that there are just some things you can’t change except maybe those mom jeans. Besides, when you take that last breath you won’t, nor would you likely want to be remembered for your cholesterol number, pounds lost on diet or your perfect eating.

Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.

Intuitive Eating and Eating Disorder Recovery: Is it Possible?

Intuitive Eating and Eating Disorder Recovery: Is it Possible?

Kelly Boaz, CNP

Sarah Swinton

When I went to eating disorder treatment for the second time, they gave us two books to read upon admission. In fact, reading these books was one of the conditions for moving through the levels of treatment. These books are still on my professional bookshelf to this day - Life Without ED, by Jenni Schaefer, and Intuitive Eating, by Evelyn Tribole and Elyse Resch. Intuitive Eating is one of the cornerstones of many eating disorder recovery programs. How do you know if it's right for you?

Well, as far as I'm concerned, learning to eat intuitively is important for just about everyone. BUT, it's not right for everyone all the time. Sometimes, following a meal plan is more beneficial. Here are some common stages of eating disorder recovery where it may not be possible to practice intuitive eating:

1. You're just starting nutritional therapy

Many people seeking treatment for an eating disorder aren't used to eating appropriate amounts of food. Whether you're eating too little, too much, or just irregularly, chances are your intuition is off. It's important to work with a dietitian or nutritionist to help figure out what the right amount of food for you is. Everyone's needs will be different, so it's important to get a meal plan that is tailored to your needs. Following this meal plan will help you understand your hunger and fullness signals, and get used to eating an appropriate amount of food for you. Over time, it will be important to let go of the plan, and start to trust your intuition.

2. You're working through fear foods

Some people don't really have fear foods. Some people have a LOT of fear foods. During this stage of recovery, you may move back and forth between a meal plan and intuitive eating. If trying fear foods puts you at risk for restricting the rest of your intake, you may need a meal plan more solidly in place.

I struggled at this stage, mainly because I was in denial about my fear foods. I was convinced I just didn't like certain foods, so I didn't have to include them. Luckily, my team recognized the restriction hidden in my preferences and challenged me to try these foods. Some foods I genuinely disliked. Some foods, however, were fear foods in disguise. Because my intuition was still clouded by my eating disorder, eating 100% intuitively at this point wasn't possible for me.

3. Finances are tight

When we talk about intuitive eating, we sometimes exclude those who can't afford to eat how their body wants to eat. They need to make food choices that fit in their finances. In fact, most people can't afford to eat out 3 meals a day, so planning is important to make sure you have food available when you need it. During these times, you may be able to be intuitive when you eat and related to how much you eat, but you'll still need to plan the "what". It is important to keep things as varied as possible, though, to keep your food choices from becoming food rules.

4. Your schedule is weird

Similar to those who can't always choose the "what", shift workers and those with set schedules don't always get to choose the "when". Some days, you may not be hungry when it's time to eat. You may have to eat anyhow. Some days, you may be hungry before you have an official break. Keeping portable snacks on hand (like granola bars) will help you honor your body's timing, even when you can't control meal times.

5. You're under a lot of stress or battling depression

When I get stressed out, my appetite goes out the window. If I was trying to listen to my body's cues during these times, I would be severely under-feeding myself. When stress hits, I need to go back to the meal plan. I know what my body normally needs, so I try to feed myself as I normally would, even when I don't feel like it.

For those with a history of eating disorders, living in a calorie deficit can put us at a high risk for relapse. When we're going through periods of stress, anxiety, or depression, we may need to ignore our bodies' signals and eat more mechanically for a time. This doesn't mean that you're going backwards - it means you're ensuring you can keep moving forwards.

Whatever stage you're at in your recovery, it's helpful to have a professional guiding you through the transition from meal plan to intuitive eating. It can be tricky to figure out whether your intuition is still influenced by your eating disorder, and an outside eye can help with that.

Wherever you're at, keep going. It's hard work, but you're worth it.

Kelly Boaz, CNP is a Toronto-based Holistic Nutritionist (CNP), specializing in eating disorder recovery and food freedom. After winning her 17-year battle with anorexia, Kelly Boaz turned her life’s focus to helping others do the same. She is also a writer and speaker (TEDx, TDSB), raising eating disorder awareness, and helping people heal their relationship with food and their bodies. You can find out more about Kelly, or get in touch via her website.

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How to Become a Love Warrior

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Center for Change

Jade

We all have 'junk' in our lives. Unless we get rid of all those things that no longer serve us, we carry them with us everywhere we go. Some of us (unconsciously) choose food, alcohol or drugs as a way to cope, but, eventually, they add even more weight. It’s exhausting. So we choose to numb ourselves further to avoid feeling or confronting our problems. It’s normal to try to avoid stress, but engaging in self-destructive behaviors won't make it go away. It actually makes things worse.

So, what can we do? One of the best approaches is to learn from others with first-hand experience. Glennon Doyle, the New York Times bestselling author of the book Love Warrior, was recently the keynote speaker at the Innovations in Behavioral Healthcare Conference in Nashville, Tennessee. Throughout her talk (as in her other writing), Doyle wears her heart on her sleeve, talking openly about her history of addiction. At first, sobriety is simply not drinking alcohol, she says. But as she learned to be still and not numb herself, her views on sobriety changed. For Doyle, sobriety now has three layers to it.

Sobriety Leads to Truth

First, sobriety is a path that leads to truth. It leads to love. It can even lead to God, which — for some people — means sobriety can be a form of religion. Sobriety is a way to live life on its own terms, feeling the good and the bad instead of numbing ourselves from them. It means not ignoring anything, but facing it, taking things as they come.

Sobriety Brings Our Life Together

Sobriety also becomes connected to our integrity. It’s a way to integrate our outer life with our inner life. There is no longer a divide with our 'junk' on one side and an unrealistic version of ourselves on the other. Once we come to grips with this, merging our outer life and inner life, we can finally be at peace.

“As an alcoholic in recovery, I love knowing I will never have to doubt myself, my instincts, and my power. I love the clarity of sobriety. I love how much I have gotten to know myself and the process of realizing and embracing what a wonderful person I am.” – Emily C. shares on her recovery journey with Heroes in Recovery.

Sobriety Leads to Healthy Boundaries

Sobriety is also a way to protect yourself by creating and setting healthy boundaries. As you learn what triggers cravings, you can learn how to cope with them or even minimize those things in your life so you can reconnect with who you really are. You can choose to say “no” to things that drag you down and instead do things that bring you peace. As you make peace with yourself, a funny thing begins to happen: You can start to love yourself. And that enables you to love others too.

That doesn’t necessarily mean that you throw your whole life wide open on Facebook or Twitter, especially when you’re facing struggles. In those cases, Doyle advises that you share with a few carefully chosen friends and family members, privately. But why, if sobriety is all about transparency? Because when you share a struggle while it’s happening, you aren’t thinking clearly.

Think of it like this, Doyle suggests: The best way to be a “love warrior” is to share from your scars, not your open wounds. It’s great to be authentic and honest, but your open wounds are still fresh. You need to let them heal before you can use them to serve someone else. With time and healing, perspective and wisdom follow.

Sobriety is the key to feeling again and caring for yourself. But be warned: It’s not an instant fix or a one-time event. It’s a way of living you have to choose every single day.

(Watch Glennon Doyle’s conversation with Foundations Chief Marketing Officer Lee Pepper at the IIBH conference here.)

¹ "What is Sobriety?" BlackBearRehab.com, July 24, 2017.

Center for Change. Center for Change was founded on October 28, 1994, by a team of psychologists and a physician with a long history together. On that day, Center for Change began to live out its mission to heal women from the inside out. From those first days, Center for Change began to design the current facility and develop its core treatment programs. A handpicked team of experts forms the backbone of what we do, and they are committed to helping each girl or woman get back their life and restore a sense of freedom that may have been absent for far too long.

The Center is licensed with the State of Utah as a Specialty Psychiatric Hospital, and in April 1998, Center for Change received accreditation from The Joint Commission. This accreditation is limited to top organizations delivering high levels of patient service, reducing patient risk and creating an environment for continuous improvement. The Joint Commission has recognized Center for Change for its high standards of patient care and commitment to ongoing education.

The message of “hope is real” can be found woven through the entirety of the treatment experience at Center for Change. From those early days, our primary goal hasn’t changed: to improve lives. And research proves we’re doing just that. A Center for Change study showed that patients were able to significantly decrease negative behaviors and improve body image and health-management skills.

We understand the dilemma in trying to find the best care available for you or your loved one. So many options can make it difficult to decide which one is right for your situation. At Center for Change, our holistic approach, rigorous medical and clinical program, wide range of levels of care and nurturing environment set us apart. Our extensive team includes seasoned medical, psychological and nutritional experts who have been carefully selected because of their expertise in treating both the outward symptoms and underlying causes of eating disorders. Call us and get your life back.

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Good and Bad Don't Apply to Eating

Good and Bad Don't Apply to Eating

Karen R. Koenig, M.Ed., LCSW

Sometimes we can’t help overhearing conversations, especially when someone is talking really loudly on their cell phone, as if they’re alone in the room. That happened to me recently, and I was dumbstruck over what I was hearing. A man was telling someone about an upcoming doctor’s appointment and this is what I heard: “My doctor is going to be really mad at me because I’ve been really bad. I’m eating all the wrong things when I promised him I’d be good. Man, have I been bad.”

If I hadn’t seen that this speaker was a middle-age guy, I would have sworn I was listening to a child between 6 and 12. That’s the age when we’re often preoccupied with wishing to be good and fearing being bad. That’s the age when we don’t have a huge vocabulary and use words like “good” and “bad” because we don’t have better, more appropriate words readily available in our vocabulary.

At the same time as I felt sorry for this man who truly sounded fearful of what his doctor might say to him about his “bad” eating, I had several other thoughts and feelings as well. Why is this man so worried about what his doctor will think of him rather than feel disappointed in himself that he wasn’t eating more healthfully? Would his doctor actually use the word “bad,” as if he was talking to a kid misbehaving? If this man promised his doctor that he’d be “good,” what was the purpose of such a promise? And what did the doctor say to his patient promising something?

Two intense feelings overshadowed all my others. I was angry that we’re still stuck in this good/bad food mentality which makes us feel and sound like children and gets us nowhere in feeding ourselves more nutritiously and intuitively. And, I was frightened that maybe doctors were fostering these beliefs and making a moral judgment on someone’s eating by implying goodness or badness. I couldn’t imagine doctors actually telling patients that they’re “good” or “bad,” but maybe I’m out of touch.  

I will keep repeating this message as long as I continue to hear these words applied to eating: Good and bad are moral terms. Eating a salad doesn’t make you good and eating cheesecake and Fritos doesn’t make you bad. How and what you feed yourself doesn’t make you more or less of a valuable person and says nothing about your integrity or ethics. Honesty, bravery, fair-mindedness, and loyalty are aspects of morality. Feeding yourself is a self-care and nutritional issue and, though you may treat yourself well or poorly, even that doesn’t make you a good or bad person.

So, could all of you who are reading this please take a pledge, on your own behalf and for the benefit of others, to avoid applying these words to your eating or fitness behaviors? And, if a health care provider uses them to describe you or your behavior based on your efforts in these arenas, please give them this blog to read and tell them about my new book, "Helping Patients Outsmart Overeating: Psychological Strategies for Doctors and Health Care Providers."

Karen R. Koenig, M.Ed., LCSW, is an international, award-winning author of seven books on eating, weight and body image, a psychotherapist with 30 years of experience, a health educator, and a popular blogger. Her expertise is in eating psychology and helping over-eaters and binge-eaters improve their self-care and become “normal” eaters. She lives and practices in Sarasota, Florida.
Visit her website

Sleep: An Essential Yet Overlooked Component of Recovery?

Photo Credit: Katarzyna Bruniewska-Gierczak

If you’re not getting enough high-quality sleep then you are missing out on a huge component of recovery.

Our culture has a funny attitude towards sleep. We love it (because it feels good!) but we also act like it’s a weakness. People boast about how they only need 4 hours of sleep to function as if that’s a noble thing. You don’t hear anyone bragging about how they make sure to get a solid 9 hours of sleep every night. It’s seen as “indulgent” or “lazy.”  

Is it lazy to have lower levels of inflammation in your body?
Is it lazy to be more productive at work?
Is it lazy to retain information when you’re studying?
Is it lazy to lower your risk of cancer and Alzheimer's disease?
Is it lazy to let your body repair itself and increase your muscle strength?
Is it lazy to be more creative?

I don’t think so. Sleep does all of these things.  

The irony is that people who don’t sleep often make it sound like they’re using their “extra” waking hours doing “productive” things like working or exercising. What they aren’t acknowledging is that they’re shooting themselves in the foot because the things they are trying to accomplish are infinitely harder without proper sleep.

What does any of this have to do with eating disorder recovery?  

Everything.

The initial phase of recovery involves stabilizing the eating disorder behaviors and restoring physical health. Even if you can’t see or feel it, your body has internal repairs to do from being inadequately nourished. This is true whether you have anorexia, bulimia, binge eating disorder or anything in between.  

The recipe for these repairs is nutrition + sleep. The repairs require the substrate of food and lots of sleep. In fact, when you're sleeping is when the actual action happens. There is a shift in your hormones when you are in deep sleep that promotes growth and repair.  

Our best shot at deep sleep happens between 10 pm and 2 am. That’s when humans naturally fall into the deepest sleep based on our circadian rhythm and the earth’s light and darkness patterns.  

Tips for getting great sleep

• Have a bedtime routine - Create a routine that lets your brain and body know that you are winding down and getting ready to sleep.  
• Go to bed at a consistent time each night - Your body needs to have a predictable bed time to make falling asleep easy. Go to bed and wake up at the same time every day, even weekends.  Sleeping in will throw off your bedtime schedule the next night.
• Have a fluid curfew - Cut yourself off liquids about 2 hours before bed time to give your bladder plenty of time to empty before bed. We don’t want you waking up because you have to pee.
• While you’re at it, have a caffeine curfew too - Everyone’s body processes caffeine at different rates. Regardless, caffeine stays in our system for hours and even if you don’t feel the buzz, it can still be impacting your sleep. A good rule of thumb is to cut yourself off no later than 2 pm.  I personally have been shooting for noon as my cutoff time.
• Avoid screens in the bedroom - The glow from your TV, cell phone, tablet or computer makes your brain think that it’s light outside. And light = awake. It interferes with your body’s natural production of melatonin, a hormone that is higher at night and helps us sleep. And don’t think that taking a melatonin supplement will counteract it because it doesn’t. Your body gets desensitized to the melatonin supplements after a while anyway. Try reading a fiction book before bed - something that gets you out of your own head and doesn’t have you thinking too hard.
• Keep your room dark and cool - We sleep best when there is no light (not even a night light), and when our environment is cool. In fact, studies have shown that the optimal sleep temperature for humans is 62-68 degrees F. That’s pretty chilly to a lot of people - and if you are struggling with body temperature regulation due to the eating disorder, you may need it a little warmer than this.  

There are tons more things you can do to help yourself sleep better, but these tips are a great place to start. If you are having trouble falling asleep or staying asleep through the night, talk to your treatment providers and they can help you figure out what’s going on. It’s common for people with eating disorders to also struggle with anxiety or insomnia, and there are lots of things that can be done to help with that. 

Give yourself the gift of great sleep. You’ll be shocked at how much better you feel. 

Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City.  She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.

Mirror Mirror on the Wall Mirror, Am I Hypocrite After All?

One of the biggest reasons I love my job is the amazing people I work with and the opportunity to build relationships with them. Their trust in me as their dietitian is that I not only talk the talk, but I also walk the walk. Many times in my career, statements that I have made to my clients have come back to gnaw in my ear like a pesky gnat. Humble pie can be a hard slice to swallow, but if I am going to be authentic to these incredible yet vulnerable people I MUST do the same as I tell them.

I have always prided myself on how resilient and tough I thought I was. However, if I speak honestly, these two traits are not what they used to be. As a collegiate athlete, I had the energy of a three-year-old on a Halloween candy high and a pain threshold so high that I was up hours after having an emergency c-section because I was determined to be with my baby as much as possible even if my legs were like wet noodles. Now I find myself scheduling power naps so I can function at the end of the day and the slightest possibility of a cold has me trading in my Chardonnay for Emergen-c cocktails because, well, who has time to be sick?

The biggest test of all is now my role as a mother. As independent as we believe these little humans to be, they are also absorbing everything we do so they can model it. As a mother of a young daughter, it breaks my heart to see and hear the societal messages she will grow up with.

Things to keep in mind as you go about your day, unaware that impressionable little ears may be listening:

• When we get ready in the morning, are we mirroring a woman that is confident in herself – not based on how her outfit looks, but rather by how she is preparing to tackle that day?
• When you step on the scale, are you giving the impression that the little “hunk” of metal is a grade of who you are?
• When you are on your “diet,” are you giving the impression that you are not enough and you need to change?
• When we tell our kids to go outside and run around to get their energy out, what do you think they associate with when you say, “I have to go run to burn off this ice cream?”
• Do we walk proudly as we are responsible for bringing these amazing people into the world, or do we crawl into a shell so we may not see the amazing blessings that have come our way?

I often wonder if God has possibly put a time line on those youthful traits that I once admired so that I may slow down and enjoy the day with more diligence. Perhaps making myself more aware of pain so that I actually pay attention to what is hurting me? If I could mirror anything to my daughter, my friends, my clients and the world it would be that we need no explanations for who we. Just take me as I am and allow for grace, as I am guaranteed to make some mistakes!

Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.

Why We All Need to Read Carolyn Costin's Review of To the Bone

Netflix/Carolyn Costin

Watch this week's recovery video in which I share my thoughts on To the Bone.

Below you can read Carolyn Costin's official review of To the Bone:

"I was hesitant to see the new Netflix eating disorder movie, To The Bone. As someone recovered from anorexia and an eating disorder therapist, author, educator and spokesperson I generally do NOT like eating disorder movies, documentaries, TV specials, “reality shows” or even autobiographical books about eating disorders and tell my patients to steer clear of them. However, when asked by Project Heal to attend the screening and moderate a panel discussion afterward, I agreed.

The film stirred up controversy even before its release and because of its significance as the first major film on eating disorders with the potential to be seen in 100 million homes, I wanted to ascertain the situation for myself. Did To The Bone have something of value or was it going to end up on the “do not watch” list with so many others.

To The Bone is based on a true story about a young woman with anorexia nervosa, and brings viewers into the eating disorder world, including interactions her family, her doctor, and a variety of other patients in a treatment center. The patients are portrayed realistically, without showing gratuitous scenes of behaviors such as wretching into a toilet while at the same time not glamorizing the illness by avoiding anything that could be potentially controversial or disturbing.

This is a film based on what happened in the life of one individual, not a movie about understanding, preventing or treating eating disorders. It’s not meant to educate the public on the causes of the illness, or how best to treat it. It is writer/director Marti Noxon’s autobiographical story (with some artistic license thrown in). Marti felt her story was important to tell in order to raise awareness about a misunderstood subject.

To The Bone will, for sure, raise more questions than provide answers, and that is exactly what Marti had in mind. Her hope is to promote a conversation about an illness that is still not well understood by the public and does not get appropriate coverage or concern.

The film’s main character, Ellen, has anorexia nervosa, from which more people die than any other mental illness, yet no one has taken it seriously enough until now to put resources into a major film. Marti felt compelled to make a film and make a difference and faced many obstacles along the way. For example, several people whom she tried to get interested in the project told her they did not think the eating disorder topic was a big enough issue. She knew, and many of us know, better.

Are there things I dislike about the movie? Yes. Do I think there were unrealistic parts? Yes. Would I have done things differently? Yes. As an eating disorder treatment provider, educator and activist, I wish there ha been more explanations given about the disorder and that the movie had shown more about how treatment helps people recover. I would have included much more and much different therapeutic dialogue and I would not have depicted the eating scenes at the treatment center in the same way.

Much of the controversy surrounding the film comes from the fact that Lily Collins, who played the part of Ellen, also suffered from anorexia as a teen and yet she lost weight to authentically play the role.

I too was concerned and unsettled upon hearing the leading actress had suffered from anorexia in the past yet lost weight to play the part. As a therapist I certainly would not recommend any of my clients do this. But after meeting and talking to the real person, Lily, her mom and Marti, I learned about the care and thinking that went into her decision including the medical and nutritional monitoring that took place. But even that is not the most important thing here. What is far more important is that Lily is fine. Not only did she not relapse, she found the entire experience “insightful” and “therapeutic” learning many things she did not know or understand when she was 16 and suffering from her eating disorder.

To those who express their anger and boycott the film, I wonder what would they suggest as an alternative? As far as I know, no one has yet offered a better solution for Ellen’s character. Should Marti have found an actress currently suffering from anorexia to play the part? Should some other actress have lost weight for the part? Should she have hired a normal weight actress to play the part of someone with severe anorexia nervosa? All of these alternatives would have brought their own problems, concerns and controversies. To avoid all potential problems or criticism, no movie could be made at all.

You can’t make a film about a troubling topic without troubling people. There is no way to deal with a sensitive, disturbing, and difficult subject, such as eating disorders, without upsetting or “triggering” a sub set of individuals most closely associated with the issue, whether professionals, patients or their families. If no one was disturbed by this film, there would indeed be something terribly wrong. Eating disorders are disturbing, confounding illnesses. Would I advise patients to go, no, they don't need to see it, they already know what the movie is trying to reveal.

The other controversy has so far sprung from those who have seen the trailer and complain that showing a white skinny girl is not fully representative of the spectrum of eating disorders and the scenes might be triggering for those who are vulnerable or already suffer from the illness.

They are right. However, the trailer is not representative of the movie. The movie portrays 7 patients with varying diagnoses, body shapes, gender and color. Particularly arresting is Alex Sharp’s portrayal of the male patient, Luke.

Will the trailer and the film trigger some people, yes, but I found this film less potentially triggering than most. The trailer shows perhaps one of the most triggering scenes of the film. But you can’t make a film about eating disorders without upsetting or triggering some people. During my own eating disorder just watching someone in a movie eat, get on a scale, go on a diet, or work out at a gym was triggering. Any program, of any kind, about eating disorders will trigger some and that will be the case withTo The Bone, but not such that is loses all value which will be as diverse as the people who go to see it.

With my 40 year history in the eating disorder field, I am passionate about anything that can be done to help understand, prevent and treat these illnesses and even though To The Bone has weaknesses and is not the movie I would make, it is still an important step in bringing eating disorders front and center. I can put aside my own biases both as someone who recovered and as a current expert in the field and see this movie for what it is, one woman’s story that is authentic, sad, realistic, disturbing, scary, and true. And as for hopeful, let me just say that the real Ellen, Marti Noxon, is recovered and here to say it is possible and that speaks volumes." - Carolyn Costin, July 14, 2017

Carolyn Costin, MA, MEd., MFT, CEDS, FAED, is a world renowned, highly sought-after eating disorder clinician, author, and international speaker. In her twenties, Carolyn recovered from anorexia and became a teacher and a psychotherapist. After successfully treating her first eating disorder client in 1979, she recognized her calling. In 1996, she created Monte Nido, the first licensed, residential eating disorder treatment facility in a home setting. Having left Monte Nido in 2016, Carolyn maintains her private practice and remains very active in the eating disorder field lecturing, training, teaching, writing and supervising. In 2017, Carolyn founded The Carolyn Costin Institute, which offers Eating Disorder Mentor and Coach Training, online and in-person Continuing Education for clinicians, and other specialized trainings.

Should You Watch 'To The Bone'? A Yoga Therapist Shares Her Hopes and Concerns About The Movie

Photo Credit: Netflix

When pictures and trailer clips of a disturbingly thin Lily Collins began to show up in my news feed the other week, I resolved to avoid the movie To The Bone and all discussions about it. I wasn't going to watch the trailer, read about the movie, comment about it on social media, or write a blog post about To The Bone, the first motion picture about eating disorders due out in the US on July 14 on Netflix. I was determined to sit this one out and wait for the buzz to pass.  

Collins plays a severely anorexic teenager named Ellen, and when I say "severely anorexic," I am not exaggerating. She's a haunting figure, barely there. She is painfully ill and her body is painful to take in. Even now, writing about her, I feel a pit in my stomach--a raw visceral reaction that comes from a sincere concern for the actress, the memory of and deep care for the women with whom I have been in treatment, and from an honest and personal knowing about the life she portrays in the film. Also unsettling for me is the fact that Lilly has a history of anorexia and bulimia. And now, here she is, as sick as can be again, reliving anorexia. For all these reasons, I was set on not getting caught up in To The Bone. I just couldn't see how this movie and the hype around it would support me in my life.

Low and behold, the very next day after explaining all of this to a friend, I received an email from The Renfrew Center of Philadelphia, asking me to appear as an alumna on a local news station with Samantha DeCaro, PsyD, Assistant Clinical Director at Renfrew to discuss my reaction to the 3-minute trailer for the film. Of course, I was excited (exhilarated really) and quite touched Renfrew invited me to do this. How could I not be? And I am grateful they did, because it turns out I do have some important things to say about the trailer, and I am actually a better woman, mother, yoga therapist, and member of the eating disorder recovery community for speaking out. 

In the less than 48 hours I had to prepare for my 3-minute interview on Fox29, I watched the trailer several times, read articles about the film and its director and lead actress, had a heart to heart with my husband, and put out an inquiry on social media, asking people to tell me about their thoughts, opinions, and concerns about the trailer for To The Bone.

After hearing back from so many people, I felt secure in my initial reaction to avoid the film. Many people had similar responses to Collins' physical appearance. More than that, they were deeply disturbed that the actress has a history of anorexia and bulimia and reported she lost weight in a "healthy" way for the film. Like the others who wrote to me, I am very worried about the message this sends to the recovery community as well as teens and others who are vulnerable to messages about weight loss and the connection between one's self-worth and jeans size. After more than 20 years of healing from anorexia, I can say with confidence, that it is highly not possible to lose weight in a "healthy" way. And there is clearly nothing healthy about Collins' body, and I am worried about the state of her mind after embodying this role in such a dramatic way. 

Based on the trailer, anorexia is clearly front and center. I am concerned that anorexia has become the face of eating disorders in the media. The "thin ideal" has glamorized the disease, making it a one-dimensional disease about weight and food. I am hopeful (fingers and toes crossed) that To The Bone will give voice and attention to other types of eating disorders and that other bodies, genders, races, and a spread of ages will be represented. To exclude these bodies and voices would be a severe shortcoming on the part of the film and an enormous disservice to the eating disorder community, including the families and supports of those who struggle.

I am also hopeful that the movie will portray the complexity of eating disorders as well as capture the resiliency that is possible with proper treatment and dedication to one's healing. The joke in the trailer about "calorie Aspergers" is offensive, and not one appreciated by several of the people I corresponded with on social media. In the context of the movie, it may work. But as a one off, it makes me wonder if the complexity of anorexia will be brought to light. 

Another concern is that the movie's ending will suggest that Ellen gets to go home cured. This just isn't the case in real life, and to give families and supports such false hope could be devastating for all parties involved. Let's hope that recovery isn't itself glamorized as a mountain that is conquered after a few weeks or months away at treatment.

Although I value Collins' lived experience and dedication to her career and mission to, I am concerned that To The Bone will fall short in its efforts to accurately educate. I worry it will trigger many and even set off a desire to be "sicker" in others. Still, I am hopeful that this film will initiate important conversations about eating disorders and their prevention and treatment. I am hopeful that the recovery community will come together with honest feedback about whether or not a motion picture in the first place is helpful. As my husband shared with me, a documentary is much more humane and real; let the individuals who are living it share in real time about their experiences.

There are many more concerns and hopes I have about To The Bone, but I want to turn this blog post over to you now. I'd like to hear your thoughts and opinions about the trailer. Please share in the comments below or email me. It's only from learning from one another that we can grow stronger in our voice and more confident in our right to use it!

Sadly, the video clip of my interview is currently unavailable. Should it become available, this post will be updated!

Jennifer Kreatsoulas, PhD, RYT 500 is the founder of Chime Yoga Therapy and specializes in eating disorders and body image. In addition to her private yoga therapy practice, Jennifer leads yoga therapy groups at the Monte Nido Eating Disorder Center of Philadelphia, is cofounder of the Body Kindness Project, and a partner with both the Yoga and Body Image Coalition and the Transformation Yoga Project. She is the creator of the home video series Yoga to Strengthen Body Image and Support Eating Disorder Recovery. Her writing on the topics of yoga, body image, motherhood, and eating disorder recovery can be found on her blog as well as several influential online publications.  Connect with Jennifer.