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Sarah Voegtle
29/Jan/2019

Disordered Eating in the Military

For just over 4 years, I worked as a dietitian for military members (and their families) on one of the largest Marine bases in the world.  I was and am honored to work with this unique and special population.  Just a few months after I started that job, I realized that disordered eating ran rampant among these men and women in uniform. My eating disorder (ED) patient load became so large that I knew that I had to get additional knowledge and training to ensure these folks were getting the best care possible. You see, not all dietitians specialize in eating disorders.  It is a very specialized field of nutrition that requires additional education to ensure competency in treatment.

Unfortunately, there is only outdated and limited research about eating disorder prevalence and treatment in service members. This may be in part because many wouldn’t want to actively admit disordered eating due to the possible consequences.  In my experience, many of those who came forward to seek help were also administratively separated (honorably discharged)- if these service members wanted to continue to serve their country this would be a good reason to keep their mouths shut.  That being said, we do know that military members are six times more likely to have an eating disorder than their civilian counterparts. We also know that Marines are affected more than other branches but likely because they have the most stringent physical fitness tests (PFTs) and weight standards. Don’t get me wrong, though, all of the branches of the military suffer from an increase of disordered eating and eating disorders.

So why the higher numbers in service members? Well, there isn’t great research on that. My professional and personal opinion would point to a multi-factorial cause:

  • Trauma – people who have experienced trauma (whether physical, emotional or sexual) in their lives are at a greater risk for developing an eating disorder
  • Control – when a person is in the military, they are pretty much owned by the government. They have no control over their day to day lives (at least not like civilians do). The eating disorder could be a way to maintain control in a world where nothing else can be.
  • Perfectionism – some have hypothesized that the things that make up a good soldier are the exact same things that can breed eating disorders. Perfectionism is praised in the military – even receiving higher/better evaluations for better fitness scores.
  • Body-shaming – in many instances I treated patients who were shamed by their higher-ups. Unfortunately, this is very common. These patients would often be referred to as “fat bodies” (a not so endearing term that military members use to label someone they feel is out of regulations).
  • Unrealistic standards – the military measures body fat with the “tape method”- an non-researched and inaccurate measuring of different body parts where those measurements get put into a formula that spit out a certain body fat percentage. Research has shown that this is an inaccurate way to measure body fat when compared with gold standard of DXA or underwater weighing. Unfortunately, being able to use these gold standard methods would be too costly, thus the military continues to measure body fat with the “tape method”.
  • Misinformation – many military members look to their recruiters (prior to joining) or their chain of command to see how to get into shape and/or lose weight. Disordered eating methods are so prevalent, unfortunately, because many of these folks have experience with trying to cut weight fast for a weigh-in. (Remember if standards aren’t met, they’ll get kicked out of the military).

As previously noted, I think that there are many reasons that military members are at higher risk and have a higher prevalence for ED. The real concern, however, is the need for these patients to get the specialized care for their eating disorder. Often, patients are sent to the closest dietitian or therapist when he/she may not be the most appropriate in treating the disorder.  If you are a service member, or know someone who is who suffers from ED, remember to advocate for your health; find a local specialist in disordered eating so that you can get the best treatment possible.

Sarah Voegtle, MS, RD, CSSD, LDN is a registered dietitian specializing in eating disorder and sports nutrition. If you’re ready to get specialized treatment and any nutrition needs, contact Chrysalis Center at (910) 790-9500 to schedule your initial appointment with Sarah. 

 



As the new year approaches, many people start thinking about making resolutions. The practice of setting resolutions actually dates back 4000 years. During a massive 12-day religious festival, the Babylonians crowned a new king or reaffirmed their loyalty to the reigning king. They also made promises to the gods to pay their debts and return any objects they had borrowed. The ancient Romans began each year by making promises to the god Janus, for whom the month of January is named.

With thousands of years of practice, you’d think we’d be better at achieving resolutions. The reality is, while 45% of people make resolutions only 8% of them achieve them, with 80% of resolutions “failing” by the second week of February. Why set yourself up to feel bad in five weeks or less? A more effective practice, taken from Acceptance and Commitment Therapy, would be to set values-based goals.

Acceptance and Commitment Therapy (ACT) is a type of research-supported therapy that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. Psychological flexibility means connecting to the present moment fully and changing or persisting in behavior in the service of chosen values. Many of the groups offered at Chrysalis are based in ACT.

According to ACT, the first step, before any goal setting is to clarify what value(s) is (are) underlying your goals. Studies have compared goal setting alone, versus goal setting plus values clarification, and found that those who identified their values actually performed better.

Once you have selected values that are important to you, make sure you set a SMART goal. There are different versions of this acronym, but in the iteration used in The Happiness Trap by Russ Harris (a leading expert in ACT therapy), SMART stands for:

•Specific: specify the actions you will take, when and where you will do so, and who or what is involved.

•Meaningful: The goal should be personally meaningful to you. If it is genuinely guided by your values, as opposed to following a rigid rule, or trying to please others, or trying to avoid some pain, then it will be meaningful. If it lacks a sense of meaning or purpose, check in and see if it is really guided by your values.

•Adaptive: Does the goal help you to take your life forwards in a direction that, as far as you can predict, is likely to improve the quality of that life?

•Realistic: The goal should be realistically achievable. Take into account your health, competing demands on your time, financial status, and whether you have the skills to achieve it.

•Time-bound: to increase the specificity of your goal, set a day, date and time for it.

If this is not possible, set as accurate a time limit as you can.

The next step is to write down a graduated series of goals, starting from tiny simple goals that can be achieved right away, to long term goals that may not be achieved for months or years. ACT experts break it down in the following format:

  • set an immediate goal-something small, simple, easy, I can do in the next 24 hours
  • short term goals- things I can do over the next few days and weeks
  • medium term goals- things I can do over the next few weeks and months
  •  long term goals- things I can do over the next few months and years

Hopefully trying a different approach to a time-honored tradition leads to better success with achieving your goals. Cheers to a happy and healthy 2019, living your life in harmony with your values!

For more information about Acceptance and Commitment Therapy:

www.thehappinesstrap.com

https://contextualscience.org/act

Kelly Broadwater is a psychologist who uses ACT in her individual therapy and as a group facilitator. She helped develop the Mindful Living group series offered at Chrysalis, which is ACT and DBT informed. Her motto, informed by her values, is “Work hard, play hard”.


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It’s that time of year with holiday feasts and parties galore. It’s also that time of year when you’ll hear lots of recommendations for tackling those festivities in a way that keeps excess weight at bay. Not all such advice is worth following. Here are nine of the worst holiday healthy eating recommendations, and how you should approach eating this season instead:

1. Wear tight or fitted clothes to a holiday party to prevent overeating.

You should be able to wear whatever makes you feel your best instead of letting food dictate your fashion choices. Your body’s hunger and satiety signals will work regardless of how you dress. The holidays are about connecting with family and friends, not being preoccupied with how uncomfortable you are.

2. Don’t eat all day to save all of your calories for the feast or party.

Not eating quality food with protein and fiber throughout the day is a surefire way to cause you to dive headfirst into the dip bowl because of extreme hunger. I always recommend having packed breakfast or brunch and a small snack like a hard-boiled egg or Greek yogurt with berries before leaving for your celebration. That way, you can take a more rational approach to the appetizers and avoid filling up too quickly on high-calorie and high-fat snacks.

3. Fill your plate with salad and crudités at the holiday buffet so you don’t overdo it.

This advice is just plan sad, plus it sets you up for a buffet binge later in the night when the cocktails may have kicked in. You can get baby carrots anytime! Instead, acknowledge your desire for something special and be mindful of your choices. Take a small portion of just those items that you can’t get at other times of the year or that are most special to you.

4. Don’t make a plate; you’ll eat less.

No! Make a plate. Fill your plate once so you know exactly how much you consumed and won’t be tempted to keep revisiting the buffet. Finger foods can be dangerous since you can easily walk by the buffet table and grab more than you realize. Before you know it, you are full of sausage balls, cheese cubes and cookies.

5. Go on a liquid cleanse the day before the feast or party to negate the excess calories consumed during that meal.

Depriving yourself of adequate meals prior to a day when mindful recipe options may not be available will lead to excessive eating because your body is seeking nutrients and food. You will find yourself overeating on this day to compensate for the lack of food the day prior. If you keep your meals balanced throughout the week, however, one day of splurging on that pumpkin pie and seconds on the gravy and stuffing will not hinder your health (or your weight).

6. Make a totally different version of your favorite holiday dish to reduce calories.

While using, for example, less butter or cream may not make a difference [in taste], if you make mashed cauliflower instead of grandma’s creamy mashed potato recipe that you only have once a year, you likely won’t feel satisfied. This ‘strategy’ not only takes away from a holiday tradition but can also lead to overeating on the food to attempt to feel more satisfied.

7. Eat more to prevent food from going to in the garbage.

While food waste is a big concern, there are other ways to put leftovers to use than eating them all in one sitting. Leftover turkey can be used to make sandwiches or a homemade turkey soup, while the extra vegetables and potatoes can be combined with eggs to create a colorful frittata.

8. You can work off all those extra calories with some exercise.

Just because you did a turkey trot doesn’t mean it’s a good idea to eat two turkey dinners and waddle home. It’s a great idea to keep up with your exercise routine during the entire holiday season but be careful not to use that as a constant reason to overindulge.

9. Skip the party!

Holidays are not about the food – they are about the friends, family and fun to be had with all. Live fulfilled and enjoy them! Food brings us together to nourish our bodies; people around us nourish our spirits and knowing you will be OK nourishes your mind. Keep yourself on track and embrace every holiday by practicing mindful eating.

Happy Holidays

Terri Mozingo, RD, LDN, CEDRD is a Certified Eating Disorder Registered Dietitian passionate about helping her clients achieve overall wellness.



Endless to-do lists, financial strain, dreading family functions, feeling lonely, fear of holiday weight gain, experiencing mental and emotional exhaustion with a full calendar can rob us from our happiness during the holidays.  Mindfulness is a century old Eastern concept that is well known to gift us with more peace.  Mindful eating means paying closer attention to your body, habits and triggers.  I’d like to share a few tips to find more joy and treat your body with respect this year.

Gracefully arrive to the meal.  Food represents the gift of energy, effort and life.  No matter what personal or faith-based beliefs you have, find some words to cultivate gratitude either silently or aloud prior to eating. Before diving into the meal, pause and reflect both inward and outward.  Enjoy the food with attention and appreciation.  It has a powerful ability to nourish your body while you experience pleasure.

Let go of the rules.  It’s OK to get seconds and it’s OK to leave food on your plate.  Using your sense of appreciation and gratitude for the food, reflect inward to your stomach cues with intention to eat an amount that gets you comfortably full.  Make food decisions from a place of wisdom and acceptance rather than habit or obligation.  Listen to what your stomach tells you.  Find what works for YOU rather than doing what you think you “should” do.

Stay present.  Appreciate the holiday food by recognizing the taste, flavor, texture and smells.  Become aware of your choices without judgement.  Compassion and empathy are the remedy for judgment.  Mindful eating can mean eating with a deep awareness of what we are eating and why we are eating.  Be curious of what comes to surface, it may be worth investigating later.  Allow yourself to have a thought or experience an emotion without having to react to it.  Be aware of your surroundings, urges to eat out of obligation as well as emotionally driven cravings.  Be aware of various degrees of hunger; mindfulness works best when we avoid the ravenous stage of hunger.

Practicing mindfulness brings an opportunity to experience food as an enjoyable source of nourishment, something to welcome and celebrate.  Consciousness is an essential ingredient to your well-being.  Eating mindfully is a journey and takes practice; expect yourself self to slip up from time to time.  The key is not giving up when you stumble.  Be kind to yourself and keep learning; progress no perfection. I challenge you to be more mindful this holiday season and you may just feel more merry.

 

Chaundra Evans, RD, LDN, CEDRD-S is a Certified Eating Disorder Registered Dietitian and an approved supervisor for the International Association of Eating Disorder Professionals. She helps her clients build a healthy relationship with food and improve their eating habits using a non-diet approach. If you’re looking for this type of nutritional support from a nutrition professional, call our office at (910) 790-9500  today to schedule your appointment. 



  The holiday season is a universally stressful time of year – a lot of people get stressed about money, winter is upon us, there is a lot to do that is out of our daily routines. Given all this, it is no wonder it gets to us.

While it might seem stressful to add mindfulness to your list, it can help us manage the stress and get the most out of the season. After all, this is a time to connect and be thankful as well. And for those with eating disorders, the holidays can feel like an enormous roadblock – parties, dinners, family, travel – that just keeps hitting you from Halloween all the way to Valentine’s Day.

Here are some ways to use mindfulness to cope with the season in general as well as some ways that loved ones and those with eating disorders can use it to mitigate the negative impact their eating disorders have on the holidays.

Practice gratitude and acceptance – If there is only one part of this that you implement, let it be this. Practicing gratitude through journaling, affirmations, meditation or prayer has been proven over and over to increase general life satisfaction, improve medical outcomes, and elevate happiness scores. Obviously, we focus on this at Thanksgiving but let’s not end it there! Just thinking about gratitude is enough to get the positive effects – even better if you are able to do it every day. Also, saying your thanks to others helps you share that gift with the people you care about.

Acceptance operates in much the same way, but it allows you to get un-stuck from the worries, demands, or people that might get you down. If you are able to identify those situations beyond your control that are getting you stuck, sometimes all it takes is acknowledgement to accept the situation and move through it. The same way you write, speak, or think gratitude works for acceptance – though you might not want to tell your Great Aunt Ann out loud that you accept her fill in the blank issue.

Be aware of your own needs – it is important to be open to and make space for your own needs, thoughts, and feelings. We all have different associations with the holidays – family, traditions, past experiences, loss – and need space to process them our own ways. Do not forget to take care of yourself and be good to yourself.

Allow yourself some peace – letting go of judgement, enjoying experiences and not focusing on the outcomes, doing less, unplugging, and spending some time alone are just some of the ways we can get some peacefulness and space in our lives. There is no other time of year when we have so much time with our support system and so many reminders of the importance of them. Everyone on the planet needs that in their lives. But we need to remember that everyone has different levels of need for connection and it is important to give yourself and your loved ones room to do that in their own ways.

Play – having fun is sometimes lost in the busyness of the season. What makes you smile? What positive associations do you have with different holiday or winter activities? Adults need playtime too! Think about something you liked as a child and do it with your own kids, your dog, or your partner. Connect. Make it happen!

Practice compassion – compassion and lovingkindness are two important concepts to apply to yourself as well as others. When we keep compassion in the forefront of our minds, it allows us to take care of ourselves, and be more attentive and more relaxed. Usually, that also makes us kinder and more open to others, keeping the holiday spirit alive.

For those whose loved ones are suffering with an eating disorder, here are some other ways to manage food stress associated with the holidays:

Don’t be the “food police” – for adults, it is not anyone else’s responsibility to manage their food choices, it is something each individual has to decide. If you have an eating disorder, try to stick with the plan that you and your therapist and dietician have worked out. If you are supporting someone, talk about what would be helpful to them ahead of time and follow through.

Pick your moments – walking on eggshells or avoiding difficult topics might let your family dinner be more peaceful, but some issues do need to be addressed. If you are concerned about someone’s eating behavior, or even just their stress level, it is important to talk about it. But maybe not at the dinner table or in front of the uncle who gossips about everyone all the time. If you do confront them or attempt to have a conversation, make sure you are being honest and saying what you mean to say. It might even be helpful to have a plan, especially if you have tried to talk about it before and it hasn’t gone well.

Let go of judgment (and practice compassion) – mindfulness is all about not judging. There are lots of stereotypes that stigmatize eating disorders – do not assume you know what their experience is like (or vice versa).

Family can sometimes trigger judgment and criticism – try to notice when you are judging yourself or internalizing messages from others. Next, take a step back and try to observe the feelings without judging them and you might be able to give yourself some much needed space for kindness, empathy, and compassion.

Use “I” statements – eating disorder or not, it is never a good idea to assume you know where the other person is coming from. “I” statements – “I feel (an emotion)   when you       do this behavior or say this specific thing)        .” help solve this problem. By expressing your own feelings, you increase your ability to connect and reduce defensiveness. Stick to pointing out what you have observed and keep your non-verbal communication calm and open.

Here are some things that are never appropriate – “Just eat!” and “Just stop!” are not useful comments. Never comment on the weight or with an eating disorder or tell them they look ”healthy” – try not to make any comments about that, especially when food is involved. Commenting on what they are eating, especially during a meal, is not helpful (unless they ask you for feedback directly).

 



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This column contains a couple of common questions from the parents of my patients about kids during the holidays.

What are your suggestions for helping kids have reasonable expectations for what “Santa” brings (when other kids get expensive stuff)?

There is no one answer to what is right for Santa to bring so please keep that in mind as you read these suggestions. Santa is an extension of family and as such should match your family’s values.

Having family conversations with your children well ahead of the exciting build-up to Christmas can help children have expectations that match what is right for your family. Even though children learn about Santa in many places, the main place they learn about Santa is at home. This is a great opportunity to teach them what Santa means to your family. Having these conversations together before the buildup to the holidays can help teach children many of your family’s values that go far beyond material gifts.

If your child complains that gifts are “not fair” or that another child got a “better” gift from Santa than they did, try to respond with empathy rather than lecturing them for being ungrateful for what they received. In doing so, you are teaching an important value—namely that you care about each other and hear each other out when you feel wronged.

This does not mean that you need to agree or promise the moon for next year. Just acknowledging a hurt goes a long way to helping someone feel understood and loved. Even though we may not think so, showing empathy in this way is a gift that we can give our children and Santa would surely approve.

How do we help our children learn boundaries and ways to stay safe around unfamiliar family and friends during holidays?

Recommendations from pediatricians and child psychologists/psychiatrists have changed dramatically from the “old days” when children were forced to hug and kiss family friends and relatives. The reason for this change is that it corrects a harmful mixed message that may have made children more likely to be exposed to dangerous touching.

The current recommendation is that that you should not force children to have unwanted physical interactions with others. This allows children to decide who and when to hug. In addition, you should help your child set limits if you feel a situation is not appropriate or if an adult is trying to force a hug or a kiss and your child seems hesitant.

It is ideal to have conversations about this as a family before the holiday season. This will give your child plenty of time to ask questions and also to let the ideas you share with them “marinate” before they have to apply them. You can let children know that they don’t have to do the same thing to every person or every time and that is okay. They don’t have to offer explanations to people for not giving physical affection. And importantly, that you support them no matter what.

Monitoring your children at family events is important. It is also appropriate to step in and say, “If Bobby does not want to hug that is okay.” Instead of physical affection, you could have your child help put up guests’ coats or show guests where the snacks are set out. This way children learn about respect and hospitality while also learning that you support them when it comes to setting limits about physical interactions with others.

The Girl Scouts have a parenting article on this topic that has additional considerations: “Reminder: She Doesn’t Owe Anyone a Hug. Not Even at the Holidays.”

Last, try to avoid using labels for your child or giving excuses such as, “Oh, he’s just shy.” Your child may take that label to heart and it could have an unintended negative impact on your child’s self-esteem. It is not “shy” to set a limit and decide not to hug a relative. It is a show of strength and there is no need to make excuses about it. Supporting your child and modeling limit setting is the best way to ensure that your family enjoys the wonderful holiday festivities at hand.

Happy Holidays & Happy New Year!


 

 Dr. Kate Brody Nooner is a licensed clinical psychologist and associate professor of psychology at UNCW. She also holds an adjunct appointment at Duke University and is the principal investigator of NIH-funded grants aimed at reducing child and adolescent trauma and preventing alcoholism.


Emily Lockamy
30/Nov/2018

‘Tis the season for invitations – to holiday parties, performances, Secret Santas, tree lightings, cookie swaps, and other fun-filled, festive gatherings.

But for people who are wrestling with mental health concerns or painful life transitions, like a divorce, a recent loss, or serious depression, such activities can seem overwhelming and unappealing.

But the pressure to appease well-meaning friends and family members who request your presence at such events can feel immense. You may feel as though you can’t say no for fear of disappointing them, even if you know that accepting their request will only bring more stress and distress at a time when you feel like you’re hanging on by a thread.

Declining invitations can feel difficult, but setting boundaries and doing what works best for you as you try to cope and recover is important. And there are several ways in which to make the act of saying “no” feel more doable:

  1. Use Mindful Self-Compassion to justify your choice.

Self-compassion involves being kind to yourself during difficult moments – instead of berating yourself for not being “strong enough” to want to celebrate this holiday season, speak to yourself like you’d speak to a close friend. Say, “This is a period of pain… Pain is a part of life… May I be patient with myself and give myself the compassion I need.”

Instead of blaming or shaming yourself for “letting others down,” acknowledge your shared sense of humanity: “Everyone struggles at some point. I’m not alone.”

  1. Recognize your rights as a human being.

As leading expert on self-compassion, Dr. Kristin Neff, points out: none of us signed a written contract before birth promising that we’d be perfect, that we’d never fail, and that our lives would go exactly the way we want them to. So why should we hold ourselves to unrealistic standards?

Experts in Dialectical Behavior Therapy (DBT), explain that we all have legitimate rights that reflect our value as humans. A few rights in particular are key to remember when it comes to navigating relationships and having hard conversations:

“You have a right to need things from others.

You have a right to put yourself first sometimes.

You have a right to say no; saying no doesn’t make you bad or selfish.

You have a right not to justify yourself to others.

You have a right, sometimes, to inconvenience or disappoint others.”

It’s perfectly okay to exercise those rights when needed.

  1. Use assertiveness skills to respond.

The ability to say no is an essential part of healthy communication.

“Saying no is simple and hard at the same time,” write authors of the DBT Skills Workbook, McKay, Wood, and Brantley. “The words are simple, but often it takes courage to say them.”

Effectively passing up an offer entails just two steps:

  1. Validating the other person’s needs or desires.

Example: “I appreciate you including me. You always throw great dinner parties.”

  1. Stating a clear preference not do it.

Example: “But I’m really not up for it this year. I need to take some time to rest.”

While it may feel uncomfortable at first, the more you practice being assertive – confidently expressing what you want, need, or believe, while respecting others’ feelings – the easier it will be.

  1. Remember that boundaries make for better relationships.

We can’t please all the people all the time, and we can’t be everything for everyone. And even if we could, it would come at a high price. Maintaining good boundaries is one of the healthiest things we can do for ourselves and our relationships. Protecting our own boundaries helps us avoid feelings of hurt and resentment, and enables us to take better care of ourselves and experience a clearer, more positive self-concept. Respecting others’ boundaries helps us cultivate more balanced, supportive, and caring connections. And sometimes, having firm boundaries means saying no. 

  1. Recognize that all feelings are valid, but no feeling is final.

It’s hard to be in a dark place during the “most wonderful time of the year,” but these feelings won’t last forever. Give yourself permission to hibernate a bit, or change up your traditions (knowing that you can always revert back to being busier and more social next year). But also be mindful of the tendency to isolate and withdraw, which can worsen depression. Try to seek and accept support in ways that feel helpful.

Lastly, while you may assume that all the bright lights, merry music, and cheery people will surely only fuel your low mood, try to stay open to the possibility that being around others and getting out of your comfort zone may help lift your spirits.

If you do decide to go out, you can give yourself an out.

Example: “Gotta get home to take my dog out!” or “I think I’d better leave at intermission.”

You can also say “yes” to something and reserve the right to change your mind, at any time.

If you do opt to don your “ugly sweater” and attend the annual bash, it can help to plan ahead and anticipate difficult feelings that may surface and how you’ll handle this (if you’re at a loss for coping skills, therapy can help). At the same time, try to practice positive thinking by interrupting anxious ‘what if’ thoughts with a different kind of question: “What if I have a great time?”

Most importantly, be gentle with yourself this season. It’s not an easy time of year, but pain does not have to equal suffering, and suffering does not have to be done in silence. If you’re finding that you need to talk to someone, call 910-790-9500 to set up a therapy appointment at Chrysalis Center for Counseling and Eating Disorder Treatment.

And remember, ‘no’ can be a full sentence.

Emily Lockamy is a licensed professional counselor associate and freelance writer passionate about helping people find their way through grief, anxiety, and other struggles. Emily also facilitates Healing Words: A Therapeutic Writing Group, helping people process emotional pain through the art of writing.

 

(Image source: BBC)


Sarah Voegtle
21/Nov/2018

With the hustle bustle of the holiday season, it is very easy for anyone to get stressed out and overwhelmed.  For someone with an eating disorder, this stress can be amplified with the gathering of people for holiday get-togethers and parties that are celebrated with food and eating.  It’s important that people with eating disorders and their families prepare themselves for the holiday season in order to reduce stress and discomfort.  Below are some helpful tips that may ease the distress of the holiday season.

 

  • Plan, Plan, Plan– Speak with your family and friends to see what the food spread might be at the get together. Come up with a meal plan that includes all food groups in order to leave you satisfied but not filled with regret after the event. Try to avoid anything that may trigger negative self-talk or urges to engage in disordered eating behaviors. If you are traveling, plan the snacks that you will take with you in order to keep your body nourished.
  • You CAN do it! The holidays are stressful but you really can do this. Challenge negative or irrational self-talk during this holiday season. Practice positive self-affirmation daily and fill your day with positive music and company. Remember to focus on facts, not irrational or unrealistic thinking.
  • Set Boundaries– Remember, you don’t have to attend every event or get together that your invited to. Choose a few that you will feel most comfortable at both with the food but also the company. If you have family or friends that you think may make a comment to you that is uncomfortable either about your body or eating, reduce your contact with them.
  • Variety is the Spice of Life– There are no “good” or “bad” foods. During the holiday season we often consume foods that we may not during other times during the year, that’s okay! Food is not the enemy, it is fuel for a living body! Allowing yourself to be more flexible with the kinds of food you eat will help you live a fuller and more freeing life. Plus, our bodies love being nourished by all different kinds of foods.
  • Breathe– You may have anxiety during this holiday season. Come up with healthy ways to cope with that anxiety. Make a list so that when you’re feeling anxiety you don’t have to think about it, but you can go right to that list and choose something. There are also great smartphone applications, such as Calm or Headspace, that offer wonderful guided meditations to help reduce stress and worry.  Don’t forget to plan some restorative time for yourself, as well, to decompress from the holidays.
  • Listen to your Body– During this holiday season try to focus on mindfulness. Focus on the flavors, smells, and sounds around you. Allow yourself to fully listen to your body when it’s hungry and when it’s full. Being mindful of any urges or emotions you are feeling and make sure to seek support when needed.

Above all else, the holidays are supposed to be a time for joy. Be kind and forgiving to yourself, as you would any other person that you care about. Embrace where you are in your recovery and always show yourself grace.

Sarah Voegtle, MS, RD, CSSD, LDN is a registered dietitian specializing in the treatment of eating disorders and sports nutrition. Sarah enjoys empowering her clients to improve their overall health through nutrition. 



Being newly single can be quite challenging during the holiday season. You feel bombarded with images of budding romance and happy families.  You realize that the traditions you had participated in will change. Overall, your expectation is that you will be lonely, restless, and maybe even depressed. As challenging as it may seem, consider this as an opportunity to learn how to be single again….and perhaps, even to embrace it.

Here are 11 things you can do to make the holiday season brighter.

Play It Forward: remind yourself that how you are feeling during this season is NOT how you will be feeling for the rest of your life. We all go through cycles and changes in life. This may be a low point for you, but there will be an upswing.

Do A Reality Check: don’t assume that everyone else is doing better than you. You never know what an individual or family might be struggling with. And, the idea of a happy traditional family setting might be more of a marketing tool than reality.

Seek Wisdom: talk to people who have gone through the holidays as a single person. Ask for their advice on how to cope. You will find comfort and support in their responses.

Create New Traditions: find new ways to celebrate the holidays. If you always had turkey for a holiday meal, try something different. Attend a different holiday religious service. There are many creative ways to start new traditions.

Learn To Say “No”: if you receive an invitation and you’re just not ready to go out socially, or the situation might make you uncomfortable, it is okay to say “thanks for the invite. I’m going to take some time out for now”. It is also okay to accept invitations, attend the event, and leave early. In other words, give yourself permission to set limits.

Go Public: if, on the other hand, you are someone who enjoys chatting and connecting (most women do), then accept invitations and approach each one as an opportunity to feed your need for connection. Research has found that one way to treat depression is to put yourself in a public setting in order to be around people and enhance your mood.

Practice Altruism: it is a proven fact that acts of kindness improve our mood. In addition, exposure to the hardship of others gives us a meaningful perspective on our own problems. The holidays are a perfect time to get out and volunteer or organize donations for those in need.

Reclaim An Interest: is there something you neglected or gave up entirely while you were in your previous relationship? Now if a great time to reclaim it. Set aside time and space dedicated to doing something you enjoy, especially if it is creative or offers the opportunity to meet new people.

Try Something New: there’s probably something you’ve been wanting to “try” but have held back. Use this season to “just do it”. Not only are you likely to enjoy yourself, but imagine how good it will feel to have stepped outside of your comfort zone. You’re likely to feel proud and confident which will add to the sense of reclaiming your life.

Declare A “Me Day”: be a little selfish and spend a day focused on yourself, whether you stay home in PJ’s watching TV reruns or movies, or go out for a nice meal, get a massage; whatever makes YOU feel good.

Follow the Sun: exposure to natural light is known to be a mood enhancer. If you don’t have the resources to travel someplace warm and sunny, try a full-spectrum light. If you can’t get natural light, use environmental cues to enhance your 5 senses: look at sunny climate images, rub suntan lotion on yourself, play uplifting music, burn a candle, eat some strawberries.

Take this list and track your use of it. Having a plan that offers choices gives you a sense of taking control of your life. Tracking your behavior and emotions gives you accurate feedback about your successful transition from “we” to “me”.

For anyone who is struggling….you do not need to be alone. Reach out to a support group and/or seek counseling.

Kerri Schroder, PhD is a licensed psychologist who finds passion in helping people through life transitions. 



This guest blog is written by a client who wishes to share her thoughts…

Sometimes I have to ask, “Is there something in our water?” Something that makes it okay to comment on someone else’s body? Something that affirms that “beauty is only skin deep”?

I have been pondering these ideas after a recent interaction I had on a dating site, using the dating site account profile that I set up years ago. I recently got back on the site and had not yet updated my profile. (It is now up to date: the “sick” me is not one I want to flaunt. Not only is it not a realistic representation of what I look like anymore, it also brings up old memories. Memories better left in the past.)

While updating my profile I was struck by how few recent photos of myself are included in my photo albums. Why is this? The shame of my new body. I avoid the camera at all costs. Not because I am so worried about other people who are obviously drinking tainted water, but because I am only human and I must confess: I drink water, too. I am filled with embarrassment every time I see my reflection. It just doesn’t fit what I am feeling on the inside or what I have been through in the past.

That’s the key point here: it was in the past. My past not my present. A lot has changed since then. Not just my body. Being in recovery has changed my body of course but it has also changed my life. And while I struggle with body image daily I would not return to my past for a chance to be in my “sick” body.

Sure, on days like today it seems extremely tempting to return to old patterns. I found this out all too quickly as I casually skipped breakfast this morning. The thing is – it was not casual or unimportant. It was intentional. A direct choice influenced strongly by another.

Which brings me back full circle to the dating site and profile I mentioned earlier. So, I was talking to this man, right? As people often do on dating sites. One thing led to another and we set up a time to meet. Before the conversation ended, he asked to see more photos. I agreed and shared my personal Instagram username.

After several minutes he returned to the conversation. He commented to me on “how drastic a change your body appears to have been through.” He continued, “you’ve gained a lot of weight.” My heart sank. And he is right: my body is no longer the same body I had then.

My body is now one filled with life and not just an empty shell that I wear.

Rest assured, the date is off. But today I have to pick up the pieces left behind by that conversation. Today I have to be strong. Today I have to make the choice for recovery, which is more challenging than it was yesterday. Today I remind myself that he is only human. That though what he said hurt me, I will not let it throw me back down the rabbit hole I once lived in. Today I hold both: the fact that what he said was true and that what he said was extremely wrong and inappropriate.

I hold hope today. Hope that he learns to think before he speaks. Hope that he does not so badly offend someone else. And mostly, I hold hope for myself. That I can learn to accept my body as my own and embrace it. That I can stand tall and proud of the person I have become. Because truly, I am the only person who knows the depth of what I have been through. I did not share with him that I am in recovery from a severe eating disorder. Nor did I share how hurt I was and am by his words.

Let me leave you with these two things: Have hope, it honestly gets better. And, think twice before you drink our society’s tainted water.


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