Eating Disorders: Not Just an Issue for Teens

Shannon Eberlein, LMSW – Intake Coordinator

Eating disorders have a false reputation of being illnesses that primarily impact adolescent girls.  As anyone who treats or suffers from eating disorders can tell you, that is certainly not the case.  Anorexia, Bulimia, and Binge-Eating Disorder impact men and women of all ages – from young children to senior citizens.  Many patients tell me that they can remember feeling negatively about the shape or size of their bodies all the way back to grade school.  This myth that eating disorders are a “teenage issue” that resolves itself over the years can lead to feelings of shame and guilt when the illness continues on into adulthood.

Health at Every Size

By Katy Harvey, MS, RD, LD

Albert Einstein once said, “Insanity is doing the same thing over and over and expecting different results.”  Studies have shown that 80% of American women are dissatisfied with their weight and 42% are actively trying to lose weight by dieting and/or exercising^1,3.  These strategies rarely produce lasting weight loss.  It has also been suggested that chronic yo-yo dieting is harmful to one’s health.  So why do Americans keep putting themselves through the deprivation associated with dieting if it doesn’t work and is potentially harmful?  Perhaps a shift in mindset could break this cycle of “insanity.”

Miss Representation- A must see for teens!

By Clinical Therapist- Kara Shelman, MSW, MPH

“You can’t be what you can’t see,” is the key slogan for Miss Representation, a documentary focused on how the media’s representation of women has led to the underrepresentation of women in position of power. Girls cannot become successful, self-assured, empowered and engaged in the community around them if they do not see those who hold these traits on television, movies, and covers of magazines. This is the message that is heavily interwoven throughout the film by interviews with experts, activists and actors and alarming statistics.

Instagram Bans Pro-Eating Disorder Images

By Lauren Zolton, Expressive Therapist

The popular photo sharing site Instagram recently updated its terms of service to ban images glorifying eating disorders, as well as other forms of self-harm. Images glamorizing and promoting anorexia and bulimia are nothing new. Since the dawn of the internet, underground sites have existed which seek to perpetuate and glorify eating disorders through the sharing of dangerous tips and images depicting emaciated women. 

With the rise of social media sites such as Tumblr, Pinterest, and Instagram, these pro-anorexia and pro-bulimia ideals have not only become more prominent, but they’ve become increasingly easier to access.

Navigating the often Rough Waters of the Insurance Process

By: Shannon Eberlein, LMSW – Intake Coordinator

Anyone who has lived with an eating disorder, witnessed a loved one struggle with an eating disorder, or worked in the field of eating disorders can tell you that the illness is often misunderstood.  Unfortunately, this and other factors can lead to much-needed coverage for treatment being denied or prematurely discontinued by insurance companies.  There are several pieces of legislation pending at both the state and federal levels to help address this issue.  For those who are thinking about entering treatment and their loved ones, it is very helpful to have some basic knowledge about health insurance and the approval/appeal process.

Mindful Eating

By Katy Harvey, MS, RD, LD

Mindfulness means being present and aware in the moment – non-judgmentally.  Applied to eating, that would mean using a variety of senses (e.g. sight, smell, taste, texture) to experience food.  Mindfully eating can be intense and sensational.  According to The Center for Mindful Eating, mindful eating involves:

“Am I Allowed to Exercise When I Go Home?”

By: Kara Shelman, MSW, MPH Clinical Therapist

This is a common question from our clients before they head home, and a tricky one to answer.  How to address activity on an inpatient and outpatient status has been researched in the eating disorder community and recommendations vary.  A recent article reviews the lack of standardized exercise interventions for women with anorexia nervosa in the clinical setting, and emphasizes the need for guidelines in this area.

Controversy Erupts Over Disney’s Anti-Obesity ‘Habit Heroes’ Exhibit

By: Lauren Zolton, Expressive Therapist

Disney’s Epcot Center recently opened, and quickly closed, an exhibit purportedly aimed at encouraging “everyone in the family to join the mission of good
health.” The exhibit, titled Habit Heroes, pitted protagonists, Callie Stenics and Will Power, against villains Sweet Tooth, Lead Bottom, and The Snacker just to name a few. An interactive exhibit, visitors used arcade style guns to battle food items such as cream puffs and hot dogs with broccoli and apples. Shortly after what Disney has called a “soft opening”, the Habit Heroes exhibit quickly came under fire for what many felt was fat shaming, stereotyping, and encouraging bullying.

Advocacy Group Speaks in Support of Eating Disorders Patients

By: Deborah Haber, RN, MSN

I was very honored in the last 2 weeks to be part of exciting activities related to eating disorders and making treatment more accessible to Missouri residents.

The first was Eating Disorders Awareness Day in Jefferson City, MO February 22^nd.  A group of recovering individuals, families, friends and treatment professionals met at the Capitol Building to share stories about increasing difficulties in getting treatment due to restrictions from insurance companies.  We visited with many legislators to ask for help.  This was the fourth year for this event.

The second activity was being one of 6 people who testified in front of the House and Senate to ask for support for 2 bills, Senate Bill 634 sponsored by Senator Pearce and House Bill 1509 sponsored by Representative Stream.  These bills call for all health insurance carriers and health benefit plans to provide coverage for the diagnosis and treatment of eating disorders.  We are fighting an uphill battle since insurance companies have convinced the Missouri Legislature that they provide coverage for eating disorders.  If, however, you or one of your loved ones is fighting an eating disorder, you know that coverage has decreased dramatically in recent years. 

If you are a Missouri resident, please ask your legislators to support SB634 and HB1509.  If you would like more information about these activities, contact Annie Seal at annieseal@sbcglobal.net.

F.E.A.S.T. – A Resource for Parents & Caregivers

Shannon Eberlein, MSW – Intake Coordinator

One very important part of my job is talking with parents whose child has just been diagnosed with an eating disorder.  This is a difficult time for the entire family, and parents often feel lost and overwhelmed in the process of establishing a treatment team and trying to understand the illness.

Breaking the Cycle

By: Katy Harvey, MS, RD, LD

The cycle associated with eating disorder behaviors tends to be perpetuating and frustrating for clients.  Restricting leads to extreme hunger which can lead to overeating or bingeing. This can lead to purging or more restricting, and so on.  As a registered dietitian (RD), I help clients break this cycle at the restricting phase, which then decreases the urge to overeat/binge, which decreases the urge to purge/restrict – hopefully by now you get the picture.  One of the most helpful tools for clients trying to refrain from restricting is a meal plan.  The meal plan offers structure in the schedule and amount of eating, while offering flexibility in individual food choices.  It is designed to show clients what their body needs for nourishment and that they can eat what they want and not “lose control.”

Negative Core Beliefs

 By: Catherine Mapes, LCSW

Through my experience working with eating disorders patients, I have found that our patients are, as Anita Johnston describes in her book, Eating in the Light of the Moon, “[…] some of the brightest, most talented, and most creative [people] I had ever met. This was, however, was not how they perceived themselves. They saw themselves as incompetent, worthless, and unattractive.” An eating disorder is a complicated disease. One of its most pervasive and damaging traits is the negative core beliefs that are formed in childhood and adolescence.

Talking to ‘Ed’ - Post Discharge Conversations

By: Kara Shelman, MSW, MPH-Clinical Therapist

An important part of treatment is involving the family in a discussion of what can be helpful topics to talk about and what can be more triggering topics to discuss with your loved one when they return home from an inpatient stay. Triggering topics can include discussion of weight, calories, food talk, exercise, etc. and talking extensively about these can be very difficult for your loved one. Of course there is no way we can avoid such talk outside the safe walls of treatment but family members willing to learn what can help at home is another way to show that support!

Exploring Life with Expressive Therapy

By: Lauren Zolton, BA, Expressive Therapist

Cathy Malchiodi, author of, Expressive Therapies, defines expressive therapy as “the use of art, music, dance/movement, drama, poetry/creative writing, play, and sandtray within the context of psychotherapy, counseling, rehabilitation, or health care.” Through the use of nonverbal language, expressive therapy connects the inner self with life experiences and outer realities. Expressive therapy has the unique benefit of allowing the creator direct access to his or her deepest feelings, free of judgment and bias. As Lisa Hinz explains in her book, Drawing from Within, expressive therapies can be particularly beneficial to persons with eating disorders as they are often overly reliant on intellectualization, rationalization, and other verbal defense mechanisms. Because art and other expressive therapies bypass language, the creator is freed from language-based defenses. This freedom from verbal defense mechanisms grants the creator the ability to reveal his or her innermost truth. When using expressive therapies, we are less likely to censor and argue, making it more likely to be open and honest about our experiences and struggles.

The Outpatient Team: A Key to Recovery

By: Shannon Eberlein, MSW, Intake Coordinator

When I am assessing a potential client, one of the topics that I ask about is outpatient care.  Often, clients have either not attempted outpatient care or have lost contact with their outpatient team.  This happens for a variety of reasons – financial difficulties, lack of resources in the area, transportation, insurance, and scheduling issues (to name a few).  Sometimes, clients are less likely to meet with their outpatient providers during a lapse or a relapse into eating disorder behavior.  The shame and guilt that can come with disclosing those behaviors to a therapist or dietitian can become overwhelming.

You Are Beautiful!

By Deborah Haber, RN, BSN, Director/Educator of Midwest Center for Eating Disorders and Psych Resource Nurse for Research Medical Center

Most of us are in constant mental chatter. We talk to ourselves all day long and, unfortunately, this self talk is frequently negative. Often it is tainted with guilt about our past or anxiety about our future. This negativity can destroy any seed of hope that we may otherwise have in striving for our dreams.

National Eating Disorders Association

By Deborah Haber, RN, BSN, Director/Educator of Midwest Center for Eating Disorders and Psych Resource Nurse for Research Medical Center

If you or someone close to you has a problem with eating disorders, the National Eating Disorders Association (NEDA) is a wonderful resource for patients, families and professionals.  Currently on the site is a link to www.Proud2Bme.org that provides tips for how to survive Thanksgiving and other holidays.  Also, NEDA is preparing for Eating Disorders Awareness Week in 2012.  There are many fun activities planned.  Please visit www.nationaleatingdisorders.org for more information.

Fighting for Insurance Coverage for Eating Disorders Services

By Deborah Haber, RN, MSN, Director/Educator of Midwest Center for Eating Disorders and Psych Resource Nurse for Research Medical Center

Patients and families have been fighting for years to insurance companies to recognize the severe medical needs associated with eating disorders.  With the assistance of the National Eating Disorders Association (NEDA), Virginia's legislators have agreed to start assessment and educational programs in the school districts.

Eating During the Holidays

By Cassie Whitmore, RD, LD

Many people struggle to eat appropriately during the holidays. They skimp at one meal, planning to overdo it at another. While the holidays can be difficult for everyone, they are especially difficult for patients recovering from an eating disorder. Here are some tips for getting through the holidays.

Males and Eating Disorders

By Deborah Haber, RN, MSN, Director/Educator of Midwest Center for Eating Disorders and Psych Resource Nurse for Research Medical Center

Both males and females suffer from eating disorders and may experience distorted body images.  Often girls are focused on losing weight.  Males are more likely to suffer muscle dysmorphia, a disorder characterized by extreme concern of becoming more muscular.  Boys with this disorder see themselves as smaller than they really are and try to gain weight or bulk up.  Boys and men are also more likely to use steroids and other dangerous drugs to increase muscle mass.

Research about Eating Disorders

By Deborah Haber, RN, MSN, Director/Educator of Midwest Center for Eating Disorders and

Psych Resource Nurse for Research Medical Center

What causes a person to have an eating disorder?  While researchers don’t have all the answers yet, they do know it is a combination of genetic, biological, psychological and social factors.  One possibility may be combinations of human genes that increase the risk of developing an eating disorder.

Tips for Treating Patients with Eating Disorders in an Acute Setting

By Cassie Whitmore, RD, LD

While the treatment of Eating Disorders is commonplace for those of us working on Eating Disorder Units (EDU’s), it is not always so easy for practitioners in other environments. The following tips can help those practitioners to treat these patients more easily in the acute setting.

A Helpful Resource to Find Eating Disorder Treatment

By Shannon Eberlein, MSW – Intake Coordinator

Finding treatment for an eating disorder can often be a lengthy and frustrating process.  When I am searching for treatment options for someone outside of the Kansas City area, I often use EDReferral.com.  EDReferral.com is a resource to find providers who specialize in eating disorders, and they’ve just made it easier with the release of an app for your Smartphone.

What Our Program Has Been Talking About This Week: Maggie Goes on a Diet

By Kara Shelman, MSW, MPH  Clinical Therapist

'Maggie Goes on a Diet', which came out in October, is stirring up controversy in the eating disorder professional community and a lot of strong feelings from our patients last week.  The book is intended for young children and is the story of 14 – year-old Maggie who is described in the book as an overweight and unhappy girl. She then loses weight by eating healthier food and exercising more and instantly has more self esteem, popularity and becomes a soccer star.

Combating Compulsive Exercise Myths

By Kara Shelman, MSW, MPH – Clinical Therapist

It is very common for us to see an individual who uses exercise in a compulsive manner in a way to purge calories and to cope with their emotions and anxiety. Compulsive exercise along with other eating disorder behavior of restricting or purging can be very harmful to the body.  Those struggling with compulsive exercise come in with beliefs that they have heard from many outlets such as media, coaches, etc, that they use to rationalize behaviors. It is important to address beliefs that an individual has surrounding exercise and health and to give them accurate information.  Here are few common ones to tackle.