What is an Eating Disorder Dietitian?

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Being a dietitian for individuals with eating disorders is a privilege. I can’t imagine a more rewarding profession. I am truly thankful to every one of the people who I have had the opportunity to treat over the years. Eating disorder dietitians however, are unlike traditional dietitians. We have often experienced our own struggle with food, which enables us to truly empathize and connect with our clients.

As far back as I can remember into my childhood, I was obsessed with food and nutrition. I was a label reader, a lover of all foods. I loved to prepare food. I loved all the colors, flavors, and textures. I had a great relationship with food, and I was ambivalent about my body. I really didn’t think about it too much. I was a tomboy. I loved to play outside with the neighborhood kids. I was strong. I was an athlete. My body and I got along just fine. All that changed when I was in high school and developed my eating disorder. My eating disorder took away my enjoyment of food and replaced it with negative thoughts, fear, food rituals and unhealthy eating behaviors. It wasn’t my choice. It was an illness that I was afflicted with for 10 long years. Back in the days when I had an eating disorder, treatment was almost non-existent. I was told by my doctor that I wouldn’t be able to have kids in the future unless I ate more. Yep…that was the extent of my treatment. So, in essence, I had to find a way to get better from this illness that I didn’t even know I had at the time. No one formally diagnosed me with anorexia nervosa. In college, when I had bulimia, there was no such diagnosis as bulimia. It wasn’t even in the DSM (Diagnostic and Statistical Manual of Mental Disorders). If there was no diagnosis, there was no protocol for treatment. There basically was no such thing as this mental illness, except I was in the throes of it, as were countless others. There were no treatment teams, no specialists, no courses of study, no self-help books, no support groups. Nothing. Obviously at that time, I had no idea I would eventually be a specialist in the treatment of eating disorders. I was just trying to survive college and keep my grades up. As I got well, and as good eating disorder treatment finally became available, it became obvious that I was going to serve sufferers, like myself, who needed a treatment provider who could empathize with them, who walked in their shoes, who had been in the depths of illness and despair, and who came back to life, better, stronger, and whole.

What do dietitians who specialize in eating disorders actually do? It’s easier to start with what we don’t do. We don’t simply educate about nutrition. We don’t discuss in depth the amount of grams of protein in a piece of chicken (unless it is important to treatment) or the breakdown of types of carbohydrate in a fruited yogurt (unless it’s important to treatment). We don’t place a moral value on certain foods. We don’t believe in “clean” eating. We don’t use fad terms like “macros”. We abhor fad diets.  We believe that “all foods fit”. We don’t force clients to eat, to not eat, to stop behaviors. We believe in “health at every size”. We don’t judge or shame clients for ANYTHING. We are NOT traditional dietitians. We are educated and fully trained, but we know that it takes more than education and training to help someone with an eating disorder. We have to “get it”.

We offer a safe place for people with eating disorders to say things about their food and body that often they have never said to anyone before. We allow them to be authentic. We listen to all the thoughts and feelings they have about their food and their bodies. We let them feel the pain that they have endured throughout their struggle with their illness, and we try to help ease that pain. We validate them and help them understand why they developed this illness and what the eating disordered behaviors represent. We slowly help them dispel the food myths, lessen the fear, recognize and challenge their intrusive critical eating disordered thoughts, and challenge the black and white thinking they have lived by. Slowly and gently, we help them make changes in their eating so that they can live a fuller life, unencumbered by the eating disorder “terrorist” that has invaded their mind. We help them restore their physical health so that they can thrive. We help them learn to accept, to tolerate, and then ultimately to learn to like their body.

It takes skilled professionals to effectively treat someone who suffers from anorexia, bulimia, binge-eating disorder, ARFID, or disordered eating. Fortunately, now there are numerous qualified treatment providers around the country and around the world. There are inpatient and residential treatment centers, day programs, intensive outpatient treatment centers, outpatient clinics, support groups, online resources, books, etc. There are organizations like NEDA, BEDA, Project HEAL, ED Hope, and more, who can assist individuals and families on what to do to get the treatment they need.

We’ve thankfully come a long way from when I was a 15 year old suffering from an eating disorder. If you know someone who is suffering, let them know that treatment is available and that recovery is possible.

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In the eating disorder world, we often refer to the sufferer as having separate and distinct sides of the mind – one is the healthy mind and the other is the eating disordered mind. Some people with eating disorders actually give the eating disordered side of their mind a name. Why would this be helpful? It is essential, in recovery, to know which thoughts are coming from which part of the mind in order to know whether the thought is healthy or disordered, and whether to follow it (listen to it) or not. This very often applies in the food arena but also in many other areas of life as well.

For example, Sarah is a 17 year old in recovery from her eating disorder and she often has conflicting thoughts about what types of food she should eat. During the development of her eating disorder, she followed numerous food blogs and began making decisions regarding what to eat and how much to eat, based on the information she read on these blogs. She lost touch with her true food preferences, and began to only follow the rigid guidelines she read about. Then, as she developed an eating disorder and the eating disordered side of her mind “hijacked” these rules, it made them much more rigid, intense, and  made Sarah feel like the decision to follow or not follow them was as consequential as “life or death”. The eating disordered side instilled fear into Sarah each time she veered off the “healthy” eating plan she read about.  The eating disordered side of her mind would tell her things such as “if you don’t eat these particular foods, you will get fat.” “If you eat any food in XXX category, you will never stop eating it, and you will go out of control.” “If you eat these foods and gain weight, your friends will hate you.” The problem was that her eating disorder sounded an awful lot like the blogs she was reading. She became very confused and perhaps even thought these were healthy thoughts and healthy behaviors. Through treatment, Sarah had to first differentiate between her healthy rational voice and her eating disordered voice and then had to challenge the thoughts and subsequent behaviors coming from those disordered thoughts.

Eating disordered thoughts appear initially as helpful, which is why they are so confusing to the sufferer. They seem to have legitimacy since their origins were from the internet, a book, video, parent, friend, or even a heath care provider. It is through the help of an eating disorder professional, that the sufferer can begin to challenge these thoughts and regain their intuitive healthy thoughts and behaviors again.

Some basic ways to differentiate between the healthy side and eating disordered side is that the healthy side is flexible, forgiving, compassionate, curious, and open-minded. The eating disordered side is rigid, stern, critical, and creates guilt and fear. Talk to your treatment team about the thoughts that you have on a daily basis. Then let them help you differentiate between the two sides and strengthen your healthy voice!

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12 Tips For the Holiday



This post was originally written several years ago, but it is worth repeating at the onset of each and every holiday season. Holidays can be stressful when you have an eating disorder. Here are 12 tips to help you through the day!




  1. Keep your expectations of yourself realistic. You have an illness that makes holidays challenging. Don’t beat yourself up for doing whatever is necessary to get through the day and remain in “recovery mode.”
  1. Don’t try to please everyone else at your own expense. You are the one who matters most.
  1. Do your best with the food. Remember, it’s only one meal in one day of the entire year.
  1. Try not to alter your entire day in anticipation of a difficult meal. Be as consistent as you can before, and after the festivities.
  1. Once the day is over, try not to let “thought hangovers” carry into the next day. Once the day is over, it’s over.
  1. Practice in advance answering any difficult questions that might come up, like:
  • “What are you eating?”
  • “You look good!”
  • “You don’t look so good.”
  • “Try this food.”
  1. Find a “safe” person who you can go to or sit with if you get anxious. Text or call people for additional emotional support.
  1. Change the subject away from yourself if someone starts up a conversation about your illness, or anything you are uncomfortable about. Divert the conversation toward a topic related to them. People love talking about themselves.
  1. Don’t internalize others’ words or opinions about you. Put up an imaginary shield to protect you from getting hurt.
  1. Go outside and take some deep breaths if you need to escape for a few minutes, or distract yourself by playing with children if they are present.
  1. Plan a good self-care activity after the day is over. Take a bath, curl up with a good book, do some online shopping, go to a movie with a friend.
  1. Remind yourself often throughout the day about what your strengths are, and the things you are grateful for.



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Is Media Madness Hurting Your Recovery?


Social media and media in other forms are not the root cause of eating disorders, by any stretch of the imagination, but their effects can be very powerful and damaging. Have you ever scrolled through your Facebook news feed, Instagram account, or merely flipped through a magazine or channel surfed and felt triggered by what you saw or read?

No one posts pictures of themselves on Facebook or Instagram on a “fat” day. They post pictures of themselves standing in the perfect pose, in the perfect lighting, with a well thought out perfect outfit on.

When you flip through the latest People magazine and see the movie stars in their designer gowns, with their bodies all shrink-wrapped in spanx underneath, do you think they just woke up and slipped into that gown? They spent weeks preparing (unhealthfully for most) for their moments in the spotlight.

Even when people take selfies, they aren’t posting the ones where they look like they just woke up. They post the ones where they look their best. They adorn the perfect smile or perfectly pursed lips, breasts beaming with just the right amount of cleavage. Stomach sucked in…

Looking at pop-up ads for a miracle skin cream, latest weight loss supplement or diet, clothing, etc. makes you feel like you literally cannot escape all the media madness. I often do research on weight loss fads to educate myself on the things my clients discuss with me, and then, sure enough, I get bombarded with diet ads.

And then, for those of you who are in a Facebook “recovery group”, how many times have people posted triggering comments or pictures in order to get support or attention? How does this make you feel? Did you join this group to be triggered? Of course not. You wanted additional recovery support,  but sometimes you got more than you bargained for.

Youtube, Vine, Twitter, Facebook, Instagram, and on and on and on. There almost seems to be infinite ways to be bombarded…

So, is there a solution to all the media madness?

First off, if any form of social media or media in general is hindering your recovery, it NEEDS to be addressed. If you are sensitive to triggering images and words (like most people are), your recovery could be negatively affected by media, and changes need to be made. Remember, images and words “pop” up, and once you have seen or read them, you can’t “un see” or “un read” them. Once the damage is done, you then have to cope with all the subsequent negative thoughts and feelings that were triggered by the words or images.  There is real danger here, danger to your mental health.

Take a look at the cost/benefit of what media you are involved in. What are you getting out of it vs what are its liabilities? How often are you logging off feeling worse than when you logged on?

What changes can you make? Can you un-follow some people or get out of some groups? Can you block or un-friend some people? Can you make a new account and be more selective about whose pictures you follow? Can you be more selective about which websites you visit? Can you “like” more reputable sites like Project Heal, NEDA, BeginWithin Center, and sites with positive, inspirational quotes or size friendly pictures and posts? Can you purchase or subscribe to only those magazines and apps that are non-triggering and supportive of your recovery?

Please take care of yourself in this media driven world.  Remember, you are vulnerable and need to put all aspects of recovery on the top of your priority list.


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Does Your ED Provide Control?

The Following blog post was written by one of BeginWithin’s therapists, Sally Sauter. I hope you find it valuable. I also recommend that you share the posts on this blog with others who may not understand eating disorders as well as you do. We strive to explain the issues that sufferers face, in such a way to provide support for them and their loved ones.

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One of the words that nearly always sneaks into a conversation about eating disorders is control.  In fact, you can back right up from eating disorders and disordered eating and just look at the topic of food, period.  The most basic lunchroom discussions about food choices can meander into tangents about control, strength, confidence, and power.  To me, that is striking.

I honestly can’t imagine many people saying that they “enjoy” feeling out of control, and that they strive each day to feel less and less agency in their own life.  However, given the extent to which we see control as such a valued commodity in our lives, who among us even knows how “in control” we really are?  For something that is so sought after, and so furtively guarded, knowing whether you have it or not sure is difficult.  It’s not like finding out your credit score.

The best we can do is say how in control we feel, and in fact, there is already a long-standing foundation for looking at the matter of control in this way.  Rotter coined the term “locus of control” back in 1954, the concept referring to the extent to which individuals believe that they can control events.  A person who believes that they are exclusively and entirely in control of their life is said to have an “internal locus of control”, whereas one who has an “external locus of control” believes that they have nothing to do with any outcomes in their life.  Everything that happens is attributed to aspects of the surrounding environment, or by “chance” or “fate.”

What does the research tell us about eating disorders and control?  A 2002 study published in the Journal of Adolescence found that individuals with an external locus of control had significantly more eating disorder symptomology than those with an internal locus of control.   Said another way, numerous people who feel like their lives are out of their control, manipulate food.  I mean ‘manipulate’ in the purest definition of the word: they use it or change it in a skillful way, for a particular purpose.

The ED behaviors do literally nothing to shift one’s locus of control from outside to within.  Binging, purging, exercising, starving- none of these things truly help a person to feel a sense of global power or control over their own life.  Instead, a person who feels ineffectual and unable to do things in their life continues to feel that way, but now, that feeling is also interwoven with shame, fatigue, guilt, and a total preoccupation with food.

The false promise of control offered by disordered eating behaviors has a maddening way of ebbing and flowing.  The promise looks “golden” in the beginning, and in early phases of behavior use, it can feel real and true.  It transports you from your ordinary existence to some parallel universe where you think you have your shit together.

But when behaviors take on a life of their own, you may feel as though you fell into a sinkhole.

If you work really hard to get out of the hole, by clutching and grasping and pulling, at first, you will feel a surge of relief, but your relief may quickly change to disappointment, sadness, anger and disillusionment.  You may only remember the way ED “promises” glistened gold in the beginning, and forget the worst moments you spent in your sinkhole.  Maybe you think you can tinker with the behaviors again, toy with the food in a slightly different way for a better outcome.  Maybe you think you did it wrong.  Clearly, this is one of the distorted thoughts that could contribute to a vicious cycle of worsening eating disordered behaviors.

At the core of all of this, the perceived control problem was never addressed.  You still feel as though there is little you can do to ensure that your life goes the way you want it to go.  And you may be wondering, if you can’t sustain a feeling of control through using disordered behaviors with food and exercise, how can you?

This may be a point of contention, but I don’t believe that people who recover from eating disorders do so by “finding a new means of control.”

What if instead of trying to wrap your hands around some type of control, you slowly, systematically enter into the very types of situations in which you felt the most fearful and the least powerful?  Instead of rehearsing excuses for why you will have to leave early, you remain firmly planted in those environments which make your skin crawl the most.  You just remain put in your own anxiety.  What if each time you felt the urge to retreat, to withdraw, or to avoid, instead, you inched a little bit closer, leaned slightly forward, or said softly “yes- I’ll be there.”  And then, you went there.

Over time, the pain and the fear will lessen.  Very slowly, you will begin to see clearly that all those things you thought you couldn’t do, those places you were sure you couldn’t be, those people you could never, ever speak to with ease are doable. You CAN do those things, and exist in those uncomfortable places, and look those people square in the eye and not shatter.

Through realizing that you could endure more than you imagined, I wonder, what then might happen to your locus of control?


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I’ve been speaking a lot lately about acceptance. Yes, in recovery, there MUST be some degree of acceptance of a lot of things. For example, you need to accept that other people may not understand the eating disorder and all its complexities. You need to accept that some people in your life are unwilling or unable to change in ways that you need or want them to. You must accept that certain relationships need to change or be extinguished in order for you to be healthy. You need to accept that avoidance and shutting down are ineffective coping mechanisms and will keep you sick. You need to accept that your voice is a necessity, not an option. You need to accept that life beyond your eating disorder will be complicated, challenging, scary, very imperfect, and yet rewarding.  You need to accept that your eating disorder will never be the ticket to happiness, joy, peace, or satisfaction, no matter how hard you try, or how long you have it. You need to accept that your illness is just that. It is an illness, not a lifestyle, not something to hang on to, not something that brings you genuine control, strength, escape, distraction, or self-worth.  It temporarily reduces anxiety, but causes more anxiety and distress in the long run. Acceptance of these things does not mean “giving up.” The Oxford dictionary defines acceptance as “willingness to tolerate a difficult or unpleasant situation.”

Additionally, you need to accept that through recovery, your eating will not be perfect.  Your eating may “feel” out of control at times. You may eat more at a meal than you had “planned” to. You may eat when you aren’t hungry, just because the food is placed in front of you. You may also, at times, have less of an appetite. You may be voracious at times. You may get overfull at times. Your eating may be imbalanced. It may be chaotic and messy at times, and more structured at others.  It may not always make sense. Through recovery, you need to accept that food IS enjoyable. It is a gift to yourself to truly, deeply, passionately savor food. There’s also no “one size fits all” way of eating. Your eating will continue to evolve over time, depending on age, circumstances, medical issues, etc. You must accept that your eating will be trial and error, an experiment of sorts. You must accept and TRUST that this “recovery” way of eating will be significantly better for you that the way you relate to food while you have an eating disorder. The focus of your day may NOT be significantly on your eating, and that’s ok.

Through recovery, your body will not be “perfect.” Your body is not designed to be “perfect”, an arbitrary label, and it will not be “perfect” as a result of recovering from an eating disorder. It may have bumps here and there. It may have cellulite. Your thighs may be bigger than you had thought. Your belly may be softer than you’d like. Your arms, back, butt, and chest may not be the picture that you had envisioned they’d be. Your set point may, or may not, be what you wished it would be. You must accept that there is wisdom in your body to take care of you. You must also accept that you are NOT just a collection of body parts. You are comprised of billions of cells (heart cells, brain cells, liver and kidney cells, hair cells, eye cells, muscle cells, etc)  that need to be nourished to thrive. You have a soul that needs to be nourished. You must accept that taking GOOD care of your body is significantly better and more rewarding than enduring the abuse that your eating disorder imposes on it. You must accept that in order to be ok with the imperfections in your body and in yourself, you must remove the negative attention you pay to it’s appearance, you must stay positive about your body and the process of change, stop the self-criticism, focus on your strengths, and FEED your passions, interests, relationships, and all things in addition to your body. Self-acceptance is the ability to love yourself unconditionally, no matter what flaws and traits exist.

Acceptance and Self-Acceptance = Freedom

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Are You a “Numbers Slave”?


What type of system are you using to determine what to eat, how much to eat, when to eat, when to move, how much to move, etc? Are you a slave to your numbers? Have you ever tried to disentangle yourself from your numbers? Is fear keeping you stuck? Fear of your hunger, appetite, weight? Why have you gotten so far away from your intuitive way of eating and living,and so reliant upon your system?

Think about what types of numbers you are enslaved by?

Numbers on a scale?

Number of fat grams per day?

Number of carbohydrates?

Number of times to eat per day?

Number of crackers, pretzels, pieces of gum, teaspoons of half and half?

Numbers of hours between meals?

Numbers of days per week you exercise?

Numbers of minutes you need to complete before you get off the piece of equipment?

Number of calories you can’t exceed per day?

Number of crunches, push-ups, leg lifts you need to do?

Number in the back of your blouse, your skirt, your jeans?

Number of items in a serving?

Number of ounces your piece of chicken is?

All these numbers for what?

Are they improving your sense of happiness?

Do you feel free when you count? Or do you feel like you can’t be happy unless you focus on all these numbers?

The truth is, the more you focus on any types of numbers, the less you focus on what your body really wants, how much it wants and needs of the essential nutrients, water, movement, and when it needs these things.

Numbers are a dishonest, fabricated replacement for intuitiveness. They are arbitrary, counterfeit ways of feeling in control. They are useless. They render you powerless, NOT powerful. They don’t give you control over anything. They merely give you the illusion of control and disable your inner means of determining your needs. Why are you afraid to give them up? Most likely because you distrust yourself, yet you ARE the best, most trustworthy determinant of what you need. Perhaps society has influenced you. Perhaps you have heard of, or embarked on numerous diet plans that are based on numbers. Perhaps you have been made to feel that you are GOOD when you are following numbers, and BAD when you aren’t.

The longer you rely on numbers, the more disordered you will become. The fear will ultimately keep you enslaved, and you will never know how free you can actually be by trusting that inner self that has been there all the time, ever since you were a baby and knew when to eat and when to stop.

Try to take small steps away from your numbers, and prove to yourself that you can survive. It won’t be perfect. You will make mistakes. There’s no such thing as being perfectly intuitive, 100% of the time. But, that’s life. Your number system is fraught with mistakes, but you trust it like a lifeline. Unfortunately, it keeps you from experiencing the freedom, flexibility, and spontaneity that life has to offer.  Systems don’t keep your weight or health in a stable place either. If you followed the same number system at age 15 that you did at age 5 or at age 35, it would be preposterous that your weight or health would benefit.  

Before January 1st, when you will be bombarded by an enormous onslaught of “new and improved” diets, number systems, and weight loss plans that society will be urging you to follow, why don’t you take a stance against all the numbers propaganda, and turn inward to the best, most trusted resource for health information ever…YOU!!!

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Top 12 Tips for the Holiday

Holidays can be stressful when you have an eating disorder. Here are 12 tips to help you through the day!

1.      Keep your expectations of yourself realistic. You have an illness that makes holidays challenging. Don’t beat yourself up for doing whatever is necessary to get through the day and remain in “recovery mode.”

2.      Don’t try to please everyone else at your own expense. You are the one who matters most.

3.      Do your best with the food. Remember, it’s only one meal in one day of the entire year.

4.      Try not to alter your entire day in anticipation of a difficult meal. Be as consistent as you can before, and after the festivities.

5.      Once the day is over, try not to let “thought hangovers” carry into the next day. Once the day is over, it’s over.

6.      Practice in advance answering any difficult questions that might come up, like:

·        “What are you eating?”

·        “You look good!”

·        “You don’t look so good.”

·        “Try this food.”

7.      Find a “safe” person who you can go to or sit with if you get anxious. Text or call people for additional emotional support.

8.      Change the subject away from yourself if someone starts up a conversation about your illness, or anything you are uncomfortable about. Divert the conversation toward a topic related to them. People love talking about themselves.

9.      Don’t internalize others’ words or opinions about you. Put up an imaginary shield to protect you from getting hurt.

10.   Go outside and take some deep breaths if you need to escape for a few minutes, or distract yourself by playing with children if they are present.

11.   Plan a good self-care activity after the day is over. Take a bath, curl up with a good book, do some online shopping, go to a movie with a friend.

12.   Remind yourself often throughout the day about what your strengths are, and the things you are grateful for. thanksgiving


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Diet Bull #%&*!!!

no diet

Today was another typical day in today’s crazy weight obsessed world. But today, I JUST CAN’T TAKE IT ANYMORE! I woke up and checked some things online. You know…Facebook, emails, the usual. Of course I saw several ads for weight loss. A “new” trick, supplement, twist on calorie reduction, blah blah blah.  Although I’m completely numb to their content, I still get angry that I’m even forced to see them as they invade my inbox, and pop up in the margins of everything I read. I wish I had some type of power over making them disappear. Maybe like a laser explosive device that would explode all diet ads. I’d love to watch them disappear from my screen. It would be no different than a video game where people blow things up. I’d just be blowing up stupid diet ads.  After I perused through my inbox and mentally blew up all the diet propaganda, I wandered downstairs to make my coffee and read the local newspaper. A few pages in, I saw a gigantic ad from a local doctor who is touting her new weight loss program. She talks about how she was overweight when she was young and how she just made some “simple” lifestyle changes and lost her weight and then became healthy and happy, blah blah blah. Her ad continues to profess her clients’ weight loss successes and her guarantee of weight loss in eight weeks or some such nonsense. If you follow her program, you’ll lose weight and everyone will be happy… especially her, because she will make a ton of money. Yes, some of her clients will lose weight temporarily (especially because she recommends her diet to women who have just had a baby) and I’m sure her “lifestyle” recommendations are sound, but if her diet was the best diet in the land, she’d have people from all over the world lined up to try it. It’s just another gimmick like EVERY OTHER DIET!

My “diet disdain” has been climaxing lately, for a number of reasons.

An adult client came in last week and told me that in years past, she would go to diet meetings and hear how so many people had lost 25, 50, 100 pounds and were so completely happy with themselves and their losses. They received their key chains of success, applause for milestones, and “well –deserved” time on the podium to profess their success to the audience of captivated diet success hopefuls. She said she felt like a loser, a weak excuse of a human because she couldn’t do what they did. She’d skulk out of the meetings, having hoped to get inspiration, but instead feeling defeated. She’d quit the diet and rebound overeat, gaining more weight than she’d ever wanted to lose. What she wasn’t able to “see” was that those same “success stories” regained all the weight they had lost, and had to redo the same diet or embark on a new one to re-lose the same 25, 50, 100 pounds over and over and over again.

In the past few weeks I’ve seen several CHILDREN who have been told by their pediatricians that they are “too fat”. The pediatrician showed these innocent children their growth charts, as if a 9 or 12 year old can even figure out what the chart means. These children were told that they were eating too much and that they were going to get heart disease or type 2 diabetes if they didn’t lose weight. The doctor told their mother to put them on a “restrictive weight loss regime”. WTF!!!!!! When a child leaves the pediatrician’s office begging to never have to go back again, it is a certainty that the child has been traumatized by the experience.

I also recently started seeing a 12 year old who was in the throes of a severe eating disorder because her doctor told her she was “dramatically” overweight and that she needed to lose “XX” pounds. She lost that weight all right, and subsequently lost her innocent childhood as a result because now she lives in fear of everything she puts into her mouth and she’s in intensive treatment for anorexia. Thanks, Doc!

The reality is:


DIETS DON’T OCCASIONALLY FAIL. THEY FAIL 99% OF THE TIME. (The 1% of people who need to lose some weight succeed at it because they achieve an inner shift and then the weight loss is a side effect, not the intended result)







We are a culture of diet obsessed, fearful, self-conscious, self-deprecating people. Why??? Because we listen to, read, and watch too much nonsense about how we are supposed to look, what we are supposed to eat, how much we are supposed to exercise, etc. If we aren’t eating less and exercising more, killing ourselves to look “amazing”, we are made to feel inferior.

Individually, and collectively, we need to look at food and weight drastically differently. We need to examine in ourselves and in our children “why” we may have food and weight concerns. Are we using food in certain ways to cope? Are our children crying out for something by eating “too much” or “too little”?

We need to look at our eating as a “doorway” to find out something deeper about ourselves. If our eating is “off”, and our weight is affected as a result, let’s make a change in our inner world, and let our food take care of itself. Food and weight is never the real problem. It is just a clue. A diet is just a distraction from the real problem. Dig deep. Don’t be afraid to address what’s really going on. Don’t read diet nonsense. It’s just nonsense, but it can negatively affect/hurt you if you are vulnerable.  

I vow to NEVER read any diet propaganda. Will you do the same???

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Body Image and Eating Disordered Behaviors


“My body image is terrible. All I want to do is use behaviors to feel better, but my body image gets worse no matter which behavior I use. If I restrict to lose weight, I feel fat. If I binge to soothe myself, I feel fat. If I exercise to feel better, I feel fat. Why won’t my behaviors stop me from feeling fat?”

 “Feeling fat” can’t be fixed through using an eating disordered behavior, because it’s not about your body or your weight. It can’t be fixed by bad mouthing yourself, hating yourself, or hurting yourself. All that results from those tactics is feeling lower, more worthless, and in much more psychological and physical pain. The path to recovery, self-care, or positive body image cannot be paved by negativity of any sort. It never has, and never will. It is a fundamental impossibility. If you keep trying, you will never get anywhere, except exactly where you already are, or worse.

Why won’t negativity and/or eating disordered behaviors stop you from feeling fat? Because “feeling fat” is code for feeling bad about yourself. Feeling “fat” is a synonym for feeling low, worthless, sad, lonely, anxious, lost, depressed, confused, disconnected, angry, etc.

Feeling fat is about anything and everything else other than your body. You have to try another tactic. Try to imagine what you might really, genuinely be feeling. It might be painful, but this approach is the doorway to recovery and feeling better about your body. If you continue to feel “fat”, and do whatever eating disordered behavior at your disposal to feel “better”, you may feel relief for a moment, but the feeling will ALWAYS come rushing back like a freight train and you will feel just as bad, if not worse.

The road to feeling better about your body is the road to having a better, more authentic, more fulfilling life. So, if you are feeling lonely, you need to begin building healthy relationships. If you are feeling sad, you may need to cry and feel the tears pour down your face. If you are angry, you may need to shout out loud what you are angry about. If you are confused, search for clarity. Seek advice from trusted people. If you are hurt, express your feelings openly and honestly. If you are living in fear, take small baby steps, leaps of faith, small risks. If you are living an unfulfilling life, try something new, no matter how big or small. Start to develop a hobby, or a passion for anything that you could immerse yourself in. Sing, dance, color, walk in nature, develop your spirituality, learn a new language, do a puzzle. The more immersed you are in living an authentic life, one where you are honestly expressing your emotions, communicating effectively and openly, taking emotional risks, and developing interests and passions, the healthier mentally and physically you will feel. The better you will feel, the less “fat” you will feel, and the less you will be drawn to use eating disordered behaviors to numb out from life.

Remember, the road to healthy body image is NEVER accomplished by trying to “fix” the outside. Search inside, and the outside will take care of itself.

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How Does Stress Affect Your Metabolism?


Did you know that your metabolism can be affected by stress? Most people think that their metabolism increases during stressful times, but actually it has the opposite effect for most people.

Some amount of stress is “normal”, and actually encourages your body to produce the appropriate amounts and types of chemicals to keep in a state of equilibrium. When your body is in balance, you will occasionally produce stress chemicals (hormones) to handle the stress and then your body goes back to normal. This level of physiological stress is typical, and one’s metabolism isn’t greatly impacted for any length of time.

The state that many of you find yourself in, however, is not a “normal” amount of stress. You may experience heightened stressors in your home environment and/or work or school environment. These stressors are ongoing and unfortunately, some of them aren’t controllable by you. Added to the outside stressors are the ones that are controllable by you, but often are the worst offenders when it comes to the amount of stress chemicals you produce. Why are they the worst offenders? Because they are happening all the time, instead of occasionally. If stress chemicals slow down your metabolism, wouldn’t you want to lessen them if you could?

A quick lesson in physiology:

As humans, we have an autonomic nervous system (beyond our conscious control) that regulates our internal organ system (heartbeat, lung function, brain, etc). The two sub-parts of this autonomic nervous system are the sympathetic nervous system and the parasympathetic nervous system. In very general terms, the sympathetic one causes us to “act” where the parasympathetic one causes us to “relax”. Another way to look at them is “quick response” and “slow response”.

Stress activates the sympathetic nervous system and our “fight or flight” response. Stress de-activates our parasympathetic (relaxation) nervous system. It makes sense, for example, if you are being chased by a saber-tooth tiger, you would want your “fight or flight” response to kick in to save you from being eaten.

During “fight or flight”, your body produces a surge of cortisol, a stress hormone, as well as insulin. Both of these hormones accelerate fat storage. The movement in your intestines slows down (your body isn’t interested in digestion when a saber tooth tiger is after you). Blood flow to your gastrointestinal tract drastically slows down. There is a significant decrease in your digestive enzyme production, as well as a decrease in thyroid hormone production. Healthy gut bacteria die off, and you excrete essential minerals and vitamins. There’s an increase in inflammation and a decrease in oxygen. In a nutshell, when you are in a constant state of stress, or “fight or flight”, your metabolism slows down.

What does all this mean for you?

Ask yourself 2 questions:

1.      Where am I creating my own unnecessary stress?

2.      How can I lower the stress that I have created?

Are you too hard on yourself? Are you taking on too many responsibilities that you don’t need to? Are you not speaking up for yourself? Are you taking on others’ stresses as well as your own? Are you speaking negatively to yourself?

Studies show that NEGATIVE SELF-TALK is a tremendous controllable stressor. This is an unnecessary stress that will have an enormous negative effect on how you digest and assimilate your food. If you are “trash talking” yourself all day long, beating yourself up for anything and everything that you do, you are hurting yourself in an unconscious physiological way, and slowing down your metabolism.  How many of you say things like:

·        I’ll only be happy when I lose weight.

·        I am disgusting.

·        I hate my body.

·        Everyone else is skinnier than me.

·        I suck.

·        I’m worthless.

·        I’m a loser.


On the other hand, if you REDUCE OR STOP some of your controllable stressors and trash self-talk, AND attempt to add pleasurable things into your life like:

·        sense of purpose

·        healthy connections/relationships

·        sense of belonging

·        spirituality

·        healthy hobbies

·        relaxation

·        quality, enjoyable food and drink

·        sunshine

·        POSITIVE (or neutral) SELF TALK

You will have a positive effect on your overall well-being, you will dramatically reduce your physiological level of stress, and you will effectively increase your metabolism.

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Thank you!

heart-handsThis post is a follow-up of sorts to a Facebook thread that I accidentally started yesterday. What prompted the thread was an article that was sent to me written by a nutritionist who treated people for years for weight loss. It was an apology letter of sorts. The article really resonated with me because in the work that I do, I see many clients who, over the years, have been counseled by “professionals” about how to lose weight and have been harmed physically and emotionally by the advice. These professionals did nothing intentionally to harm their clients. In fact, I’m certain that they thought they were performing a valuable service or dispensing sound advice. But, an essential component to counseling an individual about food, nutrition, and their relationship with their body, is the human factor. It is essential to help the client see what is behind their struggles with food and weight. Their struggle is RARELY about the food or weight. It is OFTEN about other things. Trying to “fix” their weight in the hope of creating a happier life is missing the most essential information about the client. It is, essentially, missing the point. Helping the person to heal their life is where the real work lies. If someone is given nutrition information, factoids to help them become a smaller size, without addressing the underlying issues, it is like placing a Band-Aid on a gaping wound. It will cover up the problem, and provide a distraction from the issues for a period of time, but eventually it will backfire and the problems will persist. Not only will the problems persist, but then they will search frantically for the next diet to embark upon, and start the cycle all over again, shoving all the underlying issues further and further into the recesses of their mind and body.

I have a client who has worked for several years to heal her relationship with her food and body. She had anorexia as a child and now, as an adult, she suffers with emotional eating, and binge eating. As a result of her “use of food” as a coping mechanism, she has gained weight. Thankfully she didn’t come to see me with the sole intent to lose weight, because I wouldn’t have been able to treat her. In fact, I tell all my clients who want to be in a smaller body thinking that their lives will drastically improve when their weight goes down, that I will help them to improve their lives and, if their weight goes down as a side effect of improving their life, then their weight is supposed to go down. We will never intentionally do anything together as a deliberate attempt to lose weight. Over time, this particular client was tremendously successful in making changes in her life, putting her needs on the list of importance. She was able to prioritize her mental health for the first time in her life. She took the time that was needed to listen to, and attend to her needs in multiple areas of her life – private, social, physical, psychological etc.

In the past, she used to exercise purely as a way to lose weight. She was the “cardio queen”, focused purely on how many calories she could burn, and how that translated into what she could eat for the day. It was all a mathematical equation. Food became both her friend as well as her enemy. There were good foods, bad foods. Food was never eaten in a pleasurable way. Getting pleasure from food was “bad”. The moment she put something “pleasurable” in her mouth and swallowed it, she would feel guilt and remorse, swearing she would never touch that food ever again. She wanted to need only the bare minimum of food, but her needs were consistently higher than she wanted them to be. She wanted to restrict and control her body, but her body told her otherwise. She restricted and craved what she wouldn’t allow herself, and then restricted harder and craved more and more till she would “break” and give into the cravings, gaining weight in a rapid fashion.

When this client finally gave up the quest to focus all her attention on calories, fat grams, carbohydrate grams, calories burned, and cardio, and turned her attention to what the issues really were (by the way, this takes an enormous amount of courage and fortitude. It is much harder than focusing on calories and fat grams), she began to lead a much fuller and rewarding life. In fact, the rewards she achieved were FAR BETTER than anything she ever felt by fitting into a smaller pair of jeans for the brief moments that she did.

Currently, as a result of living a fuller life, and not using food as a reward or punishment, a distraction or a drug, she has been able to eat a variety of foods and enjoy every morsel with NO GUILT. The only problem that occurs now is when a “professional” tells her to stop eating this, or eat more of that. Only now, the problem is not HER problem, it is theirs, because she will tell them point blank “Don’t tell me what to eat! I’ll eat what I want to.” It’s amazing the response she receives when she tells people that she never diets and she eats whatever she wants. Now, of course, she doesn’t eat whatever she wants in the quantities that defy her body’s needs. She eats when she is hungry (which took a long time to discover), she stops when she is full (most of the time), and she pays attention to the messages and information that her body and mind give her. She eats foods that provide her with nourishment, and she eats foods that are just for pleasure and don’t provide nourishment. She has the wisdom to know what she needs.

There is no weight loss information, fact, knowledge or instruction that could have “fixed” this client’s issues. There is no diet or subsequent jeans size that could have replaced the healing that she achieved. There is no amount of information that could been better than the wisdom she discovered she had all along, that just needed to be tapped into and unveiled. There certainly would never have been ANY judgment or shaming about her size that could even remotely done anything beneficial to help her along her journey.

So, it is the amazing healing journey of clients like this one that enable me to say that I am so eternally grateful that I have not been a weight-loss professional. I did not write this post to criticize those who want to focus on weight loss as a profession. There is no “one size fits all” approach that works for everyone. I am certain that there are numerous professionals who, with integrity, are helping many people with body image and weight issues.

My advice is simply this:

I would encourage all of you to find the approach that truly “works” for you, not only in the short term, but in the long run.

Don’t blindly take any advice from a professional, simply because they hold themselves up as an expert. If it doesn’t feel right, question it. If a professional doesn’t want to explain their reasons or philosophies, ask yourself why.

Do your own research, not only on the internet or in magazines.There is a lot of misinformation and bias out there.

Find what resonates with you.Discover your own inner wisdom. It’s in there, even if it is buried.

Challenge the notion that weight loss at any and all costs, is healthy. A jeans size cannot determine health or happiness.

Challenge any and all of your toxic dietary beliefs (those that may not be true or are hurting you).

Invest time and energy NOW in finding non-weight related things that can enrich your life. Experiment with different things. You may not enjoy the first, second, or third thing you try.

My approach is not perfect and isn’t right for everyone. I am very fortunate however, to do the work I do and work with the most remarkable clients who have searched for an alternative approach to their food/body issues.  We are on a shared journey. I am grateful for you! Thank you!

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Please Show Kindness to Those in Need!

Dr Suess

A 12 year old client came in this week and cried the entire hour she was in my office. She was despondent over the lack of happiness in her life. She struggles to get through a day in school, then spends her free time in her room fantasizing about the life she wants, creating imaginary friends who aren’t image conscious, who won’t criticize her for having gained weight, who don’t care if she has a “thigh gap” or not, who eat a normal lunch at school, and who will want to do the fun things she wants to do instead of obsessing about thinness, makeup, perfect hair, and clothes. She hears comments by the boys about how “hot” certain girls are. They only pay attention to the girls who are ultra-skinny, have long hair, and wear the nicest clothes. She feels unloved. She has given up going to school clubs and activities. She still cheers but has been demoted to the back of the team, because she weighs too much to be a “flyer” like she used to be. Every day she is reminded of how painful it has been to gain weight, so she turns to the only “friend” she now thinks she has…food. The pain she feels in her life, she exacerbates by bingeing. She soothes the pain momentarily while she is in her food obsessed moments, but as soon as the binge is over, she is starkly reminded physically and emotionally of the pain she feels. She is in 8th grade!

Sadly, this client’s experiences are similar to many middle school and high school girls that I see. They live each day in the world of comparisons, diet talk, sexuality, and bullying over anything and everything. They often turn to restrictive eating, bingeing, purging, compulsive exercise, and self-harm to “feel better”.

I decided, in this post, to share my story. Several people have asked me lately why I am so passionate about treating people with eating disorders. You see, like my 12 year old client, I was bullied in middle school for being “ugly”. I struggled in middle school to be sane. I fantasized about a life I didn’t have just to give myself hope. Home wasn’t a place of reprieve either. I encountered stressors there as well. I never thought at age 12, that things would get better. But, they did. I struggled throughout high school and college with an eating disorder, but I finally got help. There weren’t good resources back then, but it helped just finding someone to listen.   I am very fortunate to have recovered and can pay it forward by having a career where I can help people who struggle. (For those of you who have read my book, you have seen my story before.)

What I want everyone to do after reading this post is to pay attention to the girls and boys who may need support. You can’t take the place of a treatment professional, but you can provide someone in need with a little kindness and a positive connection.

We can’t tell these girls that it will get better in time, when they are in college, or as adults. Those words are not reassuring. They need help NOW! Anyone who is involved with the school systems needs to develop more diverse clubs and activities, support groups, safe places and people for those who aren’t the “popular” kids. And, for those who are “popular” or “happy” on the outside, they are often suffering too.  I know we are all deeply saddened and frustrated by the amount of bullying in schools. It is heartbreaking to talk with a 10, 12, 14, 16 year old who feels worthless because she (or he) has been made to feel that way by her peers. I think we also need to keep a close eye on those kids who may need a little something extra. It is so simple to give a few more minutes of time, ask a few more questions, lend a hand, and show a little more interest to those kids who may not have the voice to be able to ask for help.

If YOU are one of those girls or boys who struggles, don’t be afraid to ask for help. People will care. You just have to find trustworthy people. I know, at times, it may not seem like things will get better. They will, with just one or two caring people to support you.

What we achieve inwardly will change outer reality. Plutarch

Find a place inside where there’s joy, and the joy will burn out the pain. Joseph Campbell

Believe you can and you’re halfway there. Theodore Roosevelt

We can’t help everyone, but everyone can help someone. Ronald Reagan

The best way out is always through. Robert Frost

The most authentic thing about us is our capacity to create, to overcome, to endure, to transform, to love and to be greater than our suffering. Ben Okri

Only those who have learned the power of sincere and selfless contribution experience life’s deepest joy: true fulfillment. Tony Robbins

And, when all else fails, remember Dr Seuss’ five lessons of life (above)!

My story:

I am a nutrition therapist for individuals with eating disorders and disordered eating, a wife and mother of two amazing children, and stepmother to a wonderful young woman. I am a daughter, a sister, and a friend. I am also recovered from an eating disorder. I struggle at times, but I triumphed over my disorder. I am a warrior when it comes to defeating my illness. While it gets easier and easier, I am always cautious, because my disorder has far-reaching roots.

Seeking My Place in the World

I learned very early in my childhood that I was the “good girl.” Good girls do what they are told and never ever complain, never voice discontent, take only what they are given, and ask for nothing. If good girls ever have a problem, they isolate, cry on their own time, wipe the tears from their faces, and emerge smiling. If they express negativity of any sort, they are told they are unappreciative and they can go live somewhere else, or they get beaten or ignored. These are the principles by which I lived.

My father was a deeply compassionate man. He was reserved and a good provider. He worked tirelessly as an air traffic controller to provide us with a home in a middle class neighborhood, two cars, food, clothing, two vacations a year, and an occasional dinner out at a local restaurant. He worked all different shifts, ranging from the day shift to overnights. Our lives revolved around these shifts and how well we needed to behave based upon “dad’s sleep schedule.” He was an alcoholic, and he had significant medical problems ranging from high blood pressure, diabetes, and gout, to inoperable cancer. Mom blamed his drinking on his stressful job. My brother and I simply did not know what to expect from him day to day. I was the good girl though, so I never got into trouble. I never got hit by him. I followed the rules to the letter. I feared the ramifications. My brother, on the other hand, was the recipient of verbal abuse and physical altercations. I would often try to come between them to keep the peace, but it made things worse. I learned it would blow over if we did what was expected of us. I had to be mute, and my brother had to be submissive.

My mother was raised by a single mother, “The Dragon Lady,” and therefore had no role model for how to take care of two children. I admire her tremendously for how she survived her upbringing without having been parented or loved and eventually fled her abusive mother. I have no doubt that she loved my brother and me. But love was not enough. Simply stated, she did not have the resources to parent us.  At times, she would be incapacitated and bed ridden from stress.  She struggled during our childhood with severe blood sugar irregularities, which led to emotional volatility, sometimes causing her to become violent and punish us with an assortment of kitchen utensils. During happy times, she was adoring and affectionate. During stressful ones, she was unpredictable and frightening.

My brother is three years older than me. As adults, we joke that we raised ourselves. We did not do a very good job. As teenagers, we partied together, we did considerably reckless things behind our parents’ backs, and we supported each other during the tough times at home. When our parents would fight, scream, and throw household objects across rooms, we would sit together in my brother’s room, blast heavy metal music to drown out the noise, and cope with the chaos.

As a child, I loved being out of the house. I was preoccupied with playing and exploring, as most young children are, and did not think about my looks at all.  In seventh grade, at the age of twelve, all that changed. A boy in sixth grade called me an “ugly dog.”  I was devastated. I went home and asked my mother if I was really that ugly. Her response, in a kindly mothering way was, “Well, you have other attributes which you should emphasize. You are good at sports and you are very smart.” 

That was not exactly the reassurance for which I was looking. I thought, If my own mother can’t even lie and tell me I’m pretty, I really must be ugly.

In high school, I decided to go out for cheerleading and track team. I needed to be good at something that would help me change the way I saw myself. And it could not be based upon my looks, or I knew I would fail. When I tried out for the track team, I felt such urgency, almost as if the course of my entire life depended on being accepted. During freshman year, I set the record for the high jump and the discus. I felt like I had found my niche. As my confidence in track grew, my self-consciousness dwindled. I was validated for the first time! I was good at something! 

Then, sophomore year, I could no longer get over the high jump bar. No matter what I did, it was all over. I asked my track coach why I could not do it. His response:  “You’ve got a fat ass.” I felt like I had been sucker-punched. Here was a person who I admired, trusted, and actually thought was one of my staunchest supporters, and he not only betrayed me; he humiliated me in front of the whole team. In reality, I was not even overweight, but his comment sent me reeling. I felt defeated and trapped, with no other options for success. I could not bring myself to muster up the courage to try harder to improve my track skills. I gave up trying – and trusting. Now not only was I ugly; I was fat, too, and alone.

Taking Control

 At that moment, I decided I would never again be criticized about my looks or size. If I got thin enough, no one would call me fat, and if I spent enough time putting on the right makeup and the right clothes and styling my hair just the right way, maybe I would not be so ugly. All I wanted was to be happy and sure of myself. Happiness, as far as I knew, meant being a “good girl,” pretty, and thin.

I was on a mission. Breakfast became a miniscule bowl of oatmeal, lunch was crackers and pickles, and dinner was steamed vegetables. On weekends, I would have an enormous elaborate salad for the day that would take me hours prepare and hours to eat. I would allow myself to eat no more, only less. The rules were the rules. If I ate a morsel more than what my rules had demanded, I would do jumping jacks until I felt I had worked it off. I would spend hours baking beautiful cakes, cookies, and breads for my family and watch them enjoy the treats. I would smell the wonderful fragrance coming off the food but would not put a crumb of it into my mouth or I would have to face days of insane self-criticism and hundreds more jumping jacks.

My weight went down, my clothes grew looser, and I thought I was on my way to being happy. I obsessed day in and day out about food and my weight. I gave up track. I could not bear the humiliation. I kept cheering, not because it was fun anymore, but simply because it was a great way to burn extra calories. I did not care that I was depressed or that I lost my period. Being dizzy and hungry was a small price to pay for eternal bliss. Was I closer to happiness?  Not a chance.

During junior year, I began drinking. I would starve myself during the day and then drink after school with friends. I would get completely obliterated, sober up enough to come home, do my homework, eat the smallest amount of dinner I could get away with, and escape to the isolation of my room. On weekend nights, I would guzzle a bottle of sangria on my way to the bars, knock back massive amounts of mixed drinks until the bars closed, black out, and get dumped on my doorstep by anyone willing to drive my drunken self home. I would inevitably end up vomiting on myself and be forced to clean up the dried caked-on mess the following day.

Off to Rutgers University I went. I was so excited to leave my past behind and start over. I would re-invent myself! I would be the perfect student, perfect friend, perfect daughter, perfect college athlete, perfectly thin, happy, all-American girl. Right from the start, to keep myself in line, I decided to join a sport that required me to “make weight.” As coxswain on the crew team, if I gained a pound, I’d have to starve myself, run, and take laxatives to get the weight back down. Being the only girl on the boys’ team was a dream come true though. For the first time in my life, I got the positive attention I craved. I was, dare I say, popular. The reward for years of obsessing was finally paying off…or so I thought. The stakes were never higher. I could not ever let this go.

I took diet pills to curb my growing hunger and give me a reprieve from stomach pains so I could study. Three a day, then ten, then twenty, then a bottle every few days seemed like it would do the trick. Then, I would chew a sleeve or a box of chocolate laxatives with diet iced tea to make sure any food I had allowed myself to consume would come out. I would spend hours obsessing about which clothes to wear to make the best first impression. Multiple clothes changes seemed like normal female behavior. I did everything everyone wanted me to do so I could stake my claim as the best friend anyone could have. I never wanted to let anyone down. That would surely be the death of me. I would not allow myself to fail at anything. But this self-imposed pressure was more than I could bear.

I spent every waking moment in pursuit of the next level of starvation I could accomplish. I was driven to keep the weight off, above all other goals. I panicked at a fraction of a pound of weight gain, fearing I would lose precious control and become the shameful loser I feared lurked within me. I suffered constant splitting headaches from lack of food and unsuccessfully tried to mask them with bottles of aspirin.

One day while studying, a friend told me her little secret. She ate whatever she wanted and then got rid of it by vomiting. I thought I had found the answer!  I began bingeing and purging, sometimes six or more times a day. I would ride buses from campus to campus within the university to go to different dining halls and fast food restaurants. I would find a secluded table in the dining hall, carry my tray piled up with all sorts of food, and binge until my stomach would be in excruciating pain. Then I would purge in the bathroom, hop on the bus and go to another campus and do the same thing.

By the time the bingeing and purging became addictive, I had already gained a substantial amount of weight, and it was climbing. Now I was unable to stop. My weight kept going up, and I thought I was going mad. I was beginning to unravel.

Losing Myself

I was so focused on perfecting the outside that I lost complete touch with (or perhaps was never in touch with) who I really was and the things in life that were really important. I gave up time with friends so I could binge and no one would be suspicious of my habit. My bingeing was my best friend. I thought it made me happy. It distracted me from all the realities of life, because it took up all my waking hours. I spent countless hours planning and scheming to find the right time and place to binge and to hide my secret. I did not care about my grades. I skipped classes due to food hangovers, sore throats from purging, and pounding headaches from constantly straining my head over the toilet. The next binge and purge were the only “accomplishments” I focused on. I did not make the connection that my eating was going out of control because my life was out of control.

Avoiding Reality

I avoided those feelings about myself that I feared: the feelings of worthlessness, loneliness, lack of direction, emotional immaturity, extreme anxiety, and vulnerability. I was running from who I might be since I was certain that I was not beautiful and did not know how to strive to be anything other than beautiful, thin, or smart. My grades were slipping away, reinforcing for me my loss or lack of intelligence. My boyfriend and friends stopped tolerating me. I stole their food, constantly apologizing and promising to buy them more food, only to steal it again when the impulses to binge were more powerful than any promise I had made. I would binge day and night, causing my mood to deteriorate, and I canceled any plans for social events. They began to avoid me, only validating my assumption that I was unlovable. Once again, I was alone – with just my food, that imposter for my friend.

Whenever I thought I might need help, I could not bring myself to ask for it. You see, as the “good child,” I had no voice for anything unless it was positive. I was not allowed to complain, to feel sad, to feel hurt, or to ask for anything. I was mute. To make matters more confusing, I did not even know I had an eating disorder. Eating disorders were not talked about or well-understood then. There were no support groups. I was alone with my shameful secret. The prison walls were getting higher and stronger, and I did not know how to break out.

Then my dad died. I hit rock bottom. I had nowhere to turn, no one to run to. I was backed into a corner, face-to-face with myself.

My Turning Point

The turning point came for me, ironically, while at college. Looking back, I think it was losing everyone and everything in my life that made me finally face myself. I never felt so alone, but in a way, it was necessary, because part of my problem was that I could not see myself through my own eyes; I could only see myself from others’ perspectives, and what I thought they saw was never good enough.

               One day in my junior year at Rutgers, I was so despondent that I took myself to the college counseling center. There, I met a therapist who was so kind and compassionate. He told me that I was worth saving, that I was not the horrible ogre I thought I was. I almost felt guilty going to our sessions because surely he could not be saying these things about me; he just had not seen the real me yet. It took me weeks just to feel like I even had the right to be there.

I must have wanted to believe him, because I persevered. I embarked on my “healing/feeling” journey, and I began to realize that what I was going through had very little, if anything, to do with my eating and my weight. I had merely been using food behaviors for years as a means to shut down, control, and distract myself from my feelings, my past negative experiences, my mother, father, brother, friends, and anyone with whom I could conceivably have a real relationship. I had been trying to be a human robot, getting by doing normal human things, with no feelings, no hopes, no dreams, and no true sense of self.

We began talking about how I felt when I ate, when I did not eat, when I purged, and when I binged. It took me a long time to even figure out how I felt during these times; it was hard enough to just admit to him that I did these things. Gradually, we began talking about some of the experiences I mentioned earlier: the chaos in my household, my father’s drinking, my mother’s temper, the comments from my track coach, my inability to stand up for myself, and how, as time went on and I continued to separate myself from others, I lost the ability to voice anything important to me for fear of being ridiculed or hurting someone else’s feelings. I especially could not express how I felt, because half the time I did not feel I had a right to these feelings and, during the other half, I could not feel anything but absolute numbness.

Finding My Voice

I knew from experience that I could not just change my feelings, so I began to practice trying to understand what I felt. I was so used to numbing my feelings out with food in one way or another that I felt I needed to start all over. I practiced feeling sad, angry, frustrated, and overwhelmed. I talked with my trusted therapist about my “immature” feelings and practiced expressing them with him.

I started slowly, but I began speaking up. My therapist made this possible for me, because he provided a safe place for me to practice. I was so scared to feel or speak, but I knew it was the only way to stop the critical voice in my head that kept telling me that I was not good enough to have feelings or a voice, that I just needed to strive harder to be thinner, that I was not trying hard enough, that I was weak. He promised me that he would never humiliate me or disappear if I spoke up to him. During our sessions, he would bring up these very uncomfortable issues and encourage me to work through them with him. I would continue to ruminate about the issues, thinking about them for the whole week. Whenever I was alone, I would think about how much it upset me, and I would feel so tempted to binge or starve. It was the first time I was able to see the connection between my feelings and my eating. It was the first time I was able to feel anything real.

I feel sad when I look back and recognize how difficult it was for me to speak about myself. I had to practically hide my face while I said difficult things, but I persevered. I was genuinely proud of myself. I think it was the first time that I actually spoke up for myself and expressed what I was feeling. We never really talked about food after the first few weeks. We were talking about feelings. Over time when I left his office, I would feel a sense of calm I had never felt before. Of course, the old feelings would come back, but the more we talked and the more I practiced speaking up and expressing myself in very small ways, I noticed that my need to starve, hide food, binge, and purge began to diminish.

Working with my therapist helped me to feel connected in a healthy way to at least one person. That made me begin to feel better about myself and to believe that I was worthy of others’ companionship. I slowly began to get in touch again with some of my college friends, although this was very frightening to me. I took those feelings and practiced expressing them. I stood up for myself a little more, and it started feeling really good. I began to realize that I was important and my feelings mattered, even if they did not please others.

These were monumental steps for me, but I found that speaking up did not bring the earth crashing down around me. I also needed to find the language in which I could speak up. I always saw speaking up as confrontational, and that scared me. The feelings of nervousness were too unbearable and would usually trigger the need distract or numb out through starving or bingeing. I learned, however, how to set boundaries and speak up without being combative, so these situations did not terrify me anymore. I could simply say, “I’d rather do something else,” or “I’m not comfortable with that,” or “Thanks for asking, but I feel like staying home.”

Self-reflection and looking at the past were excruciating in the beginning but exhilarating at the same time. It was excruciating because feelings about the past and my current means of self-expression (eating disordered behaviors) that had been so masterfully buried were almost all negative, ugly, and painful. It was exhilarating because through self-reflection, I was able to understand that the past is past and did not have to pave the road for the future. I felt during those years that I was truly standing at the end of a road with two distinctly different paths ahead. On one path, I was destined to continue to forge through life emotionally flat-lined until some catastrophe (usually self-inflicted) jolted me back to life. On the other path of utter unfamiliarity, there stood a slim chance of happiness or joy, or at least perhaps less misery. I chose carefully. Even as I slowly trudged down that new path, there were deep grooves in the gravel from my heels being firmly planted in resistance.

About the Food

In my relationship with my body and food, I was resistant to let go of those behaviors because, although I was learning how to feel feelings and take care of myself, self-destructive food behaviors are addictive. I learned how to eat enough to satisfy my body and my mind, but the process was long, hard, and fraught with errors. I had to eat very mindfully and slowly so that I would keep the power I needed to fight urges to “keep on going” and binge and purge, followed by restriction, laxatives, and exercise. It was a time of serious mind games – my healthy mind against my disordered mind. I still made mistakes in my eating. I overate. I binged, but more mindfully. However, I did not call them mistakes anymore. They were choices. I never wanted to go back to my eating disorder. I was tempted, at times, to feel numb. I had strong desires to avoid that which was uncomfortable or painful, but it would have been a slippery slope to tread on if I even dabbled in those behaviors again. My mantra was, and still is, “My worst day well is still better than my best day sick.”

Re-Envisioning Myself

After I spent some significant time in therapy, I began to see my true self more clearly. I realized that there was much more to me than my outward appearance. In fact, I discovered passions and inner strengths I never knew I had. I began to enjoy the subjects I was studying at school. I had a clearer path toward what I wanted to do for a career. I no longer envisioned myself as an anxious, powerless, voiceless child. I felt strong and capable, yet somewhat vulnerable. I was able to set boundaries with others and use my voice to express myself. I learned how to take care of myself both physically and psychologically. I began the journey toward self-acceptance.

Redefining My Relationships

During my early recovery, I rekindled and formed a number of healthy relationships. I also began dating the man who would later become my husband. Despite my added weight, despite my outer imperfections, he loved something else about me. Of course, I constantly questioned his affection. I feared he would turn on me like everyone else had or that I would ruin everything like I had done in past relationships. I needed so much reassurance. I thought he would certainly get tired of me. It was just a matter of time. He told me I was the girl of his dreams. He told me he loved that I always had a smile on my face when he saw me, which made him feel good about himself. He pointed out my hidden, but real, strengths over and over. He began to make me question, albeit for fleeting moments, the horrible images of myself I had held onto so tightly. Was I really the “ugly dog” with the “fat ass?” Or were those perceptions inflicted upon me as a vulnerable, insecure girl. Why had I felt so deeply that I was worthless?

This man, Dean, helped me see the value of myself as a loving, caring, flawed, and worthy person. With his encouragement, I was able to talk to my mother about the issues I had dealt with in the past. I told her how I struggled to be heard as a child and how her actions and those of my father affected me. I even told her most of what I had been through with my eating disorder. With Dean’s love and support, the continual support of my mother, who currently still regrets her “motherly” comments, and the support of my college therapist who helped me see behind the walls I had built up and to find my voice, I began to slowly climb back to sanity and break out of the prison, brick by brick. It took years of gradual work, but, over time, I began rebuilding my relationships with the people in my life who were important to me. This took my constant vigilance in separating the perceptions that I had so ingrained in myself as a child from a more mature perspective, one that included me as a strong, worthy, feeling individual.

Looking Back and Making Connections

Seeing all of this in black and white, it is obvious to me now that the biggest contributing factor to my eating disorder was my inability to express my feelings and believe that they mattered. I had gained approval and attention as a child for being a good girl, and good girls never complained. I learned to be very self-reliant, never dependent on anyone for fear they would let me down. I felt that being dependent on others made me weak. I had grown so used to stuffing my feelings that when other people had strong opinions or made hurtful comments to me, I was convinced that what they believed must be correct and that I did not have the right to refute them. Since these were people I trusted, I began to believe that I did not have a right or a need to feel. Obviously this disconnect had to come out somehow. It emerged through my eating disordered behaviors.

If I could control myself to the point of almost starvation, then I could control these wayward feelings that kept popping up. When that stopped working, I would load myself with food to satisfy my needs and stuff down the feelings that were trying to scream to me. This started the vicious cycle of binging to numb out because of a need I “should not’ have or because of a feeling I “should not” feel, and purging to flush the need or feeling into the toilet. I felt I somehow needed to get rid of all of it. All of this really had very little to do with food.

My Role as a Nutrition Therapist

I never would have guessed that I would have been able to use my own difficult experiences to help others, but it was these experiences that led me to my current profession, my mission. I began studying nutrition at college, knowing someday I would want to work with people who had food, weight, and nutrition concerns. I decided to learn as much about nutrition and eating disorders as I could. I graduated from college with a degree in nutrition, earned my Registered Dietitian’s degree, and completed my Master’s degree in nutrition. I was a research assistant at St Luke’s Roosevelt Women’s Hospital in New York City performing bulimia research, primarily to gain as much insight into the illness as possible.

For the past twenty five years I have been treating individuals with eating disorders in private practice after working briefly in an in-patient eating disorders unit in a hospital in North Jersey. I consider myself a “nutrition therapist” instead of a traditional “dietitian,” because I combine nutritional guidance with insight and supportive, therapeutic listening. In my office, I provide a safe, non-judgmental environment for individuals who hope to get the help they desperately seek to share their thoughts, feelings, and fears about food, their weight, and their food-related behaviors. I teach people how to see the relationship between their feelings and their eating behaviors. I also help put structure and sanity back into their eating with the hope of  helping them regain a healthy perspective on what normal eating is. 

I speak to young boys and girls in schools to help them appreciate themselves and their differences in size and shape. I try to help them see that their unique qualities are far more important than their weight or clothing size. I try to help take away the shame that larger kids feel about their size or shape. I show them magazine pictures of the unrealistic ideals – emaciated women and “ripped” men – they are told they should look like and help them see these images for what they truly are: impossible and dangerous. I teach parent groups to recognize the warning signs of eating disorders, to de-emphasize weight and outward appearance, and instead support their children if they are beginning to go down the path of unhealthy dieting by being healthy role models with their own food and weight-related behaviors.

In my own home, we do not discuss weight and size in a negative way. We fuel our bodies well, we eat foods we enjoy, and we eat fun foods just for fun. We emphasize and appreciate diversity. We acknowledge our strengths and support our weaknesses, both physically and in other areas of our lives. We do not allow the word “diet” to be used. In our house, “Diet” is a four-letter word that is just as negative and derogatory as four-letter curse words. I never want my children to feel judged, humiliated, or unheard. I encourage my children to express themselves, no matter how difficult.


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Obsessions, Obsessions, Everywhere…None Of Them Are Truths!

positive thinking

Recently, a client said to me that she can’t go anywhere without obsessing about other women, how beautiful and skinny they are. I asked her to give me more detail about these instances and tell me what her thoughts would look like during and after seeing these “beautiful, skinny” women. She gave me a detailed description of a scenario and her thoughts that followed.

…I went to The Grove (an outdoor shopping area near my office) and stood on line at Starbucks to order my drink. All the women in line ahead of me were skinny and dressed beautifully. Their hair was impeccable, their clothes fit them perfectly, they wore the perfect accessories, AND they ordered “skinny” drinks. Even their kids looked gorgeous. Not a hair out of place. Flawless. I wanted to order the drink that I really wanted, because you always tell me to get what I am truly in the mood for. I had my heart set on a salted caramel mocha frappucino. But after seeing these beautiful women in front of me, I couldn’t do it. I ordered a skim latte, even though I don’t like skim lattes. My thoughts told me that these women are super skinny because they don’t eat. They are exercising more than me. They are happy. Their husbands are happy. Their kids are always well behaved. They have super happy lives. AND I am fat. I don’t restrict my food. I don’t look good in my clothes. I don’t have enough time to exercise like they do. I will never be like them. I will never be happy. My kids throw tantrums. My husband isn’t happy. It’s all my fault. If I was skinny like those women, my life would be great. My life is terrible. I need to lose weight. Everyone must be staring at me thinking that I need to lose weight…

She went to the milk station and put several Splendas in her skim latte and went directly to her car. She was planning on walking around the Grove to do some shopping, but now she felt dreadful and couldn’t bear to be out among people. She drove home, defeated. She felt awful about herself and her life. She obsessed about how fat and miserable she was for the entire ride home. Ironically, nothing had changed from the time she arrived at The Grove till she got into her car EXCEPT the dialog she had in her head. She went from being excited to have a fun shopping day and getting her salted caramel mocha frappucino, to being consumed by sadness, driving home with a skim latte. Topping it all off, when she arrived at home, she binged on the foods she had bought the prior day for her daughter’s birthday celebration. After the binge, she cried.

What went wrong??? To me, this story is heartbreaking, and yet it happens day in and day out with so many of you. It may not be this exact scenario. The people are different, the place varies, but the obsessions and resulting feelings are the same.  Sadness, defeat, hopelessness.

This can’t continue!!! We need to change the scenario. We need to start with challenging the core negative thoughts and beliefs you have about yourself and others. THEY ARE NOT TRUTHS!!!

Truth Number 1: People who are “skinny” are not happy due to being skinny. Happiness is a byproduct of self-care in mind, body, and spirit, healthy relationships, etc.

Truth Number 2: You can’t tell what a person’s life is like by the clothing they wear or the hair style they have. All you can tell by these two things is that they own a nice outfit that you saw them in (or maybe it was not theirs) and they have a decent stylist.

Truth Number 3: Most, if not all kids throw tantrums.

Truth Number 4: People who restrict their food are not happy. Restriction = obsession.  Obsession = unhappiness (both physically and psychologically)

Truth Number 5: People most definitely are not judging you. And, even if they are, you will never know because they aren’t going to tell you. You have the choice NOT to make these assumptions.

Truth Number 6: Your thoughts create your reality. If you want to have a healthy positive reality, you need to allow positive thoughts to enter your mind, even if you don’t yet believe them.

Truth Number 7: The story you invent about others is NOT their story. It is a concoction of YOUR imagination.

If you don’t want to use a food behavior to cope with the feelings you experience, and those feelings are a DIRECT byproduct of your own negative thoughts and obsessions, you need to work on shutting down these self-sabotaging thoughts and obsessions, replacing them with more positive thoughts, and/or distracting yourself from the obsessions until they pass. This can be accomplished by first asking yourself two simple questions. “Is this a true thought? Or, Is this thought going to help me get where I want to be today, or in life? If the answer is “no”, then don’t accept that thought as truth or as a thought you want to focus on. Next, replace the thought with a new, different, positive, more loving one. You have the ability to do this. It may take practice, but it is essential if you don’t want to always be left fighting off the urges to engage in a food behavior to put a salve on the negative feelings that result from your own obsessions.

How would this look in real terms? In the scenario with my client, as she was standing on line at Starbucks, as soon as the thought came into her head that the women in line were all skinny, beautiful, and happy, she could have immediately (1) asked herself if that thought was true or would help her in how she wants to live her day. After she answered that question with “no”, then she could (2) have replaced that thought with ANY positive, or true thought like:

·        I am excited to do some shopping today

·        I am grateful for this beautiful day

·        I am excited to have my salted caramel mocha frappucino

·        I am grateful for these two hours of solitude

If she could have accomplished these thought shifts, she could have changed the course of her day.

So, remember, that obsessions are not truths, negative obsessions most definitely lead to negative feelings, and most importantly, YOU have the power to change your negative thoughts into positive ones and ultimately change the course of your life.

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Picture “Perfect”

little children

You are at an event – a party, a holiday gathering, or vacation – and inevitably someone wants to take a picture of your group, and they want you to be in the picture.  You feel super uncomfortable. You try to run away, or tell them you don’t like your picture taken. They get upset or angry, and plead for you to be in the picture. You get embarrassed by their pleading and now you are faced with a decision. Do I allow the picture to be taken and splashed all over facebook or instagram? Or, do I persist and insist that I won’t be in the picture?

Having photos taken can be super stressful for anyone who has body image issues. Individuals who struggle with their body sometimes find it painful to see themselves in print. Why is this??? Well, when someone is super critical of themselves and their flaws, they may instantly focus on those flaws when they see themselves in pictures. Truly, no one takes a great picture 100% of the time, but when you have low self-esteem and body image issues, you often can’t look past the imperfections to see yourself the way others see you.

I recently saw a picture of four women I knew. The picture wasn’t flattering of any of them, yet they loved the picture because all they could see was the love and friendship that they shared for over 30 years. None of them focused on the way their hair flew all over the place, or, in their words, the “lumps and bulges” that might have put another person over the edge.

Memories are created through pictures. Once an event has passed, all you have as a reminder of it are the photographs. In years to come, you will crave the memories of all your life’s events. Have you ever looked at pictures of yourself as a child, perhaps with a childhood friend, and smiled at the memories it conjured up? Did you have good feelings about the young person you saw in the picture?

Your feelings about your body will hopefully improve over time, and you will want to see yourself, as well as the places and people who were special to you. And, remember, that you are special to those around you. They aren’t looking at the pictures of you picking apart everything about you. The love they have for you makes them see the beauty in you, regardless of what your body looks like.

Try not to waste another moment of your life running and hiding from the camera. Try not to let your body image issues and your eating disorder prevent you from trying to create memories. Don’t wait until you think you will take the “perfect” picture. Obviously, I’m not recommending that you put yourself into any situation that will cause significant emotional distress. I’m simply recommending that you don’t let your eating disorder guide your decision to avoid the camera. Try to see what others see…your inner beauty, kindness, friendship. Create and savor each and every positive memory you can. Lastly, try not to pick yourself apart if you do see pictures of yourself. Try to find something positive about what you see.

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