Author Archives: Alison Pelz, LD, RD, CDE, LCSW

Coping with COVID-19 and Eating Disorder Recovery: Tips for College Students

Coping With COVID-19 and Eating Disorder Recovery: Tips for College Students

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Let’s face it – starting a new year in college during the COVID-19 pandemic is rough. College life looks much different than it used to, with virtual classes and less socializing, to name a few things. If you add an eating disorder into the mix, it can make starting the semester feel downright daunting.

If your eating disorder symptoms have increased since the pandemic started you are not alone. Eating disorder behaviors are a way to manage and cope with stress, so more stress can equal the exacerbation of eating disorder symptoms.

Furthermore, the nature of physical distancing can lead to feelings of worry, sadness, hopelessness, and loneliness which also can trigger eating disorder behaviors, including dietary restriction, purging, binge eating, and overexercising.

Starting a new semester (or starting college for the first time) is associated with many “positive feelings” and excitement. However, along with these positive feelings, students may experience feelings of isolation, worry, and sadness, again exacerbating eating disorder symptoms.

Remember it is normal to be experiencing more stress, worry, and sadness during the pandemic. However, there are tools that you can use to manage your feelings.

Below are some tips to help you cope with stress, the pandemic, and your eating disorder:

  • Keep connected with your treatment team.
    • Whether you are doing treatment in person or virtually, keeping regularly scheduled appointments is key to keeping your eating disorder recovery on top of the priority list. If you feel like you need more support during this time, ask your team about more frequent visits and/or attending virtual groups. To learn more about eating disorder treatment teams or how to get treatment, click here.
  • Stay social.
    • College with a side of COVID can be very isolating especially if you participating in virtual learning. It is not uncommon to experience an increase in loneliness. Social connection with family and friends can help reduce feelings of loneliness, sadness, and worry. Keep socializing in whatever way feels safe to you a top priority.
  • Make time for hobbies and other coping skills.
    • Coping skills and hobbies can help manage stress and uncomfortable feelings such as worry, sadness, and anger. Healthy coping skills are activities that you can help you positively manage stress. These can include talking with a friend, spending time outside, playing with a pet, reading, cleaning, doing a puzzle, praying or meditating, or volunteering, to name a few. Hobbies such as crafting, art, photography, and the like can also help reduce feelings of stress.
  • Keep a routine.
    • Having a routine can help reduce stress levels by adding structure and organization to your day, even during the pandemic. Having a general—but not rigid—routine around eating, sleeping, socializing, and studying can be helpful in your recovery from your eating disorders and generally improve mental health.

Remember that it is normal for eating disorder symptoms to increase during times of stress, and the COVID-19 pandemic is a very stressful time. By practicing the tools above, you can learn ways to reduce your stress and continue with recovery.

If you would like to learn how I help clients manage stress or you need help in your eating disorder recovery, please click here to schedule a free 15-minute phone consultation.

3 Important FAQs about Binge Eating Disorder

3 Important FAQs about Binge Eating Disorder

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Do you feel out of control with food? Once you start eating, do you feel like you can’t stop? Do you feel shame, guilt, and embarrassment after eating? If so, you may struggle with binge eating disorder—the most common type of eating disorder.

Binge eating disorder is characterized by eating large amounts of food in a discrete amount of time when not feeling hungry or eating at a rapid pace until uncomfortably full. Binge eating usually takes place in solitude, and there is marked emotional distress associated with binges.

Here are some most frequently asked questions about binge eating disorder:

I think I may be addicted to food. Is that the same as binge eating disorder?

There is much debate among healthcare providers about whether food addiction is a bona fide diagnosis. Some believe that food absolutely can be addictive. In fact, science shows that our brains are activated in the same way they are with drugs when we eat highly palatable, good tasting food.

People who describe themselves as food addicts have a compulsive drive to eat, even when they are not hungry, eating, perhaps, to soothe emotions or to “check out.” In the short term, overeating feels good. But in the long term, it can feel pretty uncomfortable. Attempts to stop overeating may be made but with little success.

You may not buy certain foods, fearing that you will eat it all in one sitting or over a day or two. Maybe you plan to buy certain foods just to binge on them. Or you buy certain foods and promise yourself that you will not binge on them as you have in the past. Food is often consumed in solitude.

Guilt and shame are feelings often experienced with having a loss of control with food. Sounds similar to drug or alcohol addiction, right?

Furthermore, our brains may become activated similarly to the way they are with drugs and alcohol when we eat certain foods—as a reward pathway. By design, we get pleasure from eating, so we will seek out more food (to sustain us).

However, unlike drugs and alcohol, we need food to survive. Additionally, most people who feel out of control with food are able to stop eating or ignore foods that are less appealing. Most people who struggle with drug addiction, for example, consume all drugs until they are gone. That is not the case with food.

If you are reading this, whether you think food addiction is a valid term or not, my guess is that you feel out of control with food. Feeling out of control with food is a key feature of binge eating disorder.

I have tried every diet and I can’t get my binge eating under control. Am I ever going to get better?

Yes, you can get better, but not by dieting. Dieting can actually make binge eating worse. In fact, dieting is a risk factor for developing an eating disorder. Cutting out certain types of food and/or under-eating makes your body ripe for binge eating.

It makes sense. Our bodies by design are set up to survive. Obviously we need food to survive, and our bodies send us very strong signals to eat. If we chronically restrict food, our bodies give us signals to eat large amounts at a time.

Although it may seem counterintuitive, eating regularly throughout the day and including all foods in the diet actually helps reduce binge eating. With the help of a registered dietitian, foods that are typically eaten during a binge are slowly reintroduced as part of treatment.

Can I get over binge eating disorder on my own?

Unfortunately, many who struggle with binge eating disorder try to “diet” their way out of binge eating, but this usually makes the binge eating worse.

There is some evidence that self-help programs and books can help reduce binge eating symptoms, but most likely you will need the assistance of a professional.

Asking for professional help can feel daunting. However, relief is often expressed by people with binge eating once they seek treatment because someone understands what they are going through.

Usually, a psychotherapist or counselor, registered dietitian, and a doctor are part of an eating disorder treatment team. Learn more here about how to find an eating disorder professional.

3 Important FAQs about Binge Eating Disorder
3 Important FAQs about Binge Eating Disorder

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Virtual (and Free) Eating Disorder Support Groups During COVID-19

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Eating disorder recovery may feel like a struggle during the COVID-19 pandemic. This is normal because times of stress and uncertainty, which most of us are feeling, can put a strain on our mental health. Virtual support groups are readily available and often at no cost.

Fortunately, you do not have to go through eating disorder recovery alone during this time. It can be helpful to connect with others going through similar experiences. Many eating disorder treatment centers and professionals are offering virtual services on-line, including support groups.

Virtual support groups can be a great addition to your current treatment.

Groups can be a great way to reduce social isolation while the stay-at-home orders are in effect. In general, support groups can offer many benefits, including improved motivation to recover, strengthened positive coping skills, increased sense of control, and reduced feelings of shame, isolation, depression, hopelessness, and anxiety.

For some, support groups can be a little anxiety-provoking, but a virtual group may be good for a first-time. Due to the nature of the internet, there is some degree of privacy and anonymity. Additionally, groups usually have a leader and a set of groups “rules” to help make you feel emotionally safe.

There can be some downsides to support groups, particularly if they are not well run. Some of the downsides include excessive amounts of complaining (the purpose of a support group is to provide hope), monopolization of discussion by one group member, and potential issues of confidentiality.

Together with your treatment team, you can determine if a virtual support group would be helpful in your recovery. If you don’t have a treatment team or are currently not receiving eating disorder treatment, please click here to learn more about how to find a treatment team.

Free + Virtual Eating Disorder Support Group Resources

Below is a short list of virtual support groups. Many offer multiple support groups that meet the needs of different populations, including adults, teens, families, and LGBTQ folks, to name a few. Also, ask your treatment provider about support groups which they may be familiar with.

A virtual support group can be a great way to augment eating disorder treatment, especially during the pandemic. Together with your treatment team, you can determine if a virtual support group may be helpful to you.

5 Ways to Stay on Track With Eating Disorder Recovery During COVID-19

5 Ways to Stay on Track With Eating Disorder Recovery During COVID-19

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Keeping your eating disorder recovery front and center during the COVID-19 pandemic may be the furthest thing from your mind, given that we are all adjusting to a new way of life, navigating uncertainty, and dealing with loss and worries about our health, to name a few pressing issues.

Here are some tips to help you maintain and even thrive with your eating disorder recovery during this unusual and trying time:

1. Keep eating disorder recovery on the priority list during COVID-19.

Of course, your priorities have shifted in the wake of COVID-19. First and foremost, you are dealing with the stress of this health crisis. Time and energies have shifted because you are adjusting to a new way of life, including being cooped up in the house; working or schooling from home; health risks; and isolation.

While these changes may seem overwhelming at times, know that you can tend to your eating disorder recovery during this time. As with everything right now, your recovery may look different than usual, and that’s okay.

2. Stay in touch with your eating disorder treatment team.

If you have not checked in with your treatment team—including your therapist, dietitian, and doctor—that may be a good first step. Most clinicians are conducting telehealth appointments, which may include video conferencing, telephone, email, and FaceTime appointments. Telehealth may feel a little daunting at first, but I am finding it to be an effective way to continue to support clients with eating disorders.

If you don’t have an eating disorder treatment team, read more here about how to find eating disorder services in your area.

3. Accept that your eating may be different during COVID-19, and that’s okay.

Changes in food accessibility, cooking at home vs. eating out, living situation, mood fluctuations, and activity level can all contribute to changes in eating patterns. Talk with your treatment team about any changes you have noticed with your eating as well as alcohol consumption.

4. Stay curious about your eating disorder symptoms.

Your eating disorder symptoms may change, or they may wax and wane during this time. Try to refrain from being judgmental about your eating disorder symptoms.

Instead, ask yourself something like, “I am noticing that I am doing this eating disorder behavior more. What may be going on or what may I be feeling?” Being curious rather than judgmental allows for problem-solving rather than shame.

5. Be as social as you can while physical distancing and stay-at-home orders are in place.

Social isolation and loneliness can affect your physical and mental health. Regularly connecting with family, friends, co-workers and/or classmates via telephone or virtual meetings can help reduce feelings of loneliness. Check with your treatment team, as they may be aware of virtual eating disorder support groups that can help support your recovery during the pandemic.

5 Ways to Stay on Track With Eating Disorder Recovery During COVID-19
5 Ways to Stay on Track With Eating Disorder Recovery During COVID-19

Your eating disorder recovery may look different than it usually does during the pandemic, and that’s okay. Using the tips above and taking it one day at a time is a good place to start.

Intuitive Eating: 3 Signs That It Is Right for You

Intuitive Eating: 3 Signs That It Is Right for You

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Intuitive eating is a term coined by registered dietitians Evelyn Tribole and Elyse Resch. Tribole and Resch’s book Intuitive Eating’s purpose is to help chronic dieters and people with food and body image struggles to heal their relationship with food.

Unlike diets, intuitive eating sharpens our ability to listen to our bodies and to understand when we are hungry and full, what foods to eat, and when the best time for our bodies to eat is. This results in a reduction of worry about food and guilt often associated with dieting.

In a nutshell, intuitive eating is learning to tune into your body’s signals in order to feed and nourish yourself instead of a diet or meal plan.

Are you ready for intuitive eating? Here is how to tell:

Are you tired of dieting?

Have you been on almost every diet known to man? Do you feel frustrated that diets work for a while, but then something happens-like a vacation or a stressful event-then you go off the diet?  

Trust me, it is not you, it is the diet. Most diets don’t work long -term. Diets fail, not the people on them. Dieting is a known risk factor for developing a full-blown eating disorder.   Eating intuitively can help kick diets–forever. 

Are you tired of feeling guilty about what you are eating?

Most diets have rigid rules about what, when, and how much to eat. When these diet rules are “broken,” it can leave the dieter with feelings of guilt. 

With intuitive eating, there is no set of rules about what is “good” and “bad” to eat. Eating intuitively helps people tune into their body’s wisdom in order to feed themselves.

Do you feel out of control with food?

Diets give us the illusion of control over food.  Particularly when you first start a diet, it feels like you have complete command over your eating, until your biology kicks in (because most diets don’t provide enough energy or calories) or you find yourself in a situation that you are unable to follow the diet. 

Furthermore, it is natural to have cravings for more food and certain types of foods if you have been depriving yourself by being on a diet. The overeating (perhaps even binge eating) kicks in when you have access to foods that aren’t on the diet.

Again, it is not because you don’t have enough willpower or intellect. The diet is the problem, not you. Studies show that dieting can lead to full-blown eating disorders.  

Eating intuitively rejects the diet mentality and “legalizes” all foods, thereby reducing feelings of deprivation around food. 

If you answered “yes” to any of these questions, intuitive eating may be the relief you are looking for.  

Intuitive Eating is not another diet in disguise or a weight loss program. Intuitive eating doesn’t preach what, when, and how much to eat, Rather, it teaches you to listen to your body’s signs and signals about how to best feed yourself. With intuitive eating, you will gain confidence around how to feed yourself.  

Want to learn more about intuitive eating or see if it is right for you? Call for your free 15-minute phone consultation.  

Note: If you are in treatment for an eating disorder, talk with your treatment team about if and when intuitive eating is right for you. If you think you have an eating disorder, get an assessment completed by an eating disorder treatment professional before starting intuitive eating.  

4 Ways to Build Momentum in Eating Disorder Recovery

4 Ways to Build Momentum in Eating Disorder Recovery

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Are you just starting out on your recovery journey? Or have you been in treatment for a while and feel like your recovery is stalled? You’re not alone.

Here are four tips to help build momentum or re-energize your eating disorder recovery.

Establish a complete eating disorder treatment team.

Without professional treatment, eating disorders tend to get worse, not better.  

Unfortunately, getting inadequate treatment, such as stopping treatment prematurely or having an incomplete treatment team, happens all too often. It can lead to hopelessness about ever recovering, slow down recovery or lead to recovery burnout.  

The gold standard of care in eating disorder treatment is to have a multidisciplinary team. An eating disorder treatment team usually consists of a therapist, registered dietitian, medical doctor, psychiatrist, family therapist, and possibly other specialists.  Click here to learn more about how to find a therapist and establishing a treatment team.

Make recovery a priority.  

Recovery can feel like a full-time job, which can be downright exhausting. Eating disorder recovery is definitely a marathon and not a sprint.  It takes time to understand how the eating disorder serves you and to establish new healthier patterns to cope with life.

Recovery doesn’t happen in a vacuum. Recovery happens while you are in school or working and involved with family, friends, and hobbies. So, it is easy for recovery to be put on the back burner given all of the obligations you may be juggling.

Making recovery a priority is important because without recovery, your eating disorder negatively affects all areas of your life occupation or school, relationships, physical and mental health, and overall quality of life.  

Having acceptance that recovery is going to take time and energy is a good first step to making it a priority. Carving out time in your day for self-care, meal planning, eating, rest, and treatment appointments can help you feel less overwhelmed.    

Learn to say no.

This is a tough one for me and so many of my clients.  Sometimes saying yes is like a reflex because it is so automatic.

Learning to say no is a must in order to make recovery a priority. Furthermore, you may learn in treatment that saying yes too much may be contributing to or exacerbating your eating disorder symptoms.  

Not setting firm boundaries can lead to feelings of hopelessness, worry, anger, and resentment, to name a few negative emotions. When we over-extend ourselves, often eating disorder behaviors are used to cope.

Although there are several reasons why people struggle with saying no, often fear is the primary culprit. You may fear missing out, hurting others feelings, appearing selfish or rude, being judged, and feeling rejected.

Learning how to set boundaries takes lots of practice, so be patient with yourself.  If you notice that you struggle in saying no, discuss this with your therapist and other treatment providers.  

Ask for help.

Working on your eating disorder recovery is something that you are responsible for. However, that doesn’t mean that you have to do it alone.  

As you know, loved ones can’t eat for you or attend your appointments for you, but they certainly can support you in your recovery in many different ways.  

As you go through recovery, you are going to need help, and that is okay. Often, part of what keeps people stuck in the eating disorder is isolation and feeling like they have to recover alone.

Barriers to asking for help often include fear of appearing weak, feelings of shame or guilt, or worry about burdening others. Your fears most likely are unfounded, as most people like to help others.   

So what does asking for help in recovery look like?

Well, at different times in your recovery, it could mean different things. But, for some, it could be eating a meal with someone, it could mean being social, or it could mean simply talking.

It could also mean asking loved ones to learn more about eating disorders or attending a family therapy session or doctor’s appointment.  

Consider making a list of people whom you could ask for help by asking yourself, “Who has my best interest at heart and who believes in me?”. Having some people in mind ahead of time can make it easier to ask for help.  

Lastly, don’t feel like you have to be in crisis to ask for help. If you have any inkling that you may need help, reach out. Sometimes just the act of reaching out and talking to someone can be supportive.  

The recovery road is always bumpy. But, having a strong treatment team as a foundation, making recovery a priority, setting firm boundaries, and calling on loved one for support can often make the bumps feel more manageable.