Category Archives: Eating Disorders

Graphic that reads in white font on a purple background "Anorexia Nervosa: One Size Does NOT Fit All" Next to a large photo of a woman bowling.

Anorexia Nervosa: One Size Does NOT Fit All

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Unfortunately, there are many incorrect assumptions associated with eating disorders. One I see a lot is the assumption that in order to have an eating disorder, particularly anorexia nervosa, one has to have very low body weight.

This is simply not true.

Sadly these assumptions block those suffering from eating disorders from getting the life-saving treatment they need.

In fact, most people with eating disorders don’t necessarily fit neatly into an eating disorder category.

Eating disorders are more about how the person relates to food, exercise, and body than what a person looks like.

Let’s take a closer look at an eating disorder called “Atypical” Anorexia Nervosa (AAN). I put the word atypical in quotes because it is my understanding that more people suffer from AAN than anorexia nervosa, so there is really nothing atypical about it. Basically, AAN is the same as anorexia nervosa with one exception – those with AAN don’t meet the criteria for being underweight like those suffering from anorexia nervosa. In fact, some with AAN may live in a large body.

Symptoms of ANN are exactly the same as anorexia nervosa. AAN includes significant caloric restriction, intense fear of gaining weight, and overvaluation of body size and shape (ie. evaluating self-worth based on weight and shape).

Typical signs of Atypical Anorexia Nervosa could include:

  • Extreme concern about weight and shape
  • Preoccupation and worry about food
  • Restriction of total calories consumed
  • Avoidance of eating certain types or categories of food
  • Avoidance of social situations that involve food
  • Misuse of exercise or overexercising.

Often the assumption is that only white, young, female, and very thin people experience eating disorders. Because of this assumption, many eating disorders go undiagnosed. It is not uncommon for people with eating disorders, particularly those who live in large bodies, to get prescribed weight-loss diets which actually makes the eating disorder worse.

Is AAN as dangerous or serious as other eating disorders?

All eating disorders can be harmful to both physical and mental health. Eating disorders can be associated with isolation, rigid thinking, poor self-esteem, anxiety, depression, poor focus, and sleep disturbance.

What to do if you think you have an eating disorder:

Because of the abundance of misleading and harmful nutrition, weight, and exercise information, sufferers of eating disorders are often led to believe that they can recover from their eating disorder on their own. Sadly, this often prolongs the eating disorder and the suffering. If you think you have an eating disorder, here are some next steps to take:

  • Find a treatment provider who has experience in treating eating disorders.
  • Find a therapist and/or dietitian. This can be a good place to start. In your search make sure the clinician has expertise in treating eating disorders.
  • Read about eating disorders.
  • Listen to podcasts.
  • Know that recovery from eating disorders is possible!

If you’re looking for more support in eating disorder recovery, I can help you make peace with food and your body. Drop me a note today.

Diet Culture, COVID-19, and Weight Stigma: 2020 in Review

Diet Culture, COVID-19, and Weight Stigma: 2020 in Review

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At the end of every year, I like to put together a post that collects everything I’ve published on my blog over the last year. And what a year it’s been. This year is nothing like we imagined it would be. We have lost almost a year of being with family and friends, experiencing new things, and living our ‘normal’ lives. If you’re feeling grief about this year, the lives lost and changed, and what could have been, you’re not alone. 

This year has been hard, sad, lonely, scary, weird, and pretty much any other adjective out there. It can be hard to hold space for all of those things at once, so be gentle with yourself as you work through your feelings about 2020. 

Here’s what I wrote about this year: 

This year, I wrote a lot about the COVID-19 pandemic and how that interacts with folks in eating disorder recovery. 

When things get hard, communities thrive. The eating disorder recovery community is more important than ever with many of us isolated and unable to connect with other ED survivors in real life. I wrote about 5 Ways to Stay on Track With Eating Disorder Recovery During COVID-19, Virtual (and Free) Eating Disorder Support Groups During COVID-19, and Coping With COVID-19 and Eating Disorder Recovery: Tips for College Students.

Rejecting Diet culture

One of my favorite ways to learn about rejecting the diet mentality is through podcasts! I put together a list of my top podcasts to help you break free from diet culture. (I also included a tip for how to find anti-diet resources: “It’s easy to be wary of what you find related to body positivity and anti-diet resources, since the movement has been flooded with people trying to cash in without spreading the actual message of the anti-diet movement. When looking for a trusted resource online, make sure that they mention on their website (hopefully prominently!) that they believe in dismantling diet culture, center larger bodies, and don’t mention weight loss anywhere on their site.”

Eating Disorders

Eating disorders are a complicated subject. One of my goals is to help people challenged with ED and other food & weight-related concerns to move from constantly worrying about food and their weight to being free to create the lives they want. The first step here is understanding what eating disorders actually are. To help, I discussed 3 Important FAQs about Binge Eating Disorder on the blog. While some of us understand the basics of eating disorders and anxiety on our own, it’s rare to see a blog post connect the two and tell you what you need to know if you’re living with an eating disorder and an anxiety disorder. I wrote about frequently asked questions related to eating disorders and anxiety to share what I know!

Weight Bias + Stigma

Weight bias is everywhere we look in our culture. It’s led to systematic discrimination of larger bodies in many areas of life – medical care, job opportunities, social interactions, to name a few. So many folks railing against people in larger bodies don’t realize that what really causes negative health outcomes is a result of stigma, not a result of having a larger body, so I wrote about how weight bias and stigma are the real hazards to health, not body size. 

Diet Culture, COVID-19, and Weight Stigma: 2020 in Review

If there are any topics you’d like me to cover in 2021, let me know! You can message me here. If you’re looking for even more resources, make sure you’re following me on Facebook and Pinterest!Every week, I share resources from myself + other experts in the field on both platforms!

FAQ: Eating Disorders and Anxiety

FAQ: Eating Disorders and Anxiety

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It is normal to feel worry and fear from time to time. We all have experienced worry before a big test at school, a deadline at work, or a big event. Anxiety is a normal part of life. In fact, fear can help us stay safe by alerting us to possible danger, and a little bit of worrying can be motivating for some to take care of tasks. However, if you frequently feel and have intense worry, this could be an indication of an anxiety disorder.

Q: How common is anxiety?

A: Anxiety disorders are the most common mental health conditions. It is estimated that worldwide, more than 264 million people have anxiety, and about 40 million Americans have it. Anxiety is more common in girls and women than in boys and men. There are different kinds of anxiety disorders including generalized anxiety, obsessive-compulsive disorder (OCD), panic disorders, phobias, and post-traumatic distress disorder (PTSD), to name a few.

Q: How do I know if I have an anxiety disorder?

A: The short answer is: Talk to your doctor to help determine if you have an anxiety disorder.

Let your doctor know if you experience any of these common symptoms of anxiety, including excessive and uncontrollable worry, feelings of nervousness, restlessness, and tension, trouble sleeping, gastro-intestinal upset, sweating, trembling, rapid heart rate, or a sense of panic or impending doom. Again we all experience anxiety from time to time, but if you frequently experience some of the symptoms above, it may be time to talk to your doctor.

Q: I have an eating disorder and I think I have anxiety. Can you help me with both?

A: Studies show that 50-80% of people who have an eating disorder also struggle with anxiety. It is not always clear which comes first – the eating disorder or anxiety – or if the anxiety and eating disorder emerged roughly at the same time.

Anxiety usually makes the eating disorder symptoms worse, so it must be treated simultaneously with the eating disorder.

It is standard in eating disorder treatment to also treat co-occurring conditions whether it is anxiety, depression, or another condition. Many therapies or methods used to treat eating disorders can also be used to treat anxiety.

Q: How is anxiety treated?

A: Anxiety is very treatable. Anxiety disorders can be treated with psychotherapy as well as medication. I use Cognitive Behavioral Therapy to help treat anxiety and eating disorders. In a nutshell, Cognitive Behavioral Therapy (CBT) is a well-studied treatment that proposes that thoughts, feelings, and behaviors are interconnected and greatly influence one another.

CBT helps identify and challenge thoughts that are distorted or inaccurate that often lead to intense and pervasive feelings such as anxiety and depression.

Practicing CBT skills with “homework” between counseling sessions is something that I use regularly with clients. It has been my experience that clients like to have tools that they can use outside of sessions to help them manage their anxiety and eating disorder, plus it can speed up treatment the more the skills are practiced.

To learn more about anxiety and treatment here are some resources to get you started:

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If you have started to notice that your anxiety is getting in the way of your normal functioning, it may be a good time to talk to a therapist. Get in touch here!

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.