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Spring Time Blues

Written by nutritiousthoughtsblog on . Posted in Self Care.

The weather is warming, daylight lasts longer, and the world seems to be blooming…and it expects you to be doing the same.

This month, we feature a very important blog post by Carolina Partners in Mental HealthCare, PLLC that highlights the pressure we may feel to present ourselves to the world as happy, energetic, and carefree this time of year and how it is perfectly alright (and actually makes sense) if “happy-go-lucky” is not everyone’s reality during the Spring season.

Check the post out below!

IT’S SPRING! WHY YOU DON’T HAVE TO FEEL HAPPY

Spring is finally here. People are wearing shorts, the birds are infectiously happy, flowers are blooming everywhere. In the grocery store today, a man told me, “You look so sad. Be happy! The weather is beautiful.” While there’s always room for gratitude in our days, and nice weather certainly can be something to be grateful for, I’m here to tell you why you don’t have to be happy.

There are admittedly many proven mental health benefits to Springtime. The increase in daylight provides a boost in one’s serotonin levels (serotonin is a crucial ingredient for feelings of happiness). And during the new season, people don’t need to expend as much energy to fight off the drowsiness that occurs when it’s darker outside. Also, people tend to socialize in the Springtime more, which comes with other mood-enhancing benefits; for example, laughing with friends or hugging loved ones, both of which release important endorphins.

With all of this bright light, social bustle, and beautiful, blooming nature, there can be an unspoken expectation to be as happy as possible all the time. But, for a number of reasons, many of us don’t feel happy during Spring … or we don’t feel as happy as other folks seem to think we should. And I would like to detail a number of reasons for why we may not feel happy, despite the beautiful weather and chipper social milieu:

  • The expectation to be happy itself can be stressful, and can, perversely, end up making us feel less happy. It is very alienating to be pressured to feel a certain way when you don’t already feel that way to begin with, and this social pressure is severely heightened in Springtime.

 

  • The warmer weather can make it more difficult to think clearly on a physical level. Ideally, Spring is a time of moderate levels of warmth that help us adjust to the oncoming heatwave of the Summer. But in reality, Spring is often dramatically warmer than we expect or want it to be, and those changes usually happen without warning.

 

  • A third reason is that many of us need to spend our days indoors during these lovely Spring days. Students are busy studying for exams. Office workers continue to spend eight hours a day inside, regardless of the season. That disconnect between desire and reality can be very demoralizing.

 

  • Some people experience a problem with sinuses during this time, which can make simple things like going on a walk in your neighborhood very unenjoyable.

 

  • Perhaps most importantly, it is important to remember that the regular ups and downs of life continue to happen in Spring, despite the shifting climate. For some folks, Spring is the anniversary of a loved one’s passing. Other people are experiencing terrible illness. There are folks who lose their job in Spring, or get into a car accident. The mere existence of warm weather and budding cherry blossoms does not erase the usual tribulations of life.

While there are likewise many reasons to enjoy the season, it’s important that we be aware of our own impulse to assume that everyone else is happy, or that everyone else should be happy, or that we should be happy. Spring is a time of should-ing. We “should” all over each other during this season, a practice that often makes even the enjoyable aspects less enjoyable.

As you move about in the world during this season of opening and renewal, remember to hold yourselves and others in a place of understanding and compassion. If you find yourself feeling sad, angry, frustrated, hopeless, etc., remind yourself that those emotions are a part of life, no matter the season. The same goes with other people whom you interact with. Every season is the right season to treat yourself and others with compassion, and to reach out for the help that you need.

To access other posts from the Carolina Partners in Mental HealthCare, PLLC blog, follow this link: Be Well Blog

Is ‘National Nutrition Month’ a Recovery-Positive Campaign?

Written by nutritiousthoughtsblog on . Posted in Eating Disorder Recovery, Education.

As registered dietitians dedicated to the prevention and evidence-based treatment of eating disorders and disordered eating, we found ourselves asking the following questions leading into National Nutrition Month®:

  • Does National Nutrition Month® (NNM) align with Eating Disorder/Disordered Eating (ED/DE) recovery?
  • As Health At Every Size® (HAES) informed professionals, to what extent might we ethically support participation in this month-long campaign focusing on nutrition and physical activity to our clients, our peers, friends, loved ones…ourselves?

The quick answers?

  • A little bit, kind of, sorta…
  • Proceed with caution

Here’s a more in-depth look at our perspective:

Let’s begin by explaining a little bit more about NNM!  NNM was created by the Academy of Nutrition and Dietetics (AND), the largest organization of food and nutrition professionals in the United States. AND defines NNM as follows:

What is National Nutrition Month®?

National Nutrition Month® is an annual nutrition education and information campaign created by the Academy of Nutrition and Dietetics. The campaign, celebrated each year during the month of March, focuses on the importance of making informed food choices and developing sound eating and physical activity habits.

– Academy of Nutrition and Dietetics (AND)

We’ve done a thorough review of the National Nutrition Month website for 2019 and wanted to share some thoughts with you.

What we appreciated about this year’s theme:

  1. The 2019 NNM theme is self-titled (“National Nutrition Month®”) which makes it more inclusive of many different topics of discussion – including eating disorders and disordered eating! Win!
  2. Many of the educational materials encouraged making sustainable changes towards achieving balanced food and movement routines that are individualized. We love this approach!
  3. Mental health and motivation for change (which are totally intertwined with eating and moving our bodies) were not excluded from the conversation!

What we could have done without:

  1. The language! Reviewing the NNM website brought up a much larger conundrum – the way we speak about nourishment in our society. The language we use to address nutrition and movement is morally charged. The “good/bad” or “right/wrong” polarization is not recovery-positive and continues to drive us farther away from seeing food as just food and moving our bodies as joyful and drives the shame wagon. Shame does not motivate people to adopt health-promoting behaviors.
  2. Weight management. Encouraging weight management through portion control and calorie tracking is not an approach that is respectful and accepting of all body shapes and sizes and promotes the message that larger bodies are inherently in need of “fixing” or must be controlled in some manner. Nah, nah, nah. Not buying it. Weight management is not weight neutral. It’s not HAES-informed. It’s not recovery-positive. It’s oppressive and unethical to prescribe disordered eating behaviors to people living in larger bodies. Also, there is a body of evidence against it.

*Caveat: National Nutrition Month was not created specifically for those in recovery from ED/DE, but for the general United States public.  However, even so, language equating terms such as “weight management” and “portion control” as being “right” can be harmful for at-risk populations and creates unnecessary vulnerability to developing ED/DE behaviors.

Suggestions for observing NNM in ED/DE recovery:

  1. Celebrate how far you’ve come! Take this opportunity to reflect on how eating and movement patterns have become more sustainable and balanced.
  2. Set goals. How might you propel your recovery forward this month? What would it look like to take steps to strengthen our relationships with ourselves and with food, movement, and recovery?
  3. Increase your food variety – try some new foods this month!
  4. Take up space and use your voice. Be in a larger body. Be fat. Exist as you are.

We love our field, our colleagues, and the wealth of valuable knowledge provided by AND, and we hope to continue to shift the way nutrition and wellness are presented to the general public to be more inclusive and less stigmatizing!

Check out what other ED/DE clinicians have said about NNM over the years:

https://marcird.com/my-take-on-national-nutrition-month/

https://veritascollaborative.com/blog/blog-national-nutrition-month/

https://www.sovcal.com/recovery/having-an-eating-disorder-during-national-nutrition-month/

 

 

 

What is “Health At Every Size”?

Written by nutritiousthoughtsblog on . Posted in Education.

THE HEALTH AT EVERY SIZE® APPROACH:

Weight does NOT define Health.

The framing for a Health At Every Size (HAES®) approach comes out of discussions among healthcare workers, consumers, and activists who reject both the use of weight, size, or BMI as proxies for health, and the myth that weight is a choice. The HAES® model is an approach to both policy and individual decision-making. It addresses broad forces that support health, such as safe and affordable access. It also helps people find sustainable practices that support individual and community well-being. The HAES® approach honors the healing power of social connections, evolves in response to the experiences and needs of a diverse community, and grounds itself in a social justice framework.

The Health At Every Size® Principles are:

Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.

Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.

Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.

Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.

Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

What’s Love Got to Do with It?

Written by nutritiousthoughtsblog on . Posted in Body Image.

En lieu of Valentine’s Day and with love on the mind, we thought to follow suite with February’s blog theme in a post about self love.

Except, we won’t be talking about self love.

Instead, we’re going to re-frame “self love” as “self acceptance.” Why? Hopefully the answer will be evident by the end of this blog post. In short: we don’t need to love every single thing about ourselves. That’d be unrealistic. A losing battle. Instead, making peace with our bodies through acceptance not only lifts a weight off our shoulders, but brings power through embracing uniqueness and diversity.

Merima Dervović is a public speaker and wheelchair user born with spina bifida. In her 2018 Ted Talk, Merima explains her body image difficulties and struggles with acceptance. She also shares her realization that while she doesn’t choose to love her condition, she chooses to embody her sexuality, her identity, her personality, etc. Merima identifies three steps in her path toward self acceptance. In this blog, we highlight, describe and expand on these steps.

Step 1: Acceptance means truth. “And that’s a truth that society now needs more than ever. The majority of you are not in my position, but you don’t have to be in a wheelchair to inspire change in the world. You just have to get comfortable with your imperfections, wherever those imperfections may be.” In other words, acknowledgement. Acknowledge YOU, all parts that make you, YOU. This includes parts you may believe to be flawed, less-than, imperfect to a societal-imposed standard. This blog frames self acceptance from a body image perspective, but the message is also applicable with respect to mental and emotional parts of our character as well. The first step to awareness is to acknowledge your truths.

Step 2: Become shameless. This step involves taking your power back. Now that we’ve identified our ‘flaws’ in step 1, let’s own them. Being shameless means speaking your mind and allowing yourself to be [and feel] who you truly are – completely and fully. You have all the right in the world to not fit in and still feel good about yourself.

Be more shameless by using the art of ignoring things. Merima challenges us to: “Take all the shame imposed by others, look at it, and just let it go. What has helped me navigate the world is the art of ignoring things – glances and comments from others, etc. The truth is, people will hardly ever change. You will always encounter people that will judge you, stare at you, and make you feel like you won’t fit in. The good thing is that we can change the perceptions that we have about ourselves.”

Step 3: Detach yourself with compassion. The key to this step is to switch the perspective that you have about yourself, focusing less about the things that you DON’T like about yourself, and instead emphasizing the things that you DO like.

“Acceptance is a process. You have to get comfortable with being uncomfortable. Every change is uneasy. But once you follow through with the process, you will find that most of your fears are inside of your head. They are not real. Commit to compassion day by day. Energy is put into compassion just as energy is put into self-loathing – choosing one over the other is the challenge.”

Imperfection is the key to self-acceptance. You have to own your body from the roots of your hair to the toenails in your feet. You may not particularly like those hair roots or toenails (or other bodily feature in-between), but they are yours. Every flaw carries its own story, own uniqueness. They truly are what makes you, YOU! We don’t have to love our flaws, but simply acknowledging and accepting them allows our mind to feel content – and dare I say, empowered?

*This month’s blog post was developed and written by: Emma McVey, Dietetic Intern with University of Northern Colorado

Binge Eating Disorder: The Signs, Symptoms, & Impact

Written by nutritiousthoughtsblog on . Posted in Education.

Binge Eating Disorder

According to the National Eating Disorder Association...

Binge eating disorder (BED) is an eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating. Binge eating disorder is a severe, life-threatening and treatable eating disorder. Common aspects of BED include functional impairment, suicide risk and a high frequency of co-occurring psychiatric disorders.

Binge eating disorder is the most common eating disorder in the United States, affecting 3.5% of women, 2% of men,1 and up to 1.6% of adolescents.2

The DSM-5, released in May 2013, lists binge eating disorder as a diagnosable eating disorder. Binge eating disorder had previously been listed as a subcategory of Eating Disorder Not Otherwise Specified (EDNOS) in the DSM-IV, released in 1994. Full recognition of BED as an eating disorder diagnosis is significant, as some insurance companies will not cover an individual’s eating disorder treatment without a DSM diagnosis.

BED Symptoms and Diagnostic Criteria
The DSM-5, published in 2013, lists the diagnostic criteria for binge eating disorder:

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  2. The binge eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal.
    • Eating until feeling uncomfortably full.
    • Eating large amounts of food when not feeling physically hungry.
    • Eating alone because of feeling embarrassed by how much one is eating.
    • Feeling disgusted with oneself, depressed, or very guilty afterward.
  3. Marked distress regarding binge eating is present.
  4. The binge eating occurs, on average, at least once a week for 3 months.
  5. The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Characteristics of BED
In addition to the diagnostic criteria for binge eating disorder, individuals with BED may display some of the behavioral, emotional and physical characteristics below. Not every person suffering from BED will display all of the associated characteristics, and not every person displaying these characteristics is suffering from BED, but these can be used as a reference point to understand BED predispositions and behaviors.

Behavioral Characteristics

  • Evidence of binge eating, including the disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food.
  • Secretive food behaviors, including eating secretly (e.g., eating alone or in the car, hiding wrappers) and stealing, hiding, or hoarding food.
  • Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting; and developing food rituals (e.g., eating only a particular food or food group [e.g., condiments], excessive chewing, not allowing foods to touch).
  • Can involve extreme restriction and rigidity with food and periodic dieting and/or fasting.
  • Has periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling uncomfortably full, but does not purge.
  • Creating lifestyle schedules or rituals to make time for binge sessions.

Emotional and Mental Characteristics

  • Experiencing feelings of anger, anxiety, worthlessness, or shame preceding binges. Initiating the binge is a means of relieving tension or numbing negative feelings.
  • Co-occurring conditions such as depression may be present. Those with BED may also experience social isolation, moodiness, and irritability.
  • Feeling disgust about one’s body size. Those with BED may have been teased about their body while growing up.
  • Avoiding conflict; trying to “keep the peace.”
  • Certain thought patterns and personality types are associated with binge eating disorder. These include:
    • Rigid and inflexible “all or nothing” thinking
    • A strong need to be in control
    • Difficulty expressing feelings and needs
    • Perfectionistic tendencies
    • Working hard to please others

Physical Characteristics

  • Body weight varies from normal to mild, moderate, or severe obesity.
  • Weight gain may or may not be associated with BED. It is important to note that while there is a correlation between BED and weight gain, not everyone who is overweight binges or has BED.

BED Population and Demographics
Binge eating disorder is the most common eating disorder in the United States; it is estimated to affect 1-5% of the general population.1 BED affects 3.5% of women, 2% of men,1 and up to 1.6% of adolescents.2

Demographic Information

  • Binge eating disorder affects women slightly more often than men—estimates indicate that about 60% of people struggling with binge eating disorder are female and 40% are male.
  • In women, binge eating disorder is most common in early adulthood. In men, binge eating disorder is more common in midlife.
  • Binge eating disorder affects people of all demographics across cultures.

Physical and Psychological Effects of BED
Binge eating disorder has strong associations with depression, anxiety, guilt and shame. Those suffering from BED may also experience comorbid conditions, either due to the effects of the disorder or due to another root cause. Comorbid conditions can be both physical and/or psychological.

Physical Effects

  • Most obese people do not have binge eating disorder. However, of individuals with BED, up to two-thirds are obese; people who struggle with binge eating disorder tend to be of normal or heavier-than-average weight.
  • The health risks of BED are most commonly those associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:
    • High blood pressure
    • High cholesterol levels
    • Heart disease
    • Type II diabetes
    • Gallbladder disease
    • Fatigue
    • Joint pain
    • Sleep apnea

Psychological Effects

  • People struggling with binge eating disorder often express distress, shame and guilt over their eating behaviors.
  • People with binge eating disorder report a lower quality of life than those without binge eating disorder.
  • Binge eating disorder is often associated with symptoms of depression.
  • Compared with normal weight or obese control groups, people with BED have higher levels of anxiety and both current and lifetime major depression.

BED Treatment
Effective evidence-based treatments are available for binge eating disorder, including specific forms of cognitive behavioral therapy (CBT), interpersonal therapy (IPT), dialectical behavioral therapy (DBT), and pharmacotherapy.

All treatments should be evaluated in the matrix of risks, benefits, and alternatives. Decisions regarding treatments should be made after consulting with a trained medical professional and eating disorder specialist.

To find a treatment provider who specializes in binge eating disorder, please visit NEDA’s Treatment Referral database.

Social Stigma of BED
Many people suffering from binge eating disorder report that it is a stigmatized and frequently misunderstood disease. Greater public awareness that BED is a real diagnosis—and should not be conflated with occasional overeating—is needed in order to ensure that every person suffering from BED has the opportunity to access resources, treatment, and support for recovery.

NEDA’s shareable binge eating disorder infographic offers an easy way to spread the word about BED. It is important to underscore that BED is not a choice; it’s an illness that requires recognition and treatment.

Sources
1. Hudson, J.I., Hiripi, E., Pope, H.G. et al. (2007)The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol.Psychiatry, 61, 348–358.
2. Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry. 2011;68(7):714–723