Improving Body Image

Marci Anderson - Tuesday, March 02, 2010
Many of the clients that I see for individual nutrition counseling struggle with their body image.  I was scoping out some resources and came across a couple I thought were worthy of sharing.  I hope they may be of use to you or someone you know.

1.) The Body Image Workbook: An 8 Step Program for Learning to Like Your Looks by Thomas F. Cash, PhD

2.) A Blog on Psych Central called "Weightless" by Margarita Tartakovsky, MS.

You Are Not Alone: ED Support Letter

Marci Anderson - Tuesday, February 23, 2010

I wanted to provide one more useful tool for those struggling with an eating disorder.  I recently learned about the "You are Not Alone" Eating Disorder Support Letter.  Subscribe and receive a monthly inspirational letter to support you along your path to recovery.  Please forward this along to anyone you think may benefit from this wonderful service (both patients and clinicians).

If you are looking for more support for your eating disorder and are in the Cambridge/Boston area, please do not hesitate to contact me. 

In good health,
Marci E. Anderson
Registered Dietitian

National Eating Disorders Awareness Week

Marci Anderson - Monday, February 22, 2010

February 21-27 is National Eating Disorders Awareness Week (NEDAW)

NEDAwareness Week is a collective effort of primarily volunteers, eating disorder professionals, health care providers, educators, social workers, and individuals committed to raising awareness of the dangers surrounding eating disorders and the need for early intervention and treatment.

The Theme: It's Time to Talk About It

The Mission: Prevent eating disorders and body image issues while reducing the stigma surrounding eating disorders and improving access to treatment.

How It Works: A calling for everyone to do just one thing to help raise awareness and provide accurate information about eating disorders.

Doing My Small Part
I am passionate about and fulfilled by the work that I do providing nutrition therapy for my clients who battle with an eating disorder.  But one of the biggest barriers to treatment is helping my clients get coverage from their insurance company.

I recently learned about the Anna Westin Foundation, an organization committed to helping others gain coverage for eating disorder treatment.  After their daughter died of anorexia nervosa as a consequence of their insurance company refusing to cover care for their daughter, Kitty and Mark Westin fought and settled a suit against BCBS of Minnesota.  They are now committing their lives to ensuring that this doesn't happen to others.

So if you know someone who is struggling with gaining coverage for eating disorder treatment, please pass this link along to them.

And consider what one thing you can do to support NEDAW.

Is Sugar Addicting?

Marci Anderson - Sunday, February 14, 2010
Is sugar addicting? I recently received an email from a friend who had this question. She felt that she was completely addicted to sugar and wanted to know my recommendations on how best to detox her system.  Little did she know, she was asking a question that researchers and scientists seriously debate.  Just google the term "sugar addiction" and you'll see a litany of results and no real consensus.

According to a Wikipedia article on the topic, the real issue is that no one can actually agree on a definition for the term "addiction."  I did find a pretty decent article from Penn State on sugar addiction.  If you're interested in the topic, I highly recommend you read it. It's only a page.

But on a more practical level, many people do feel as if they are totally addicted to sugar.  So if you fall in to that category here are a few bits of information and some strategies that may be helpful to you.

  • The physiological consequences of eating candy, chocolate, and other high sugar foods are a rise in serotonin and endorphins which make you feel good.  This sensation doesn't last long and may be part of what encourages you to want to eat more of it.
  • Consider the company you keep while eating high sugar foods. An encouraging companion, alcoholic beverage, or social occasion will encourage you to eat more.
  • Create a healthy environment.  If you find that once you start eating sweets you just can't stop, consider what you keep stored at home.  Rather than a jumbo bag of M&Ms, go out and buy a small pack when a craving hits.
  • If you find yourself reaching for sweets after every meal try skipping your sugary treat just once.  Distract yourself after your meal and check in a few hours later.  How do you feel?
  • Try to eat chocolate mindfully with this exercise

These are just a handful of basic suggestions. If you feel like you have a serious addiction to sugar, consider working with a dietitian that has experience working with binge eating, emotional eating, compulsive eating, or disordered eating behaviors. A little structure, support, and guidance may be helpful.

So on this Valentine's Day select a small portion of your favorite treat, sit back, relax, be present, and enjoy.

Client Spotlight: Honesty as a Tool for Change

Marci Anderson - Saturday, January 30, 2010















Today I'd like to highlight a client I'll call Tricia. I've been working with Tricia for nearly 8 months.  She's battled bulimia for years, but her recent breakthrough is a lesson that applies to anyone looking to make positive change in their life.

In short, Tricia decided to become transparent with me, her therapist, and most importantly with herself.  She decided that in order to make any progress, she needed to be 100% honest and aware of her internal dialogue as well as her actions. As a result, she's made unbelievable progress. 

So I invite all of you to take a transparency check:
1.) Keep a thought log. Write down anything and everything that you think and feel about food in the course of a day. You will learn some fascinating information.
2.) Do you entertain thoughts that are half-truths in order to soothe, coddle, or distract yourself from reality?
3.) Are you honest with other people in your life as it relates to food?

Here are some examples of sugar-coated thoughts which stand in the way of progress:
  • I don't need to make dinner tonight. It's been a rough day and I really deserve something indulgent.
  • Another helping really isn't going to hurt. Even though I'm full, I had a good work out!
  • I know I eat a lot of chocolate but it really does help me feel better. 

Note: all of the examples I gave reflect our tendency to meet our emotional needs with food. There is nothing inherently wrong with having some chocolate. The problem I'd like to highlight is the tendency we have to persuade ourselves that soothing, calming, and treating ourselves with food is ok.  The real problem is when these habits became frequent and deeply ingrained. Suddenly, food is our antidote for all of our emotional needs and none of those needs are getting met in a healthy way.

The first step to improving your relationship with food is honesty with yourself. Becoming more honest and aware of your thoughts and feelings, strengthens feelings of self-esteem and self-worth. This is incredibly empowering and takes you one step closer to positive change.


Exercise & Depression

Marci Anderson - Wednesday, January 27, 2010
If you tend to feel a bit blue during the winter months, you are not alone. Rates of depression increase during the winter, including people who suffer from SAD (Seasonal Affective Disorder). In fact, recent findings suggest that the severity of eating disorder symptoms for bulimia peak in the Fall & Winter months.

While clinically significant depressive disorders need to be treated by a competent medical professional, a little exercise can go a long way to boosting mood, reducing anxiety, and improving sleep patterns.  While you may not be as committed as these gentleman are to exercise, I thought you'd appreciate the laugh. :) How's that for a little mood booster?

Here are a few facts you might not know:

1.) As you exercise your body's feel good chemicals called endorphins are produced.  This helps to increase your energy levels which over time increases your stamina.  

2.) Exercise is a positive distraction that illicits a relaxation response in your body to help lower feelings of stress and anxiety.

3.) As you exercise, more serotonin is available to your brain.  As a result you feel happier, more relaxed, and more confident in your ability to manage your life's stressors. This may also help reduce carbohydrate cravings, a symptom of SAD.

It's tempting to want to hibernate for the winter. But a small does of exercise (30 minutes) is all you need to reap the disease-fighting and mood enhancing benefits.  And you don't necessarily need a gym either! 

Here is my Top 10 list of simple strategies to moving more.  

1. Keep it simple. The only cost is a good pair of walking shoes. Walking the neighborhood or even walking the mall is something that is affordable and easy.

2. Many schools open their gyms up to the community for walking programs so check a local school.

3. Turn up the music and dance. A friend lost 19# by doing this for 60 minutes a day with her kids.

4. Take family night to another level with a game like Wii Fit.

5. Use a pedometer and make your own records for as many steps in a single day.

6. Get outside in any season: In the summer, go for walks, hike a new trail, go for a bike ride, kayak, canoe, swim. In the fall, do your own color tour - bring your camera and walk through the beautiful colors. In the winter, ski - downhill can be expensive but if you already have the equipment night skiing is cheaper, cross-country skiing is a great work out, go ice skating, slide down a hill in a toboggan - climbing up the hill is great exercise, go snow shoeing, have a snowball fight, build a snowman. In the spring, take a walk to see all the flowers and trees budding and waking up from their winter slumber.

7. Take work breaks: 30 min at lunch, 15 min in the morning and afternoon. Other people get a smoke break, right?

8. Commercial Break Competitions: Do some routines with hand held weights (or improvised wts from filled water bottles). March, climb stairs, do jumping jacks, push ups, etc.

9. Play like your kids and with your kids. Get down on the ground with them, do somersaults, climb, run, skip, jump, play tag, toss and chase a ball. Have Fun!

10. Join a club or team.

Identify your barriers to moving more and create a game plan. Start simple and specific and let me know how it goes. And always check with your Dr. before starting an exercise program.

Your neighborhood nutritionist in Cambridge,
Marci 

Healthy Weight Week

Marci Anderson - Tuesday, January 19, 2010
You might not know it, but this week has been officially named "Healthy Weight Week."  As a dietitian in Cambridge who specializes in the treatment of eating disorders and works predominantly with women who struggle with their weight and body image issues, I'm pretty sensitive to the topic of weight.

It's been my experience that pre-occupation with weight and body size is extremely unhealthy and incredibly unproductive.  I've worked with clinically obese/morbidly obese clients who agonize over their excess pounds and fear the implications it has for their health. 

On the flip side, I've worked with plenty of women who appear to have very normal/healthy body weights but also obsess over their desire to be thinner.  This results in hours spent at the gym accompanied with guilt about they did/did not eat the day before.  

Or more commonly for many of my nutrition clients, their weight and body obsession leads to eating which becomes disordered to the point of starvation, binging, purging, laxative abuse, etc.

It saddens me to see the number of women who waste their precious time thinking, agonizing, and lamenting over their bodies and what they put into them. So naturally, I have mixed feelings about an entire week focused on that very topic.

However, when I found the website for the Healthy Weight Network I was thrilled to find out what they intend "Healthy Weight Week" to be about:

The 17th annual H ealthy Weight Week is a time to celebrate healthy living habits that last a lifetime and prevent eating and weight problems, rather than intensifying them, as diets do.

Traditionally many Americans begin a diet the first week in January and "blow" it the second week. Healthy Weight Week, the third week, is a time to stop dieting for good and help people normalize their lives. It’s a welcome antedote to the dieting and bingeing that typically begin the New Year!
Healthy Weight Week promotes healthy nondiet lifestyles for children and adults of every size. It helps them move ahead to healthy habits they can live with long term – sound, reasonable habits that allow them to live well and get on with their lives. Eat well, live actively, and feel good about yourself and others.


It's my philosophy that your "healthy weight" is:
  • Partially determined by your genetics
  • A range of a few pounds that may vary depending on the time of month
  • Where your body goes naturally when you are eating when hungry, stopping when satisfied, and usually a result of physical rather than emotional or social hunger
  • Is supported by a moderate exercise program

It's also my philosophy that your "heathy weight" is NOT:
  • Determined by a scale, jeans size, or weight chart
  • Attained by calorie counting, low cal diets, and excessive exercise
  • Necessarily what you weighed when you graduated high school :)

So let's celebrate what it really means to find a healthy weight- treating your body with respect, feeding yourself appropriately, enjoying the movement of exercise, and trusting that your body will find it's natural healthy place.

If you are interested in learning more about this approach, here are a few books I HIGHLY recommend:

And a couple of websites to check out too:

Here's to a new look at what it means to find your "healthy weight."

Food Tips for the Holidays

Marci Anderson - Sunday, December 20, 2009
As a dietitian who works in the field of eating disorders, I am a member of MEDA (Multi-Service Eating Disorder Association).  MEDA is a phenomal resource for clinicians, family members, and individuals struggling with eating and body issues.  I recently received an awesome handout from Amy Armstrong, who is the clinical director at MEDA.

The handout is designed specifically for individuals and family members of individuals with an eating disorder.  But I think the holiday tips are helpful for anybody.  Enjoy and happy holidays!

ADVICE FOR FAMILY AND FRIENDS

For individuals struggling with an eating disorder, the holidays can evoke feelings of uncertainty and anxiety. Although the media promotes holidays as a time of celebration, for someone with an eating disorder the holidays can be a reminder of an ongoing struggle to make peace with food. Providing support during the season and ensuring that the home is a place where she/he will not be judged is essential to the healing process. Here are some
helpful tips as to how to create a positive environment.

  • When friends and/or family have not seen each other in a long time, they may be tempted to comment on changes in weight or appearance. Be a friend and help dissolve conversations or comments about food, weight, or overall appearance. You will be creating a more positive atmosphere for people to enjoy each other’s company and to remember the experience as a wonderful time.
  • Perhaps sitting down to one meal as a family would help someone struggling with an eating disorder feel more comfortable, instead of “grazing” on food throughout the day. Do not forget to discuss these options with your family and welcome all input.
  • Try to avoid emotionally charged discussions before or during mealtimes. The energy of a charged discussion can lead to feelings of anxiety. Often holidays are the only times people are able to catch up on experiences, political issues, sports, etc., but it is helpful to try and limit these types of electric conversations for after meals.
  • Indulging is a natural part of the holiday season. People eat foods they normally wouldn’t eat and often they end the day feeling very full and sometimes very regretful. For some people it is common to make comments like, “I feel so fat” or “I shouldn’t have eaten that much.” These comments can have a devastating effect on someone struggling with an eating disorder. Do not support or encourage these types of remarks.
  • Try to be a good role model for your loved one with an eating disorder. It is important for your loved one to witness your healthy eating as a way to connect with her/his feelings and priorities. Remember, eating disorders are about emotions and not about food.
  • It is not uncommon for eating disorder symptoms to increase during the holiday season. Try to avoid getting into power struggles over food and do not ever force someone to eat. Be positive and maintain a healthy, nonjudgmental attitude toward her behavior.
  • If your loved one is withdrawn or isolating herself/himself from mealtime and other holiday activities, gently try to bring her/him into discussions or activities. If she/he rejects your efforts, do not take it personally and try to understand this behavior as part of her/his eating disorder. Always remember to take care of your own needs and to enjoy yourself, your family, and your friends.
  • Attempt to spend time connecting with your loved one struggling with an eating disorder in non-food related ways. Set time aside to take part in an activity of her/his choosing. Taking walks, playing games, or watching a movie together can help decrease anxiety by taking the focus off food and eating.
  • Do not forget to communicate with concerned members of the household. What feelings are emerging? Do they feel that they are handling the situation well? Seeking support and learning how to communicate feelings in a positive way is essential to understanding your role in the process of the recovery.

Information compiled by MEDA, Inc. 2002
www.medainc.org

Media Literacy vs. Thin is In

Marci Anderson - Sunday, December 13, 2009
I recently blogged about Ralph Lauren and the fashion industry’s constant stream of messages and images which negatively affect women’s self-esteem and feelings of self-worth. And unfortunately, the glorification of a thin body is so pervasive in our society; it’s becoming more and more difficult to question its validity. I’m currently in the middle of reading one of the most fascinating and thoughtful books on the topic “The Religion of Thinness” by Michelle Lelwica. I hope to write a brief book review when I finish it, as I feel like it’s a book every woman ought to read, regardless of her weight, feelings about her body, or her relationship with food.

But at the end of the second chapter, Lelwica cites three awesome organizations whose mission is to promote positive media messages. Check them out. 

**Mind on the Media: a national organization dedicated to “inspiring independent thinking and fostering critical analysis of media messages.” Through their “Turn Beauty Inside Out” program, they empower boys and girls to begin grassroots discussion, and sponsor events in their communities to increase awareness of the media’s influence on girls’ development.

**Girls, Women + Media Project: sponsors “I-CAN” (Involved Consumers Action Network) which offers information about consumer issues related to women and girls, and suggestions on how to take action.

**New Moon Girls: is an online community and print magazine targeted to girls ages 8-14 and designed to build positive body image and self-esteem through chatting, poetry, artwork, videos, and more. It is a phenomenal resource amidst the barrage of negative messages targeted to this vulnerable age group. Rather than telling our young women they need change, re-shape, and mold their body to some phony standard, they need to hear that they are intelligent, capable, and acceptable just as they are.

I’m currently working part-time as a dietitian/nutritionist in Somerville at a day treatment program for eating disorders called Laurel Hill Inn. As I grapple with the complex reasons that so many women (and increasingly more men) suffer from disordered eating and severe body image disturbance, I can appreciate the fact that the media is one very powerful aspect of this multi-factorial problem. I try to advocate for and promote any organization which strives counter the negative messages which permeate our society. If you know of any other positive resources or websites, please post them! 

Ralph Loren Boycott

Marci Anderson - Friday, December 11, 2009
So did any of you hear about the Ralph Lauren photoshopping debacle?  Poor Filippa Hamilton.  Her waist was made to look smaller than her head after some editing that went seriously wrong!  The picture, shown below, is so ludicrous.  But I think it makes for an excellent reminder that the images we see in mainstream media simply do not reflect real life. 

To add to the flames which sparked from the photoshopping nightmare- the 8 year model of Ralph Lauren, spoke out to reveal the shocking truth that she was fired from the company for being too fat to fit into their sample clothing. Ralph Lauren released a statement to the Daily News stating that Filippa is "a beautiful and healthy" woman, but their relationship ended "as a result of her inability to meet the obligations under her contract with us."  Hard to believe that 120 lbs is enough weight to get you fired.  Yikes.

So if you are as disgusted with Ralph Lauren and an industry which permeates our society with distorted ideas and images of what women ough to look like- then join the Facebook boycott of Ralph Lauren.  The creators of "America the Beautiful" (a documentary on the pressures women feel related to beauty in the States) are attempting to recruit 10,000 people to sign their petition.

As a dietitian in Cambridge, I spend most of my day working with women who suffer from eating disorders, disordred eating, and body image problems.  I'd love to see more women banding together to support a cause we could all benefit from.  Rather than obsessing about what we eat and how much we weigh- wouldn't it be great if we could contribute our intellect and energy in more productive ways?