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A New Way to Think About Body Acceptance

A New Way to Think About Body Acceptance

by | May 15, 2024

I am passionate about body acceptance work. I teach it, practice it, and continue to learn and evolve my understanding of how to do this work. The body acceptance journey is often described using the metaphor of a ladder. In fact, when I lecture about body acceptance, I use the following image to capture the idea: 

However, when we used this image in our Body Acceptance Group this last month, my understanding of this “progressive approach” was turned on its head. So many clients share about how they can be in a more accepting or healthy place with their body one day and, the next, feel right back at “ground zero.” Others describe how they can inhabit multiple places with their body at once. For example, they can feel grateful for their body while also feeling disgust for how it looks. They can feel compassion for what their body has gone through and also resent that it refuses to change the way they want it to change. It suddenly became clear in this discussion that the ladder doesn’t fit these experiences at all. I know body acceptance is a non-linear journey, but when we talk about progress, we talk about being in different places than we were before. It’s as if we keep arriving or stepping up to somewhere new, and different, and stable. The journey is so much more fluid and complicated than that. In this group, I suddenly envisioned a better way to conceptualize the body acceptance journey. And it’s one of bubbles. 

Our experiences and relationships with our bodies are deeply rich, historical, personal, complicated, and nuanced. In a holistic perspective, we always carry with us each of these lived feelings, perceptions, beliefs, and behaviors in our bodies. Sometimes certain bubbles expand and take up a lot of room. For example, an event or interaction in our lives may trigger more negative feelings about our bodies. Or maybe we are feeling more vulnerable in general and are more prone to feel amplified negative emotions about our bodies. 

Through body acceptance work, there is active movement to amplify and grow different ways of being with our bodies. There is choice in what works for you and what you value, and this journey involves a lot of trial and error and hard work. For some people they really resonate with amplifying body gratitude and find a lot of joy and relief in this. For others, maybe they want to focus even less on their bodies and so focus on identifying and living more intentionally, their values (valued living) and feel a lot of relief in doing so. Some enjoy experimenting, growing skills, and amplifying many different ways of being with their bodies and find at different times, different tools and orientation work better than others. In this work, you will notice these other experiences you are intentionally amplifying will take up more space in your lived reality with your body. And while this doesn’t make more painful experiences or beliefs disappear completely, it changes the overall experience with yourself. 

This lived experience in your body is a moving, changing, fluid experience. As we work, we build confidence and more stability in inviting and amplifying the experiences, feelings, and beliefs we want to have in our bodies. But this doesn’t mean hard days disappear where other feelings and experiences rear their heads and dominate the day. 

There is no “falling backwards” or “getting worse” with this framework of body acceptance. It is simply awareness that certain bubbles are larger today, or this week, and this affects how we feel. We can make conscious choices to use the tools and knowledge we have to attend to the bubbles we want to grow and amplify and have compassion for ourselves on days we are simply doing our best to get by. The body acceptance journey, just like mediation, is a practice, not a final destination. Over time it is easier and more and more rewarding, and it continues to invite us to work and be with ourselves in intentional ways as we move through this messy experience that is life. 

Can I Ever Stop Obsessing About Food?

Can I Ever Stop Obsessing About Food?

by | May 8, 2024

I feel like I’m thinking about food all the time. From the second I wake up, I’m stressed about what I ate yesterday, feeling guilty for how much I ate and the foods I chose. Food is always on my mind. If I’m not worrying about what I just ate, or what’s on my plate right now, I’m obsessing over the next meal. It feels like I’m thinking about food 100% of the time, and I don’t know how to not think this way. I feel like my head is buzzing with numbers–calories, weight, macros, everything–and I can’t concentrate on anything else.

If you relate to the thoughts above, you know how hard it can be to feel like you can’t stop thinking about food. The constant, obsessive thoughts, the never-ending stress and worry about food, the anxiety and guilt, can all feel so overwhelming. If you’re feeling like you can’t stop obsessing about food, please know that you can find relief. I won’t pretend like there’s some magical way to stop obsessing about food instantly, but there are some things that can help.

1: Eat enough, often enough

Preoccupation with food (worrying about food being available, thinking about food when not eating, thinking about future meals) is in part, a natural, biological consequence of being undernourished. Thinking about food can be a normal, short-term hunger cue that helps you know it’s time to eat. However, if you are chronically not eating enough food, or not eating consistently, this normal hunger cue can turn into persistent preoccupation or obsession about food. Whether you have an eating disorder or not, thinking about food all the time can be a sign that you aren’t eating consistently enough. Inconsistent nourishment, whether from an eating disorder, another illness, food insecurity, or another reason, can lead to obsessive thoughts about food. The good news is that if you begin to eat enough, often enough, you are likely to start to find that you think about food less often than you do when you are undereating or eating sporadically. There is no substitute or “hack” for bypassing the psychological consequences of undereating. Eating enough, often enough, is key to reducing obsessive thoughts about food.

2: Engage with other parts of your life

If you have been stuck in a pattern of anxiety or worry about eating, it can feel hard to focus on anything but food. Focusing on food may have been an escape, a coping mechanism, or a necessity in the past for many reasons. However, continuing to put your energy into worries about food eventually ends up making life feel pretty small. 

If you’ve noticed that most of your hobbies and interests are connected to food, exercise, or appearance, it might be time to intentionally start engaging with other interests and activities. Give yourself the chance to expand your priorities and experiences beyond the reaches of obsession about food. Doing so can literally change your brain! Neuroplasticity, or the ability for our brains to change their neural networks in response to new experiences and learning, is part of how you can find relief from obsession about food. The more your actions reinforce an obsession with food, the harder it will feel to think about anything else. BUT, the more your actions and experiences reinforce connection with priorities other than food and weight, the more your thoughts and emotions will shift away from food obsession, and toward greater balance.

3: Give it time

If you are working on doing the things I mentioned above (nourishing yourself adequately and consistently, and engaging with parts of your life that aren’t connected to food) and it still feels like you’re stuck obsessing over food, remember to give it time. Changing your habits and your brain takes repetition and time to solidify. Don’t give up! Stick with it, and gather support around you as you make these changes. Changing the patterns around disordered eating and food obsession can be a long road, but with consistency and support, you can find your way through.

Harnessing the Healing Power of Ketamine-Assisted Psychotherapy for Stress Relief

Harnessing the Healing Power of Ketamine-Assisted Psychotherapy for Stress Relief

by | Apr 17, 2024

It’s National Stress Awareness Month, and I know I am well too aware of stress and the impact it has and can have. Stress has become an all-too-common companion, from demanding work schedules to personal responsibilities, impacting both our mental and physical well-being as well as those around us. Fortunately, innovative approaches to stress management are emerging, offering hope and relief to those who seek it. One such groundbreaking therapy is ketamine-assisted psychotherapy.

Ketamine, originally developed as an anesthetic, has garnered attention in recent years for its potential in treating various mental health conditions, including depression, anxiety, and PTSD, and its role in stress management is equally noteworthy. When used in conjunction with psychotherapy, ketamine can unlock profound therapeutic benefits, providing a unique opportunity for individuals to explore the root causes of their stress in a safe and supportive environment.

One of the primary advantages of ketamine-assisted psychotherapy is its rapid onset of action. Unlike traditional antidepressants, which may take weeks or even months to produce noticeable effects, ketamine can often bring about relief within hours. This quick turnaround is particularly advantageous for individuals grappling with acute stressors or debilitating symptoms, offering prompt relief when it’s needed most.

The medicine ketamine also serves as a catalyst for introspection and emotional processing. Under the guidance of a trained therapist, individuals can delve into their innermost thoughts and feelings, gaining insight into the underlying factors contributing to their stress. Ketamine’s ability to heighten introspection and enhance emotional awareness can deepen the therapeutic experience, fostering profound breakthroughs and promoting psychological healing.

Ketamine-assisted psychotherapy offers a holistic approach to stress management, addressing the interconnected nature of mind, body, and spirit. By integrating mindfulness techniques, breathwork, and somatic awareness practices into the therapeutic process, individuals can cultivate greater self-awareness and develop coping strategies to navigate stress more effectively. This multifaceted approach empowers individuals to not only alleviate their symptoms but also cultivate resilience and inner peace in the long term.

A Letter to My Body

A Letter to My Body

by | Apr 10, 2024

Throughout the past year, my body has carried me through many life-changing experiences. She has carried me through grief, joy, connection, and has provided me the opportunity to grow in ways that I previously doubted possible. 

As I reflect on the ways that my body has shown up for me throughout it all, I am filled with comfort knowing that I can count on her to continue putting one foot in front of the other even when things feel unpredictable and vulnerable.  

The postpartum experience has given me the opportunity to find compassion for my body in ways that I had previously yet to experience. Writing a letter to my body allows me to process these physical changes while identifying both positive and neutral experiences within the adjustments. 

A letter to my postpartum body:

Thank you for showing up for me with a lens of connection and love as I navigate changing roles and challenge fears related to the unknown. 

Thank you to my soft belly for safely housing my babies and then providing a safe place for them to cuddle. 

My tired yet strong arms for holding and caring for the two of them even on days that I didn’t think I was capable. 

My powerful legs that supported me in moving forward through the hardships, grief, and joy. 

My weary eyes that fought to stay awake throughout the many sleepless nights.

My lips for the countless kisses, asks for support, and I love yous said. 

My mind for enduring all of the changes that have occurred, physically, mentally, and emotionally. 

I am proud of you. Thank you for walking through these changes with hopefulness. Your adaptability brings me comfort and peace. 

I challenge you to engage in this exercise and allow neutrality to become a part of your life experiences, too. 

Joyful Movement

Joyful Movement

by | Mar 27, 2024

In our culture, the words “exercise” or “workout” often imply punishment, burning off calories to meet metrics on our smart watches. I prefer the word movement. Christy Harrison, journalist, registered dietitian, and certified intuitive eating counselor, describes movement as “intuitive, flexible, and unrelated to diet culture.” Those in eating disorder recovery often wonder how movement can be a part of their lives again when it has historically been used as numbing, compensation, or punishment. If you are currently struggling with an eating disorder, your body needs time to rest, heal, and recover. Taking a break from movement is often necessary. As you learn to better nourish and fuel your body, you can reclaim a new role for movement in your life. 

My relationship with movement has shifted significantly over the past five years. Growing up playing competitive soccer influenced the way I viewed movement and its purpose in my life. In my younger years, I was not thinking about what my body looked like as I ran, tackled, passed, and shot. Competing in matches and practicing with my best friends was invigorating. On the field, I felt truly embodied, defined by Dr. Hillary McBride in her book The Wisdom of Your Body: Finding Healing, Wholeness, and Connection Through Embodied Living as “to be present to yourself and your experiences from the inside out.” 

As I matured, strength and conditioning training was for the sole purpose of enhancing performance; we were always taught we could push beyond the limitations of our bodies to achieve various metrics required to compete against potential opponents. In some ways, this focus on performance helped me cultivate an appreciation for my body and all she did for me. However, in the process, I became disconnected from my body, always dissatisfied with my progress and perceived weaknesses when I did not measure up.

When I stopped playing soccer after a devastating ACL injury, I wondered what purpose movement now played in my life if I was no longer training to compete at the collegiate level. With diet culture on the forefront of my mind, it was difficult to think of movement as anything other than modifying or shrinking my body. Over the years, a beautiful journey began in which I discovered my passions for hiking, yoga, rock climbing, and group classes. I reclaimed movement as joyful and connecting, energy-producing and stress-reducing!

As you reclaim the role of movement in your life, consider the following:

-How does movement promote connection with yourself and others?

-What types of movement do you find enjoyable? 

-What kinds of movement help you feel more present or embodied? What types of movement are depleting?

-How/when do you notice your body craving movement or rest?

-How can you re-invite your body to join you in movement?

What does ADHD have to do with Eating Concerns? Part 2

What does ADHD have to do with Eating Concerns? Part 2

by | Mar 13, 2024

The more we learn about ADHD and eating disorders, the more we are coming to understand that the incidence of ADHD is actually higher in the eating disorder population and is not just eating disorders “looking like” ADHD. Something is happening here that warrants further understanding and exploration of how we approach eating disorder treatment when this comorbidity is present. 

There are biological, cognitive, and behavioral patterns inherent in both that can influence the severity and longevity of the eating disorder, as well as the recovery trajectory. People with ADHD and eating disorders have differences in how their brains process rewards, often looking for dopamine hits that can come from eating disorder behaviors. Disturbance in body awareness as an associated feature interferes with the ability to feel hunger/satiety cues and feelings. Difficulties with decision-making, planning, as well as time-blindness and difficulty with transitions, make it harder to meal plan and nourish oneself consistently throughout the day. People with ADHD often seek certain types of food making it more difficult to eat a wide variety of food. These are just some of the many nuances that show up with clients who have both an eating disorder and ADHD. 

The treatment for ADHD is very clear in the literature. We know that medication is incredibly helpful above and beyond therapy and behavioral modifications alone. As I mentioned before, it gets messy when someone also has an eating disorder as many ADHD medications are known to suppress appetite. But instead of concluding that medicating ADHD for someone who also has an eating disorder is contraindicated, we need to explore the nuances in this as well. 

While ADHD medication may compromise hunger cues, the medication may also help to overcome other barriers to recovery. For example, the client may be better able to strategize and execute on their meal plan as they suddenly have the brain capacity to do so. ADHD medication can relieve some of the symptoms that the eating disorder worked to mitigate, such as dysphoria, distress, feeling overstimulated and overwhelmed. Clients may be better able to tolerate the distress inherent in eating disorder recovery with the help of medications that can calm their minds. 

I am not “that kind of doctor” that can assert medication for clients. I am the kind of doctor who advocates for treating all the presenting concerns our clients face. And the more we understand about ADHD and its relationship to eating disorders, we understand the critical importance of treating both illnesses. If we only treat the eating disorder and neglect ADHD, our clients will likely struggle more on the path to recovery and in their ability to sustain it. Besides this, we would be neglecting ongoing and treatable pain that were treated, which would bring immense relief, increased confidence, self-awareness, and continued motivation. 

We have a lot more to learn and understand about ADHD and eating disorders. And what we do know so far, calls us in the field to look closely at the nuances these presentations bring to treatment, and how we need to be flexible, mindful, and deliberate in how we help treat our clients to optimize their success.

What does ADHD have to do with Eating Concerns? Part 1

What does ADHD have to do with Eating Concerns? Part 1

by | Mar 6, 2024

Attention Deficit Hyperactivity Disorder (ADHD) seems to be the diagnostic soup de jour. We all heard about the Adderall shortages that started in late 2022 and still aren’t fully resolved now in 2024. Everyone is talking about ADHD and more and more people are getting diagnosed with it. Diagnoses are especially escalating among adults, with rates of adult diagnosis increasing four times faster than diagnostic rates for children. 

A lot of people are skeptical about this rise in diagnosis. Are smartphones making everyone develop ADHD? Is it the plastics? Is it our stressful lifestyles and chronic inflammation? Are there really that many more people with ADHD today? Or have there always been this many people with ADHD and we are now better at catching it with increased awareness and access to resources? 

Just as rates of ADHD increase, our field is continuing to grow in its own understanding of this diagnosis. As it relates to my interest in women’s issues, we know that females have historically been underdiagnosed for ADHD given the nuances of its presentation in females and female’s ability to compensate and mask symptoms. 

ADHD also has a unique and messy history with its association to eating disorders. When I started working in the field of eating disorders over a decade ago, I was implicitly and explicitly taught to be skeptical of clients who self-ascribed as having ADHD in addition to an eating disorder. I was taught that 1. Malnourished and starved brains present in similar ways to people who have ADHD, and 2. Our clients are incentivized to claim themselves to have ADHD so they can be prescribed a stimulant that would curb their appetite and further their weight loss goals. I was taught that when clients are re-nourished, their “ADHD symptoms” would resolve, confirming the above assertions. Our clients would then understand that their experiences with ADHD symptoms were really just manifestations of their eating disorder and they would feel the relief that comes with a nourished brain and be incentivized to stay in recovery. 

Join me next week for Part 2 as we discuss more about ADHD and eating disorders. 

Finding Purpose Outside Your Appearance

Finding Purpose Outside Your Appearance

by | Feb 7, 2024

I recently saw the movie Mean Girls in theaters. As a body image and eating disorder therapist, I could not help but notice how the myriad of messages about appearance and unrealistic beauty standards influence the characters in the film. At one point in the movie, Cady Heron, the new girl, is desperately trying to fit in with the popular clique. She is gathered with the three coolest girls in school as they begin to pick apart their bodies, commenting on everything from their hips to their weight to their complexion. 

Cady grew up in Africa without the internet, living in the middle of the safari with just her mother. Homeschooled and spending most of her time in nature or studying, Cady was not socialized to hate her body. She is visibly shocked by this communal dislike that somehow feigns bonding. Cady wonders why these girls are being pitted against their bodies, their ultimate strength. As the girls stare at her, she awkwardly mutters, “I’m not sure what we’re doing but… me too. I’m ugly too.” 

Sometimes I fantasize about all we could accomplish if our focus was not consumed with food and our bodies. How much more energy would we have to connect with loved ones? What if we invested all that brain power in a hobby or passion? Even though you are confronted daily with messages about how your body should look, you are meant for so much more. You have people to connect with, memories to make, and new experiences to savor.

This month, Dr. Anna Packard and I invited our Embodied Body Acceptance group members to create a “mission statement” related to their life’s purpose and meaning. I invite you to reflect on your own mission statement. Consider the following questions: 

What is your unique purpose and how much does that pertain to what you look like? 

Where do you find passion and meaning in your life? 

What draws people to you that has nothing to do with your appearance? 

What do you want to be remembered for? 

What do you want others to know you believed in and stood for? 

One of my favorite writers, Rupi Kaur, shares her thoughts related to her body’s true purpose in Home Body: “I want to leave this place knowing I did something with my body other than trying to make it look perfect.” Consider your connections, your passions, and your purpose—outside of the shape and size of your body.