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Demystifying Eating Concerns Q & A

Demystifying Eating Concerns Q & A

Being diagnosed with an eating disorder can come with a whole new vocabulary. Today, I want to walk you through one of the most frightening sounding words you may hear as you talk with a clinician about your mental health: a “comorbidity”.  

Q: What is a comorbidity? 

A: A comorbidity is a terrifying-sounding word that means a disorder is present at the same time as another disorder. You can have an eating disorder and anxiety, for example, and those would be considered “comorbidities”.  

Q: What are common comorbidities with an eating disorder? 

A: Common comorbidities with eating disorders are OCD (35% prevalence), anxiety (36%), and depression (50-70%).  This means that 35% of people with an eating disorder also have OCD, 36% will have an eating disorder and also anxiety, and somewhere between 50-70% will present with an eating disorder and also have depression.  

Q: How is understanding this helpful? 

A: When working to address an eating disorder, it becomes helpful to understand the entire landscape of your highly individual mental health needs.  

People who are working on eating recovery may have different needs with a comorbidity of depression, for example. Addressing the depression through therapy and perhaps medication would become indicated as someone works to regain health in eating recovery. In treatment, the focus over time becomes not just recovery from an eating disorder, but also providing you access to the tools that are helpful for you to improve the overall quality of your life.  

It’s also helpful to understand how different comorbidities may be impacting your eating recovery. If you were having a depressive episode- experiencing a hard time with motivation and losing interest in participating in life, for example- can you imagine how that might be impacting your ability to succeed in eating recovery? Taking a broad look at your mental health can help direct individualized treatment goals target what is most needed to ensure success.  

Q: Which is treated first? Or can they be treated at the same time?  

A: The first goal in treatment is always to ensure medical stability. Once that is ensured, treatment goals can be discussed and planned with your clinician to make certain that the targeted treatment interventions are meeting your unique needs!  

 

Sources: 

https://psychiatry-psychopharmacology.com/en/comorbidities-in-eating-disorders-132875

 

Bringing Back the Joy in Clothes

Bringing Back the Joy in Clothes

Have you ever ripped through your closet, trying on ten different outfits, nitpicking how you looked, feeling like nothing looked good? Then feeling overwhelmed by all the clothes you have thrown on the ground?

​I have spent way too much time worrying about my wardrobe, judging my body and how it fits into my clothes. 

Last year I had this moment where I no longer wanted to dread my closet. I wanted to feel supported and good about the clothes I put on my body. I cleaned my closet. Anything that made me feel uncomfortable that I had not worn in years was gone and donated. 

Through working on compassion for my body and the changes it has made in my life, I knew I wanted to support myself through the expression of my clothes. 

Shopping gave me anxiety for so long as I thought my body was meant to fit in the clothes, not the other way around. I have become very intentional when shopping to add joy back into the process. I am shopping for clothes to fit my body, and if they don’t fit, that no longer means anything about me, just that the clothes don’t work.

Here are a few things I ask when buying clothes

  1. Do I feel comfortable in these clothes?
  2. Does it fit my body right now?
  3. Does this style support the way I want to show up?

Clothes should be fun, clothes should support you in the way you want to show up, but they should not define anything about you. Take a look at your closet and assess if you should change it up to fit the body you are in right now because where you are right now is right where you should be. You are worthy and beautiful at this exact moment.

 

Protect Your Recovery

Protect Your Recovery

A phrase I often repeat with my clients is “Protect your recovery.” Picture it like this: when you go to a museum to see artistic masterpieces, you see all kinds of protection set up to keep the artwork safe and in lasting good condition. UV-filtering windows, temperature- and humidity-controlled rooms, velvet ropes to help people keep their distance from the art, and anti-theft systems are all in place to preserve the artwork. Likewise, your recovery is a precious and hard-earned treasure that deserves protection.

​One of the most important parts of protecting your recovery is having a schedule that safeguards you against slipping into unhelpful patterns. Doing your best to create a daily schedule that protects your recovery is essential to making your recovery last. Here are a couple of practical ways you can do this:

1. Prioritize meal times and snack times like you would prioritize a job interview.

If you had an interview for a job you really wanted or needed, how would you schedule your day? Would that interview be high or low on your priority list? High, of course. You’d probably make sure nothing got in the way of you being on time, prepared, and present for that interview. In eating disorder recovery, you must prioritize meals and snacks like you would a job interview. Your #1 job, especially in the beginning stages of recovery, is to nourish your body consistently. If other parts of life start to take precedence over meal and snack times, making progress in recovery will be much harder. 

If activities or commitments are getting in the way of your meals or snacks, work with your support system to find ways to stay consistent, either by eating meals during those activities, or shifting your schedule so nothing gets in the way. Set reminder alarms in your phone, cancel plans that would cause you to skip a meal, bring food with you everywhere, ask your professors for permission to step out and eat a snack during class, etc. That might sound intense, I know, but your recovery is worth protecting. And rest assured, as you make progress in recovery, more flexibility can come as you learn to respect and respond to your body’s needs consistently.

2. Get serious about your sleep habits.

Sleep might not seem like a recovery tool at first glance, but healthy sleep habits are an important part of protecting your eating recovery. Getting enough rest can help you manage emotions, and use healthy coping skills instead of turning to your eating disorder. Not getting enough sleep sets you up to be more susceptible to anxiety and depression symptoms, as well as eating disorder urges.

One of the most important parts of healthy sleep is setting a consistent wake time and bedtime, even on the weekends (see https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/ for more info). Having a consistent sleep schedule helps your body get better quality sleep, and also makes scheduling meals and snacks easier. Getting good sleep can be tough for a number of reasons, especially if you are battling health issues in recovery, dealing with anxiety or depression, have a variable work schedule, are in school, or have young kids (and the list goes on). Sleep might not ever be 100% in your control (if only it could be! I have two little kids and haven’t slept through the night consistently in over 5 years!), but do your best to protect your recovery process by improving your sleep habits.

There are many ways to protect your recovery, and your daily schedule is one of them. Your eating disorder recovery is a precious, intricate masterpiece made up of hard-earned triumphs, meaningful struggle, and priceless effort. Every piece of your recovery is worth protecting.

The Swimsuit

The Swimsuit

It’s almost summer, which means it’s almost swimsuit season. Do you dread swimsuit season? Well maybe my experience can help you. As part of my recent vacation planning, I kept a running list of items, including sandals for my one-year old, a beach umbrella, and a new swimsuit for myself. Not just any swimsuit. A maternity swimsuit. (Cue some dark scary music) I started on the impossible task of finding a cute, comfortable, maternity swimsuit.

Swimsuits are hard enough to find, but try finding a cute maternity suit and the task is almost impossible. So I took my quest online and ordered a few options to choose from. When they arrived at my house, I pulled them out of the package and instantly thought “there’s no way that will fit me – it’s huge!” Guess what, they all fit. One was actually a little tight if I am being completely honest. I could feel myself start to dread our family trip and I actually said aloud to myself “stop it!” 

When talking about her body, Dr. Anna Packard refers to it as she/her and I started to do the same. I started to list the positive qualities of her as I looked in the mirror. It went sort of like this: 

“She is growing a human!” 

“She is strong.” 

“She has the arms to carry and hug her one-year-old.” 

“She is growing a human!” 

“She can feel the ocean breeze on her face.” 

“She can read Harry Potter aloud to her son.” 

“She is growing a human!” 

I repeated that last one quite a few times. I didn’t all of the sudden love that I was fitting into these much larger suits, but the dread of laying on the beach in them started to lessen. Try it! When trying on clothes, give your body some positive self-talk. Maybe the changing rooms won’t be such a dreaded place. 

Invisible Scars

Invisible Scars

I got my first scar at five years old. I was playing at a friend’s house and bent down to pet their Scottish terrier. I accidentally surprised the terrier, and he greeted my advance by tearing flesh off my face. I remember warm towels and the feel of wiry stitches pulling through the skin above my lips. Today, this scar looks like a misplaced, poorly angled smile line.

​In third grade I loved playing soccer with all the boys at recess. I especially liked playing against Matt Cisek; the love of my elementary school world. One fateful day, Matt and I collided brutally on the field. His foot missed kicking the ball and connected directly to my shin instead. The strength of his kick was so forceful that it knocked cartilage off my bone. To this day, as my fingers trace my shin bone I can feel a divot left from the lost cartilage.

My stomach bears a variety of puncture marks. Some randomly scattered holes came from playing capture the flag on a moonless night when I was 17.  My best friend Robert told me to “run for the trees!” when the enemy spotted us. I ran full speed and never saw the barbed wire fence. Several people had to, literally, pick my body off the rusted coils and call my parents to make sure I was current on my tetanus vaccination.

Three other scars, right beneath my ribcage, bear witness to my emergency gallbladder surgery that took place just five days before my wedding. It turned out my stomach pains weren’t actually “pre-marital nerves.” The ER doctor told me that if I didn’t get my gallbladder out immediately, I wouldn’t make my wedding day. My stomach barely squeezed into my wedding dress later that week, still bloated from the surgical gas and wrapped in gauze.

Three more holes puncture my lower abdomen where doctors saved my life after an ectopic pregnancy burst my fallopian tube and tried to take me. These holes remind me of the miracle that is my preserved life and the life that was the twin baby safely nestled in my uterus. We both survived the trauma of emergency surgery and so much lost blood.

While scars manifest the physical impact life has on my body, my body also holds invisible scars deep inside her soft spaces. The creases around my eyes bear witness to years’ worth of smiles and laughter. The ache in my chest weeps my deep loss and empty arms. My upset stomach testifies of my vulnerabilities and yearning. The soft, gray hills inside my skull guard and protect my precious memories.

Scars and marks aren’t pretty, but they reflect truth. They reflect moments lived and the passage of time: a physical autobiography. My scars remind me that through all my living, my body has borne witness to my messy and wonderful life. My body was built for this. It was built to hold all that is me: every memory, emotion, and experience.  And isn’t that beautiful?  

 

Body Image and Your Younger Self

Body Image and Your Younger Self

One of the more difficult parts about recovering from an eating disorder is healing your relationship with your body. This is often so difficult because your relationship with your body has been developing since you were young, reinforced by external messaging time and time again.

Can you recall some of your earliest memories of body shame? How old were you? Do you remember how it felt? Did someone say something to you? If so, I’m betting that you probably remember their exact words and tone of voice. Did you engage in any specific behaviors after this first experience of feeling shame about your body? What other factors influenced your developing relationship with your body?

Most of your current negative experiences of your body probably stem from childhood. Part of natural child development is looking to others to help you understand the world. You watch how your friends pump their legs to swing higher and so you do the same. You see your dad lick the spoon of the chocolate cake batter and so you try it too. Your mom swears when she’s upset and the next time you stub your toe, you use that word as well, much to her chagrin. However, because young human brains are constantly taking in information from others to try to understand how things work, you might also have taken in some painful, negative messages that have been truly hard to shake as time has passed. These messages might still be part of your core belief system about your body and about yourself.

For me, one of the most difficult and informative experiences happened when I was in about 7th grade (the most awkward, humiliating time of life). I had a good friend tell me that the boy I had a crush on told her that I would “be the prettiest girl in our grade if I was skinny.” Oof. Talk about one of those memories that sticks with you. My little 12 year-old self drew some pretty painful conclusions from this conversation. Conclusions that stayed with me for more than a decade after.

When you are trying to heal your relationship with your body, I believe that it’s helpful to go back to those early, formative memories that shaped your relationship with your body and try to understand what happened there. Your younger self is probably still clinging on to those messages even if your current self understands that those beliefs are untrue.

There are several ways you could try to help younger you when it comes to healing your relationship with your body. Here are just a few ideas:

  1. Look compassionately at a picture of your younger self from a difficult time in your life. How do you feel about your younger body? Do you feel critical? My guess is that you don’t. If you can view yourself the way you’d view a younger child, you might be able to look at your body in the photograph with more compassion. That body is still yours. That body may have changed, but it never lost its value along the way.
  2. Write a letter to your younger self around a painful memory that contributed to the development of your body shame. What would she need to hear? How can you help her in a time of difficulty and uncertainty? How can you show her compassion?
  3. If you’re up for it, do some exploring of the source of some of these negative messages you received. Was this person or source trustworthy? Were they dealing with their own body-image issues? If it was a company or organization, how did they benefit from you feeling insecure? For me, one of the most healing things when it came to body image was reconnecting with my childhood crush/friend on Instagram, the same boy who said the painful comment that I had in the back of my mind for years. We kept up with each other on social media and he was kind, supportive, and respectful. This new interaction helped me look back at that painful event with new eyes. I was able to understand that he was probably also an insecure kid (at the time, he was much shorter than all the girls in our grade). He was also probably a product of diet-culture and media that portrayed beauty in a certain way. Going back and analyzing the source didn’t take little Kylee’s pain away, but it did help me recognize I gave a lot of power to a struggling, insecure teenage boy who was not actually the expert on my worth.

What is it like for you to revisit some of these difficult messages from your past? In what ways have you found healing as you’ve gotten older? What healing does your younger self need a little help with?

Honor Your Health: Gentle Nutrition

Honor Your Health: Gentle Nutrition

“Make food choices that honor your health and taste buds while making you feel good. Remember that you don’t have to eat perfectly to be healthy. You will not suddenly get a nutrient deficiency or become unhealthy, from one snack, one meal, or one day of eating. It’s what you eat consistently over time that matters. Progress, not perfection, is what counts.” -Evelyn Tribole, “Intuitive Eating” 

The final principle of Intuitive Eating is “honor your health- gentle nutrition.” 

As we have been breaking down the ideas behind intuitive eating principles, my hope is that it feels much different from rigid, diet-mentality driven eating approaches you may have had previous experiences with.  

Eating is meant to be enjoyed, not just to sustain life! This principle involves how your eating can be both enjoyable and sustaining.  

It’s last for a reason: 

The principle of gentle nutrition is, interestingly enough, not the first principle of Intuitive Eating, but the very last. That may seem quite un-intuitive at first, but as you review the principles of Intuitive Eating below, do you notice anything? 

1. Reject the Diet Mentality 

2. Honor Your Hunger

3. Make Peace with Food

4. Challenge the Food Police

5. Discover the Satisfaction Factor

6. Fell Your Fullness

7. Cope with Your Emotions with Kindness

8. Respect Your Body

9. Movement – Feel the Difference

10. Honor Your Health – Gentle Nutrition

Honoring your health through learning how to gently nourish yourself is last because you can’t effectively do that without having a secure foundation built through the first nine steps. This step requires some awareness of how this crazy world we live in has impacted your relationship with food and your body. It requires having put some work into healing those relationships. It’s not just physical work- but mental and emotional as well. Skipping any of those steps shortchanges the necessary process to be successful with intuitive eating!  

 

It’s all about balance:

When you look at this principle, you can quickly see that it’s all about balance. The idea that you suddenly “pollute” your bodies when you don’t follow certain guidelines is really strict and rigid- and when you are working towards a balanced, flexible, non-obsessive relationship with food, there is no room for rigid, black and white thinking.  

With that flexibility and balance in mind, start to examine your feelings and observations around eating.  It might help to examine:

  • What foods do I enjoy my experience eating?  
  • Do those foods leave me feeling well nourished? 
  • Do I want to keep feeling the way those foods result in feeling, or make some adjustments/try new things? 
  • Am I eating a balanced, flexible assortment of foods?  
  • Is there room to be curious about new foods? 

When we have really mastered this principle, we will be prioritizing how we experience eating in our own bodies above whatever the popular diet gurus or social media influencers are telling us our eating needs to look like. This step moves you away from that crazy-making, never ending chatter and towards honoring your own intuition that can bring healing and peace. 

Discovering Comfort in Eating Recovery

Discovering Comfort in Eating Recovery

 

Did you have a comfort object as a young kid? Maybe a special blanket, or a stuffed animal? When I was little, my aunt gave me a small, white teddy bear named Theodore. Theodore went with me everywhere. Theodore was not only the stuffie I slept with every night, but he was also my companion on road trips, campouts, and trips to Taiwan. As a college student, I snuggled him through homesickness and post-breakup woes. Theodore has been around for nearly 30 years, and he now​ belongs to my son. My heart swells when I see my little boy hug and talk to his teddy bear. Theodore was (and is) very important to me, first because he was my favorite toy, and later because he came to represent home, safety, and comfort for me (and now for my son). We all need a “Theodore” in our lives–something constant and comforting to turn to when we feel vulnerable, hurt, or alone.

Recently, in a group therapy session I was leading, I asked group members to write down what their eating disorders have given them. On this occasion, every group member listed the word “comfort.” An eating disorder often emerges, and persists, in times when you need comfort the most. It might be something you turn to for soothing and relief when life is painful, or for control when life is chaotic and overwhelming. Your eating disorder might feel like the only thing that can make you feel better when things are at their worst.

If your eating disorder wasn’t comforting in some way, you probably wouldn’t have it in the first place. As safe as your eating disorder might feel sometimes, it is not a harmless teddy bear. It will ultimately create more pain and damage the longer it stays in your life. Not only that, it keeps you from finding and using other sources of comfort. As long as you are tied to your eating disorder, you aren’t free to explore what other things in this world might bring you a sense of comfort and safety. Clinging to your eating disorder makes it harder to care for and nourish the relationships and experiences that can make your life more meaningful.

There are other sources of real, meaningful, healing comfort available to you outside of the eating disorder. There are people who are willing and yearning to support you and help you feel safe. There are experiences full of beauty, purpose, and peace that are waiting for you in recovery. Even if comfort and safety have been scarce in your past, the healing in your future can be so much bigger than what your eating disorder promises you.

It can feel terrifying to think about saying goodbye to your eating disorder, especially if it has been your most reliable source of soothing in the past. I promise you that letting go of your eating disorder will be worth it. Recovery won’t mean you’ll never struggle to find comfort again; what it will mean is that you’ll be able to find comfort from sources that expand and enrich your life, instead of making your life smaller and more painful. It’s ok to need comfort. It’s ok to need some “Theodores” in your life. Recovery will help you find them.