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Eating Disorders: Let’s Get Real

By Monique Richard MS, RDN, LDN

Eating Disorders: Let’s Get RealIt is that time of year again where I see an influx of New Year’s resolution articles related to weight loss, juice cleanses, ‘it’ diets, as well as a bevy of marketing and promotional programs for weight loss supplements, quick-fix programs, gadgets and exercise equipment. With spring break around the corner, the focus on being ‘bikini body-ready’ puts pressure on a population that may already have some distorted thoughts regarding self-care, health, and well-being. For those struggling with an eating disorder or feeling insecure and looking for ways to cope with these thoughts and feelings, it is an especially vulnerable time. The veil of empty promises and real issues beneath the surface for those facing this mental illness are mired in obsessive behavior, body dysmorphia and a sense of hopelessness. The darker side of pursuing a path to ‘health,’ ‘perfection,’ and ‘acceptance’ ensues.

A week in February is devoted to focus on Eating Disorder Awareness. This year, the National Eating Disorders Association (NEDA) awareness week theme is Let’s Get Real, focusing on the importance of bringing these issues to light, getting individuals screened, and getting the conversation moving into action.1

The NEDA website states:
Our theme this year is Let’s Get Real and our goal is to expand the conversation and highlight stories we don’t often hear. Our culture has complicated relationships with food, exercise, and appearance. 30 million Americans will struggle with a full-blown eating disorder and millions more will battle food and body image issues that have untold negative impacts on their lives. But because of stigma and old stereotypes, many people don’t get the support they deserve. Join the conversation and help us raise awareness, bust myths, get people screened, and start journeys to healing.

As a registered dietitian nutritionist (RDN) I work with a lot of patients and clients who have eating disorders ranging from orthorexia (although not an officially recognized diagnosis yet, it is a term to describe someone who is obsessed with ‘clean’ eating or being healthy to an extreme) to binge-
eating, bulimia and anorexia or a combination of all of these. Four out of 10 Americans have suffered or know of someone who has suffered from an eating disorder.2 They affect individuals across the spectrum of age, gender, race, and socioeconomic background, but I am also seeing more and more disordered eating patterns and beliefs in general.

Healthy Self-Confidence
Our society’s focus on food, external beauty, weight, and physical appearance is at an intense level, often contributing to harmful or dangerous behavior. Couple this emphasis with the multiple social media platforms and images now accessible at any given time and the intense pressure and scrutiny can be a catalyst for many to be triggered into a negative health spiral and in some cases even death. Recently I have noticed a heightened recurring theme come to light in some academic arenas and organizations as well as in the media of tying one’s self-confidence to their weight. When one ties confidence with weight only, it may be due to feeling they need to defend their body size due to perceived images, outside criticism, or discomfort within their own body. Body acceptance at any size and self-worth is critical for self-love but self-confidence based on your weight or size versus who you area as a person can be dangerous in a number of ways; it can lead to:
• disordered eating patterns
• an eating disorder
• bullying others to project negative feelings
• judgment of others’ physical image, lifestyle, choices or health status

We must understand weight can fluctuate, even on a daily and hourly basis, but self-confi-
dence should not waver based on a fluid number affected by physiological, psychological, or medical changes. Self-confidence in oneself is critically important and we should have it for so many reasons, but weight should not be one of them.  Here are some reminders of what self-confidence should be based on.

How self-confident are you?
Your beautiful brain. Even daily tasks we may consider the simplest, or the most challenging, are fueled by your body and brain. Your intelligence and drive to be better, to learn, to thrive, is a beautiful thing.

Do you care for your beautiful mind? Do you:
• read, write, paint, draw, play an instrument, listen, speak another language, sign, teach, sing or learn on a daily basis?
• drive, decide what to wear, decide what to have for breakfast, feed and take care of yourself, the kids, animals, spouse or plants?
• calculate a budget, pay bills, go to work, brush your teeth, phone your doctor?

Your health or health management. You may not be in control of all the details and diagnoses, but you are in control of the choices you make regarding your health as well as how you react to situations and how you talk to yourself. Focus on how you feel, what your health status is and what barriers are stopping you from achieving your goals. Also, reflect on where are your choices and behavior coming from, love or hate, respect or resentment, because you want to or because you feel you have to? Do you:
• exercise regularly because you love your body and want to take care of it?
• eat a balanced, varied and moderate diet of wholesome foods to support your awesomeness?
• participate in stress management practices?
• get adequate hydration and sleep daily?
• seek professional guidance when self-management becomes difficult or overwhelming?

Your kind spirit. Your generous heart, good intentions and thoughtfulness are something to be cherished and certainly humility is admired, but feel proud about the kind of person you are. Do you:
• check on your neighbor, family member, or co-worker?
• carpool the neighborhood kids?
• call a friend to check-in?
• listen to the same story for the umpteenth time?
• provide a service to the public?
• donate time, money or goods to the food shelf, church, school, community garage sale, 5K, cancer awareness program, hospital, homeless shelter, animal shelter or national organization?

I work with a lot of patients and clients that are interested in weight loss (or weight gain) the healthy way and they have had great success with time, coaching, the right skills and mindset. We discuss in-depth about weight and the number on the scale not being the center of their journey to health and nutritional adequacy. Their needs as an individual are really taken from a multi-faceted approach from sleep to stress management, supplements to exercise, water to nutrient needs, which naturally tends to lead to better weight control, self-confidence, a positive relationship to food and their body and optimal metabolic function.

As an integrative RDN my goal is to help you thrive. That means looking at several different elements and using many tools in my toolbox. If you have an eating disorder I work closely with you, your therapist and your physician. We can then address your needs as a team. One of the therapists I work with, Heather Braddock, discusses the different types of therapy (see side bar).

Beginning today, let’s get real about eating disorderes. www.eatrightrx.com

1. NEDA Awareness week http://nedawareness.org/ Accessed January 12, 2018.
2. Wade, T. D., Keski-Rahkonen A., & Hudson J. (2011).Epidemiology of eating disorders. In M. Tsuang and M. Tohen (Eds.), Textbook in Psychiatric Epidemiology (3rd ed.) (pp. 343-360). New York: Wiley.

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