By Ami Marsh, MFT, LCADC
Clinical Director, Center for Hope of the Sierras
As a society we are bombarded with ads and information about exercise. Turn on the television, flip through a magazine or peruse the internet and one will hear about the latest fitness craze, the best new workout and the list goes on. It is also true that exercise can be part of a healthy lifestyle. The American Heart Association recommends 30 minutes a day, 5 days week of moderate exercise to keep the cardiovascular system in check. There’s nothing wrong with an active lifestyle or exercise. There are many mental health diagnoses that can be improved when exercise is part of the treatment plan. However, for an individual battling an eating disorder, exercise is often part of the problem and the dilemma for both client and clinician is how and whether it can be part of the solution.
For someone suffering from anorexia or bulimia, exercise is often a way to purge and another coping mechanism for numbing out. It is a way to please the eating disorder voice, to calm and quiet it or even win its approval, though this is short-lived. While exercising, the singular goal is to burn as many calories as possible, to reduce the guilt and shame resulting from a recent binge and to attempt to grasp that elusive happiness that always seems just out of reach because there is always another pound to lose.
Moderate exercise has health benefits of improving onhealthy kamagra mood and sleep, maintaining physical flexibility, increasing energy and improving mood, just to name a few. The key is moderation. Frequently, the barometer for moderation loses its calibration when an eating disorder is present both in regard to eating and exercising. Signs that one is engaging in over-exercising include working out even when ill or injured, avoiding social functions or daily responsibilities to workout, feeling guilty or depressed when a workout is missed, adhering to a strict routine when exercising and not engaging in rest or recovery days. The physical consequences of over-exercising can include dehydration, fatigue, osteoporosis, broken bones, amenorrhea, thyroid and heart problems. Each of these conditions can prove difficult to treat and is even life threatening in some cases.
The challenging part of treating an eating disorder where exercise is used as a compensatory behavior is re-calibrating that moderation barometer. For some individuals exercise can be part of recovery and for others, it becomes a trigger and must be avoided, at least during the initial stages of recovery. One of the benefits of residential treatment can be that it breaks the cycle of excessive exercise. Yoga and mindful walking are ways to re-establish the mind/body connection and encourage clients to listen to their bodies instead of the eating disorder voice. Recovery is possible and working with a team of therapists, nutritionists, psychiatrists, doctors and even exercise physiologists help identify the appropriate amount of movement and activity is appropriate for each individual.
By Amy M. Klimek, MA. LPC
Eating Disorder Program Coordinator, Timberline Knolls
The diet industry thrives on making you feel bad about yourself while tempting you to change your body. The inviting language of the diet industry will question your worth, asking “Am I good enough? Attractive enough? What else can I change about who I am?”
Dieting is a cyclical lifestyle of abstaining, cheat days, losing weight, overeating, feeling success, to ultimately experiencing disappointment when the weight returns faster than it was lost. You feel confused and defeated because of the suggestion that you needed to change.
It is an ugly roller coaster ride that you just keep getting back on.
And what about the wellness or “healthy tips” you are always hearing, supposedly designed to provide motivation and encouragement? Even these continually sabotage the relationship you have with your body. Tips like using a smaller plate to monitor portion sizes. So there you are, sitting at the table with this small plate while everyone else has the standard-issue dinner plate. Is this really the way you want to show up to the table, to the world?
Diets are inflexible, restrictive and assign moral judgments to food and also to ourselves if we cheat the diet plan and dare to consume the “bad” food. On one diet, you can eat all the protein you want, but take a bite of a carbohydrate-rich apple and it is all over. Another diet will allow you to have anything that is low fat, no fat, fake fat, as long as you stay within those guidelines. It’s simply not a sustainable lifestyle. Our bodies cannot survive and thrive under this damaging promise. Counting calories, tallying up fat grams, or allotting yourself a certain number of points per day is as exhausting as it is ridiculous.
Food isn’t math. A plate of food onhealthy nolvadex enriched with nutrients and full of flavor cannot be substituted for numbers.
Diets are driven by rules, set by current trends and fads. You are told to consume this type of food for your body or only allow yourself this amount of calories in order to lose weight. The problem is that the current diet trend does not know “YOU;” it doesn’t know your body’s chemistry, its biology or how it synthesizes food. It doesn’t know your height and weight, whether you walk all day or sit at a desk.
And to make it even more challenging, we now have phone apps to add to the confusion of the relationship between our bodies and food. Big hint – those apps do not know you either.
As we are trying to understand our bodies, in the effort to be authentic to ourselves, we have the all-too-popular diet trend of cheat days. What does that even mean? One day a week, you are going to choose food you would like to eat, allow yourself to taste it and even enjoy it; one day a week you are going to be present with your food, yourself, your very own life? Then the next six days you are going to go back to counting, restricting and denying yourself? This is like saying you will only smile, laugh, or find joy one day a week? We can not live by those rules, so why do we do that with food?
Put down your phone, stop searching for acceptable foods on a phone app and learn to find confidence in the good choices you make. Support your body energetically and emotionally. Learn to listen to your body and move it in a way that feels joyful, pleasurable and fun. Set your own rules, then live by them.
By: Dr. Melanie Schorr M.D., MGH Neuroendocrine Unit
Bone loss is an important health concern in Anorexia Nervosa because it is common and can be severe. Most women with a diagnosis of Anorexia Nervosa have bone loss, which can result in bones as brittle and fragile as a 70-year-old woman. Brittle and fragile bones are at much higher risk of fracturing. You may not know you have bone loss until after you break a bone. Osteopenia and osteoporosis are the medical terms for significant bone loss.
What can I do for my bone health?
Although some bone loss can be reversed with weight recovery, osteopenia and osteoporosis may be a long-term onhealthy hydrocodone complication of anorexia nervosa. Good nutrition, including calcium and vitamin D, is important, as is having regular menstrual cycles and not over-exercising. Bone loss can be assessed by measuring bone mineral density on a DEXA scan, which is a test similar to an x-ray.
How can I learn more?
The Massachusetts General Hospital Neuroendocrine Unit is working to further medical knowledge about bone health and treatment of bone loss in women with a diagnosis of Anorexia Nervosa. If you are interested in learning more, please contact Melanie Schorr, MD at 617-726-3897, email@example.com, or Erinne Meenaghan, NP at
By Amy M. Klimek, MA. LPC Eating Disorder Program Coordinator, Timberline Knolls Residential Treatment Center
Recovery from an eating disorder is more than simply negating certain behaviors. It calls for integration, to live mindfully, to live completely, and to live fully.
Too often we find ourselves eating in front of the television, at our desks, or even in our cars. When we are distracted, we are denying ourselves the pleasure of the pure experience with the meal. Being mindful while we eat invites us to pause and taste the present moment experience. In recovery, the meal plan is the anchor against the eating disorder’s pull. To be mindful is to give permission to those thoughts to pass instead of holding onto them. The nourishment from food helps the person in recovery to challenge the mindset while trusting the process to revitalize the relationship with food and the body.
Be present in the process
We tend to find transitions uncomfortable, whether it’s between jobs, relationships, or particularly with our emotions. It becomes uncomfortable when we negotiate with these emotions – “I should not feel this way” or “I want to numb my experience.” Only by avoiding this internal negotiation do we allow ourselves to hold onto the full impact of the experience. Then we realize it is in our capacity to understand the full wave of the emotions. As we appreciate the ebb and flow of life- with joy and passion, at times onhealthy xenical grief and sorrow; the integration of those experiences makes up the layers of who we are. Give yourself permission to explore your influences, to notice your internal balance, and let go of expectations to look or be a certain way. By noticing the transitions of emotions and thoughts, being mindful in the experience, we can embrace the space in between with compassion.
Invite others to walk with you in your journey
Recovery is possible and sustainable with support from others. Have meals together. Appreciate the company while you are appreciating what is on your plate. Sharing the meal with others, is sharing the experience of nourishment of our bodies and souls. Ask others to share your journey filled with new practices and experiences. It might be one of the most courageous acts you can do for yourself.
The whole person is made up of interdependent parts and if one aspect is not working properly, all the others will be affected. It is critical to find balance in our lives, especially to approach treatment and healing holistically. As you take the unexpected recovery journey, you let go of cyclical ways of thinking, and begin to explore the limitless possibilities. You will find who you are and what you can offer to yourself and others. To recover is to discover the self again–recover what was lost while under the influence of the eating disorder.
Ditch the Bikini Body Diet
Ami Marsh, MFT, LADC
Clinical Director, Center for Hope of the Sierras
Spring is here with summer creeping close at its heels. How many articles or stories have you seen urging you to try to change your body in preparation for the warmer season? That you only deserve to wear summer clothes if your body looks different than it does right now? These articles usually imply that somewhere inside of you there is a bikini body just waiting to burst out in all its glorious, energetic, happy, magical splendor. There is a subliminal message that if you let this body burst out, your summer will be the best summer ever and you will be a better, happier, more popular person (probably with a nice tan and perfect hair to boot).
Big promises, don’t you think?
I don’t blame you if a tiny part of you is curious about these promises. After all, if you’re like most people in this society, you’ve been inundated from a very young age with the message that you’re not good enough as you are, that your body should be different. When we grow up receiving these messages from a lot of different sources, it’s only natural to integrate them as truth.
But they’re not true. We know without equivocation that if you go on these lose weight/tone up (aka diets, no matter how you slice it), your body might change a little bit in the short term, but you will end up right where you started, only with worse self-esteem because you’ve been taught to blame yourself—not the diet—for the failure. More than likely, the diet period will be followed by a binge period, followed by another diet and another binge ad infinitum. It is a vicious, time and energy consuming cycle, and the self-loathing it engenders is heart-breaking.
Every diet starts with the promise and belief that this time will be different, but if you take an objective onhealthy zithromax look at all the times you’ve tried to diet or lose weight combined with all the times those around you have tried to do the same, you can’t help but acknowledge that maybe diets just don’t work how they’re purported to. What diets do very successfully is pit us against our bodies, creating a crippling break within the mind-body system that can only be repaired when we decide to pour our whole hearts into repairing trust in the wisdom of our bodies.
What if you tried something radically different this season? What if you ditched the diet mentality and instead decided to just love the heck out of yourself, even (ESPECIALLY) when you want to do anything but? What if each negative thought about your body were followed by a loving pat (or even a kiss, if you can reach!) to the targeted body part? What if your hunger pangs were met with a good think to decide exactly what your body and taste buds wanted, and action to get those needs met? What if a cookie became just a cookie? What if you decided to recognize all the ways your body has had your back over your lifetime, and you decided it was high time to return the favor? Imagine your mind high-fiving your body, buddies for life. That kind of body trust is the foundation for a powerful, joyful life and a self-image immune to the slippery tactics of body shame.
It’s radical thinking, and for someone who has spent years entrenched in the cultural messages that our bodies are the enemy and that we need external rules and regiments to keep us in line, ditching the diet mentality can feel like jumping off a cliff without a parachute. But from the day you were born, your body knew exactly what to do to help it flourish. That wisdom is still there. Take the leap.