Thursday, May 23, 2013

Can You Love Your Body Without Really Loving Your Body?

Lose the Diet.
Love Your Body.
Eat in Peace.

Those are three of the major tenets of my work with eating and body image.  The order in which women accomplish these goals is fairly standard.  First, they give up dieting.  While this may be a radical notion for some, usually it's not too difficult to accomplish.  Next, and as a part of a new non-dieting approach, they learn to find peace with food.  This step may require a bit more finagling, but many women are still able to find success.  So far, so good. . .  But, what comes next is, in my opinion, significantly more challenging to approach.

Love Your Body.

What does that mean?  Do you really need to love your body to move beyond eating and body issues?  Is love a requirement to heal?

I don't believe that you must really love your body in order to recover.  The truth is that most women (and an increasing number of men these days) don't love their bodies.  But, what is important is acting as if you love your body.  What does that mean exactly?
  • You refrain from attacking your body with verbal and visual assaults.
  • You take care of your body, providing it with adequate nutrition, sleep, and other self-care behaviors.
  • You exercise for health and enjoyment, not for punishment or compensation.
  • You wear clothing that fits, is comfortable, and flatters your physique.
  • You participate in activities that you enjoy, without letting your size keep you sidelined or from enjoying these activities.  
  • You have a healthy sexual/romantic life, and your body image isn't an obstacle to your sexuality.
  • You treat your body well, and if finances allow, you go for massages, manicures, etc.  
  • You accept that while you might prefer to be thinner, taller, tanner, or more toned, this is your body now. 
Can you act as if?  

Monday, April 15, 2013

Developing a Healthy Relationship with Exercise



Exercise is a wonderful thing.  Unfortunately, that's not the case for most people I know.  It seems I'm usually either working with people to begin an exercise program or, on the other extreme, to back off of an exercise regime they don't enjoy but feel compelled to do.  As a psychologist who specializes in eating/body issues, who also has a master's degree in sport/exercise psychology and has been certified as a personal trainer for over 15 years, I am uniquely positioned to comment on both sides of the exercise spectrum, from under-exercise to exercise addiction.

We know that a large percentage of people who begin an exercise program will drop out within the first six months.  Why?  Because they don't like what they're doing.  Because they burn out. Because life gets in the way. If you follow these tips, though, you'll be more likely to commit to healthy activity over the long-haul because you'll actually enjoy what you're doing. Remember, the goal is to choose an "exercise lifestyle" that will work for the rest of your years.

1)  Cross-train:  Trainers have been talking for eons about the physiological benefits of cross-training, but cross-training has significant mental pros, too.  Participating in different activities throughout the week (month or year) reduces emotional burnout.

2)  Get outside:  There's something about fresh air and the sights, smells and sounds of city/country living that can contribute to the psychological benefits of fitness.  Nature, too, is a natural mood-booster.  True, some may also enjoy the sights (maybe not the smells) of their local gym, but still, I recommend that, weather-permitting, you mix it up a bit.

3)  Ban the gym:  Speaking of the gym, consider your relationship with your local Gold's or Equinox. If you hate going there, it's going to be an uphill battle all the way, and chances are, you'll drop out. If the gym connotes discomfort, punishment, etc., choose another venue you actually look forward to visiting.  Play tennis.  Go hiking.  Take salsa lessons. There is absolutely no need to go to the gym if that's not your thing.  Adrenaline junkie?  Try rock climbing, ocean swimming, mountain biking.  You'd be impressed at how infinitely more thrilling chasing the speed limit cycling westbound on San Vincente in L.A. or on the downhill stretch of Harlem Hill in Central Park can be than parking yourself on the stationary bike at the gym.

4)  Get your soundtrack on:  Studies show that we'll work out longer and harder when accompanied by good music.  I love my music collection so much that I look forward to the movement it commands.  You, too, can create a personal dance party on your MP3 player. For more of a challenge, choose faster-paced music, as we unconsciously move our bodies to the beat.

5)  Set goals:  It's incredibly motivating to have a project or goal to work toward.  Sign up for your first 5k (or muddy buddy race, if that's your thing).  Join a summer basketball league, knowing that you'd like to be in fighting shape before the league begins.  Having some sort of goal or deadline can enhance your fitness commitment and keep you on track.

6)  Forget the weight:  Exercise because it feels good and contributes to physical and psychological health, not because it burns calories or helps you lose or maintain weight. Those who begin exercise programs to lose weight often drop out when they don't see the immediate desired results. On the other extreme, exercise can become disordered as individuals seek to burn off each additional calorie they've consumed.  Exercise is a privilege, not a punishment for consumption.  I wish that all group fitness instructors would, in their prompts during class, focus on strength, health, and fun, rather than calories and weight. 15 years ago, I wrote my master's thesis on the mood-enhancing properties of exercise, and I still stand behind that research.   Exercise results in reduced depression and anxiety and increased self-esteem.  Work out with these significant benefits in mind.

7)  Be consistent:  Hemming and hawing about should I or shouldn't I work out today creates too much room for bailing.  Have a set schedule that you commit to, unless you're sick or something urgent arises.  Consider fitness to be a part of your everyday routine.

8)  Take it easy:  Yes, it is possible both to be consistent and to take it easy.  Schedule days off.  This one is particularly challenging for those who have a compulsive relationship with exercise, but for that reason alone, it's important to achieve.  The body (and the mind) need some time to recover.  Taking a couple of days off per week allows you to come back clearer, stronger, and more determined.  Schedule weeks off here or there throughout the year to recover more fully and further increase your drive.  Prove that you have a  healthy relationship with exercise by taking time off for work/family obligations, travel, illness, surgeries, etc. without suffering guilty, anxiety, or depression.

9)  Embrace the grays:  Taking it easy also involves embracing the grays:  Despite what almost everyone I work with believes, I still espouse that 15 minutes of exercise is better than nothing. If you don't have the time or energy to put it a full workout, do what you can. Trust me, it still counts. On a related note, your workout should not feel like 45 minutes of physical torture. Many people dislike exercise because they equate it with pain. Back off to a degree where you feel challenged, but not distressed. Especially if you're having an off day, give yourself permission to dial back the effort. Your run can turn into a walk, your kickboxing class into a yoga class class across the gym. And yes, it still counts.

10)  Practice gratitude: Take a moment to remember how lucky you are to choose to move your body.  Be thankful for functioning limbs, a healthy heart and lungs, and the lifestyle wherewithal that allows you to have  the time, space, and energy to move.

Tuesday, March 26, 2013

Bumpy Roads

What do Kim Kardashian, Jessica Simpson, and Kate Middleton have in common?  Yes, they're all famous, and yes, they're all pregnant, but all three have also been criticized for their pregnancy shape.

As if the physical and emotional aspects of pregnancy aren't enough stress to bear, women's pregnant bodies are constantly scrutinized and judged by others.  Are you gaining enough weight?  Are you gaining too much weight?  Or are you the Goldilocks of motherhood?

For those who struggled with food prior to pregnancy, these 10 months can be exceptionally challenging.  Morning sickness, weekly weight checks, a growing belly (and body. . .  even despite a real and delicious purpose), sometimes well-intentioned comments about the "right" things to eat--all can rile up an already shaky relationship with food and weight.  And, as more and more women are turning to fertility treatments these days, tack on additional pre-pregnancy gain.

A lot of this cannot be stopped.  But the comments, they need to cease.  Internet magazine Jezebel recently ran an article lambasting the media hoopla around Kim K's gain.  I say, we need to apply these words to every expecting mother.  Not one woman should be critically commenting on another woman's growing belly.  It's the quickest, surest way to devalue the miracle of life.  

Tuesday, March 05, 2013

I Recommend This Book to No One


Remember those book reports from grade school, which inevitably concluded with your recommendation for a target audience ("I'd recommend this book to other boys and girls my age. . . .")?

Well, I found a book that I would like to recommend to no one.

I was browsing in my local novelty shop and came across this title:




Never have I been so disappointed by a subtitle. And to think, the title had such promise!

So, I found myself mentally rewriting the subtitle (and, of course, by extension, the book).   Six Weeks to OMG:  Never Pick Up a Diet Book Again. . .  Six Weeks to OMG:  Learn How to Challenge Current Media Representations of Women. . .  Six Weeks to OMG:  Finally Organize Your Sock Drawer. . .  really anything than the one they chose.

How would you rename this book?  What can you accomplish in six weeks that is healthier and more productive than the promise laid out here?

Tuesday, February 26, 2013

NEDAwareness Week


You do know that it's National Eating Disorder Awareness Week, right? 

Check out NEDA's new graphics on eating disorders in men and women.  Did you learn something new?

Here are my NEDAW plans:

1) This past weekend, I attended FBT training at Stanford University.  What an informative weekend!

2)  Yesterday, I attended this great talk on evidenced-based treatment.

3)  On Friday, I kick off Sierra Tucson's Symposium for Eating Disorder Treatment (Remember those questions I asked you a while back about therapist preferences?  I'll be drawing from your responses.)  I'll be followed by a number of impressive names in the field.  

4)  On Saturday, I'm joining colleagues for the first-ever Los Angeles NEDA Walk!  

What are you doing to move yourself and others along in recovery this week?  

Are you talking the talk and walking the walk?  

Tuesday, February 12, 2013

OA (Oh No?)

12-step programs have guided countless individuals to sobriety and recovery.  I've worked with patients who fully attribute their substance abuse recovery to participation in "the rooms."  While some patients never take to the fellowship, citing a variety of objections (e.g., don't like the idea of a higher power, feel the organization is cultish, etc.), many find these self-help groups to be helpful and supportive.

Do these same benefits translate to the world of overeating? Is Overeaters Anonymous helpful or hurtful?

We know that that there is something inherently addictive about alcohol and other drugs.  With food, I'm not so sure.  Despite plentiful claims in the popular media, we don't have any good research that suggests that "food addiction" exists.  For an interesting summary on this debate, check out this dietitian's blog.  We know that people can demonstrate an addictive relationship around food, but this doesn't mean that the food itself is addictive.  Rather, behaviors like restriction and bingeing can be incredibly habit-forming.

Moreover, most of the foods that people label as addictive (e.g., sugar, carbohydrates, fats, etc.) are foods that they've tried to restrict in some ways. Deprivation can, as we know, lead to overeating.  For instance, almost every patient I see who tells me she's addicted to sugar happens to be restricting her carbs.  Once she  supplements her carbohydrate intake, much of the sugar cravings subside.

The problem with OA is that many groups (not all, but many) conceptualize food or certain foods as addictive.  As a solution, they preach abstinence (similar to other 12-step programs).  OA members will speak of their abstinence from sugar, wheat, etc.  Some OA sponsors will prescribe their sponsees specific meal plans.  Any departure from the meal plan is considered a relapse (i.e., back to Day 1).

The problem with this approach, if you're not guessing this already, is that abstinence equals deprivation!  As a result, many who try out OA, find themselves developing even greater problems with bingeing or overeating, as a result of the diet-binge cycle.  We're able to carve out an existence without alcohol or drug. but abstinence from food is impossible and abstinence from certain foods increases the experience of deprivation.  By defaulting to abstinence, OA does not teach members how to eat in moderation (which, in my opinion, is necessary to be functional around food in this world), contend with emotions that lead to overeating, or heal one's relationship with food.  It only makes it worse.  OA members may practice abstinence from various foods until a time in which they're presented with that food/can't take it any longer/give up. . . leading to one colossal binge.  I've worked with a number of patients who come into treatment, precipitated by an increase in disordered eating, which they attribute to OA.

Now, it may be possible to find OA groups and/or sponsors that are less restrictive and offer the typical benefits associated with 12-step groups.  But unless that's possible, those who struggle with compulsive eating may be better served through Anorexics and Bulimics Anonymous or emotional eating groups run by private practitioners who espouse a more intuitive approach to eating and food.

Thoughts?

*thanks to Meliss, who begged the question : )

Tuesday, February 05, 2013

News and Such (Is That a Bird?)

1)  Here's the press release for ED Hope's 25 Best Blogs of the Year.  As the release suggests, the blogs represent a diverse pool on perspectives and writing on ed's yet are unified in their drive toward health and recovery.  While you're at it, take a peak at ED Hope, a great resource for ed's.
2)  I've succumbed.  I'm now on Twitter:   

3)  And finally, don't you just love Kate Winslet?