Dear Survivor,

As a therapist who treats eating disorders, I have worked with many women, men, and families who fought to overcome their illness and reclaim a life beyond calorie obsessions, food phobias, and irrational fear of weight gain. Often, when they first made the courageous effort to step into my office, they would ask, “What can I do to fix this problem?” For years I struggled to answer this question due to the sheer number of issues involved, and the unique and complex way this illness affects each individual. However, my clients have taught me a great deal about recovery, and my answer is now fairly simple: it involves the concept of the Power of ONE.

Recovery from an eating disorder can be a long and challenging process, so if you are feeling discouraged or overwhelmed about beginning or continuing this journey, just remember the Power of ONE:

to take ONE second, minute, or day at a time,
to set ONE goal at a time,
to have ONE conversation at a time,
to deal with ONE problem at a time,
to eat ONE more bite or meal than you are prepared for,
to resist ONE more binge episode,
to reduce your number of purge episodes by ONE more,
to make ONE more healthy choice,
to establish ONE treatment team that you can rely on,
to find at least ONE passion that gives you the desire to fight for your life,
to reach out to ONE friend at a time,
to take your medicine ONE more day,
to do ONE fun thing you enjoy,
to find ONE more thing you appreciate about your body,
to dream about ONE life worth living,
to take ONE more breath in order to calm yourself down,
to find ONE solution to a problem and then ONE more if necessary,
to get up ONE more time than you fall down,
to remember ONE more person who loves you,
to go to ONE more doctor’s appointment,
to follow your meal plan for ONE more meal,
to talk back to ED ONE more time,
to take ONE more break if you need to
and then continue to put ONE foot in front of the other even when you feel discouraged,
to find ONE more reason to survive this illness,
to remember ONE successful thing you accomplished today,
to remember ONE more good quality you possess,
to create ONE balanced lifestyle,
to trust your body and treat it right for ONE more day,
to set ONE more boundary to protect yourself,
to confront ONE more person if you need to,
to stand up for yourself ONE more time,
to identify and process ONE more emotion at a time,
to defy ONE more myth about eating disorders,
to recognize ONE more unrealistic expectation and re-define it to something that is useful to you,
and to define, reclaim, and embrace the ONE and only you who is good enough, caring enough, attractive enough, smart enough, successful enough, funny enough, healthy enough, and powerful enough to create ONE life worth living with the ultimate goal of being ONE more person who did what it takes each and every day to survive this illness.

Sincerely,
Someone who believes in you

By: Tamara Richardson, Ph.D., is a licensed psychologist, part-time private practice clinician in Stillwater, Oklahoma, and a senior clinical counselor at Oklahoma State

Operation Beautiful™: Mission Accomplished!
Heather Purdin, M.Ed., CTRS, RYT

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” —Margaret Mead

Sometimes it is the smallest gestures that have the most profound impact. Who would have thought a post-it note with a short and sweet message such as “You are Beautiful!” would lead to a national trend?

Caitlin Boyle certainly did not, but that did not stop her from sewing the seed that has now become the masterpiece known as, Operation Beautiful™.

Her goal was to combat the societal epidemic of negative self-talk by countering it with a positive message. She first left the messages on mirrors in public restrooms at her work, gym, and local grocery store. She hoped, “Maybe some people read them and just smile, but I bet some people are truly touched by the effort of a random stranger.”

Caitlin eventually created a website and began putting the web address on the notes so people could join the mission as a community. In the battle against toxic self-talk, the Operation Beautiful™ website is a sort of headquarters always recruiting more soldiers to walk the talk!

Glamour Magazine, Women’s Day, Oprah Winfrey Network, and The Today Show have all taken notice. Today, Caitlin’s website receives thousands of hits from across the Globe from others who contribute to the cause. This time featuring inspirational messages geared toward girls 8-14, Caitlin just wrote her second book: Operation Beautiful™ for Best Friends. (Remember, this all started with a simple post-it note and a positive mind.)

I joined the cause two years ago when I discovered an Operation Beautiful™ note. Since, I have helped organize three “Operation Beautiful™” benefits with my band, reaching hundreds of attendees. Hopefully, some of these folks have gone on to spread the positivity. Regardless, the funds raised have been passed onto Project HEAL: Help to Eat, Accept, & Live, a nonprofit organization started by three brilliant teenagers that helps individuals battling eating disorders access the treatment they need.

Prevention + Intervention = REAL HOPE!

YOU can become part of the equation, part of the solution, and here is how:

What supplies do I need? This is the best part! This activity is incredibly accessible because it requires inexpensive items common to most households. Traditional supplies include: post-it notes as well as pens, pencils, gel pens, and/or markers. There are all sorts of shapes, sizes, and colors of post-it notes you can look for if you want to invest a few dollars into the project. You can always incorporate stickers too.

What do I write and where do I post the notes? Get creative and even animated. You can spread around your favorite quotes or make up your own encouraging messages. If you struggle with self-image yourself, just imagine what it is you might really need to hear today and then spread the love! You can embellish your messages by adding doodles, using different color combinations, and even drawing quick sketches to help your message capture one’s attention. It really comes down to how many notes you want to make and how much time you have to devote to the project.

People are now expanding the mission by using chalk on sidewalks and using non-permanent markets to draw directly on mirrors. Just be careful to respect public and private property by using methods that can easily be removed. By the way, if you walk by later and find your message is missing, it may have been picked up and taken home by someone who really needed it!

If you leave the www.operationbeautiful.com website on the post-it, people can learn more about this mission. You can also leave the website of an eating disorder non-profit organization. Regardless of your choice, just keep this to positive propaganda please!

Below is a list of 15 possible locations, as well as examples of what you might write.

1. Bathroom mirrors (Look in the mirror and repeat after me, “You are beautiful!”)
2. Dressing room mirrors (Objects in the mirror are more beautiful than they appear!)
3. Bathroom stalls (Size does not matter. Love yourself always and forever!)
4. Lockers in the gym or at school (Go out into the world knowing you are loved)
5. Scales at the gym (A mind is a terrible thing to waste and a waist is a terrible thing to mind.)
6. Diet and beauty product aisles at the store (You are magnificent just the way you are.)
7. Diet ads or Photoshopped images on magazine covers (REAL beauty is who you are!)
8. Self-help books at the library or bookstore (Rock Steady!)
9. Ice-cream shops (Life is short; eat dessert first!)
10. Children’s toy packages that encourage unrealistic body image (You are the twinkle in the stars.)
11. Public bulletin boards (You can do anything you set your mind too!)
12. Gas pumps (“Don’t worry about a thing. Every little thing is gonna be alright” –Bob Marley)
13. Random car windows in the parking lot (Smile! It’s beautiful and contagious.)
14. Inside your cabinet doors (You deserve to enjoy your life.)
15. On your refrigerator (Nourish your mind, body, and soul. Breathe deeply & repeat!)

Whether you run a treatment program, suffer from an eating disorder, have a loved one battling an eating disorder, or have recovered from one, you have wisdom to share, so go out and share it! My partner surprised me with a note a few days before we held our first Operation Beautiful™ benefit and I still cherish it!

One you get started, the ideas will start running and you might even have a difficult time keeping up with yourself. Remember, this will benefit you and someone else! It’s like feeding two birds with one seed. Beautiful indeed!

Did you answer yes to any of these questions?

If you answered yes to any of these questions, you need to know that bullying leads to children’s eating disorders or other dysfunctional behaviors. More and more children are finding they need treatment for an eating disorder who are younger than 12.

Bullying is dangerous and can even lead to suicide. The internet has exposed the terrible truth about the effects of bullying. Remember, Phoebe Green, who hung herself at age 15 because of cyber bullying.

Only recently have we as health care professionals begun to look at the seriousness of bullying particularly after reported teenage suicides. Does your child use the internet? If so, be alert. Know that the internet has exposed the terrible truth about the effects of bullying, severe enough to drive some kids to self-harm or suicide.

Bullying effects millions of students but parents and teachers don’t understand the serious outcomes. When professionals or parents tell kids to ignore teasing, or to just get on with it, this not the kind of advice or understanding they need.

What does bullying looks like?

1. Emotional or verbal abuse looks like “Fatty fatty two by four, can’t get thru the kitchen door” or Piggy, piggy!
2. “Hey Jew boy.”
3. Cyber abuse is on Facebook where everyone from your school can see it.
4. Cruel emails can be sent from anywhere.

A person can be picked on by an individual or group with more power. Someone with more power may be peers, older kids, even teachers or parents. Bullies choose their victims because they look different, have a different religion, or are disabled. Bullies pick on a person simply because the person is shy or is gay or is a lesbian.

We must never forget that bullying is a severe form of abuse, i.e. emotional abuse, verbal and sexual abuse. Being excluded socially is a form of abuses. Verbal bullying, cruel email, or cyber-bullying (posting insults online) are forms of abuse.

Bullying like most forms of abuse is ongoing, like water dripping on a stone. The person being bullied lives in a constant state of fear. Everything in his or her life is affected. School work and health are both affected. A person being bullied can get stomach-aches, diarrhea, and headaches from the stress.
Kids abused by peers or family members can suffer from depression, low-self-esteem, and anxiety occasionally or a great deal of the time. They might even consider suicide!

Here are 8 tips to help you protect yourself from bullies. What advise will help if you feel bullied or know someone who is being bullied?

1. Tell someone about it, a teacher, a friend, a parent — tell anyone but tell right away.
2. Stick together with your friend who is being bullied — never leave him or her alone.
3. Learn to ignore the bully. Don’t add wood to the fire.
4. Don’t get physical (or angry) with the bully.
5. Practice feeling and looking confident. Posture is a give-away.
6. take small steps to be in charge of your life. This is where a good coach can help.
7. Talk about the bully and bullying to anyone and everyone. The more public you are, the bully will hide out.
8. Find true friends, friends that can offer you unconditional friendship.

If you’re a kid, find an adult who can guide you step by step through the process of taking charge of your life.

As you grow in confidence, you’ll stand taller knowing that no one will bully you again.

With these words, Marc Lépine opened fire at Montréal’s École Polytechnique, killing 14 women and injuring 10 other women and four men before turning the gun on himself. The event took place on December 6, 1989, just a few miles from where I was living at the time.

Lépine’s words rang in my ears when, 21 years later, not far from my home in Tucson, I learned that a young gunman had killed six and injured 14 others in an attempted assassination of Arizona Congresswoman Gabrielle Giffords.

Loughner, like Lépine, was a troubled loner who was rejected for military service. Loughner was kicked out of school a few months before the shooting; Lépine dropped out of school, failed in two attempts to win admission to the École Polytechnique and blamed feminists for ruining his life.

While there has been much speculation about Loughner’s ties to far right politics, I can’t help wondering why he fixated on Giffords, a moderate Democrat who had been the youngest woman elected to the Arizona state senate in 2002, rather than on her more prominent male counterparts.

In recent decades, we’ve made great strides in improving women’s access to education and participation in the workforce and politics, but violence against women is still tragically widespread. In a 10-country study of women’s health and domestic violence, the World Health Organization found that

• between 15% and 71% of women reported physical or sexual violence by a husband or partner, and
• one in five women report experiencing sexual abuse as children.

The health consequences of violence can include not only injury or death, but also an increased risk of depression, post-traumatic stress disorder, sleep difficulties, emotional distress and eating disorders.

A 2006 study found a high correlation between family violence and disordered eating. About 30% of women with eating disorders were sexually abused as children (Connors and Morse, 1993), and 28% of young women practicing some form of weight control also reported sexual abuse (McCreary Centre Society, 1998).

A U.S. study found that 45% of women with bulimia reported being physically victimized at least once during an adult relationship (Root and Fallon, 1988). Of these, 23% had been raped, 23% had been battered, and 6% had been both raped and battered. A similar study by Bulik and Sullivan (1993) found that 40% of women with bulimia as compared with 5.9% of women without bulimia had been battered one to three times per week during an adult relationship. The risk of battering was 6.8 times higher for women with bulimia.

Yes, we have come a long way, but women and girls continue to suffer disproportionately from violence at the hands of the state, the community and the family.

Sources:

www.who.int/mediacentre/factsheets/fs239/en/
www.phac-aspc.gc.ca/ncfv-cnivf/publications/femrav-eng.php

Jenny Kirk on Figure Skating’s Eating Disorder Epidemic

Body dissatisfaction: it’s not just for teens and young women anymore.

Eating disorders are on the rise among middle aged and older women. And they are often misdiagnosed — not only because they’re unexpected — but because weight loss and changes in appetite can also occur as a result of illness or medication.

Our culture’s obsession with youth, thinness and looking good can cause many older women to experiment with compulsive exercise or dieting to ward off the signs of aging.
Older women may also experience increased trauma as the result of the death of a spouse, divorce, children leaving home, menopause or a combination of sources. For some women, even natural aging can be traumatic. They look in the mirror and no longer see the bright, hopeful face of their youth.

When a traumatic event occurs, some women may choose to focus on the things they can control — like their eating, weight and fitness — rather than experience the pain of events that are completely out of their control (like the aging process).

A recent study in Austria is one of the first to look at poor body image and eating disorders in older women. The study included a random group of 475 women between the ages of 60-70.
90% of the women in the study felt fat, and 60% were dissatisfied with their bodies! Over 80% of the women made great efforts to maintain or lose weight. 4% of the women had clinical eating disorders, and another 4% had at least one symptom of an eating disorder, such as abuse of laxatives, diuretics, vomiting, bingeing, or compulsive exercise.

I don’t think that I’ve ever met an eating disordered client that didn’t struggle with digestive issues. The digestive tract is directly affected by binging, purging and restricting. The discomfort from digestive problems is a common obstacle to recovery. It’s such a challenge for women to adhere to their meal plans when their bodies are rebelling.

Women with eating disorders often experience heartburn, indigestion, gas, bloating and constipation. Fortunately, naturopathic supplements are very effective in assisting efficient digestion. Using digestive enzymes with meals assists in the breakdown of foods. A probiotic supplement can reduce gas, bloating and constipation. Drinking aloe vera juice can calm heartburn. And I often prescribe a magnesium citrate supplement to ensure regularity.

The whole foods approach is healing in itself. Whole foods supply needed fiber. Many people have too little fiber in their diets. I may encourage the use of ground flax meal to increase one’s fiber intake. Water is important for regularity, especially in the desert environment. A minimum of half your weight in ounces should be ingested each day.

Finally, the most important “supplement” is reducing stress and anxiety. Our program emphases the creation of stress-management tools for each client. Yoga, bodywork and healthy exercise are encouraged as lifestyle changes. I also help women train their bodies by allowing regular bathroom time. These are all important and effective components of healthy digestion.

TLC is a new program based on 10 years of research into the most effective options for eating disorder treatment and relapse prevention. Like Mirasol’s primary residential program, it combines traditional therapy with alternative therapies proven effective in the treatment of chronic stress-related conditions. However, TLC recognizes that not everyone can take time out for long-term residential care, so its flexible program emphasizes real world skills and therapies that can achieve rapid improvements in the client’s ability to cope with stress.

“We offer process groups, individual therapy, nutrition education, cooking classes, medical support and other elements of traditional eating disorder treatment,” says TLC Program Manager Diane Ryan. “But we also do a lot of experiential work, including challenge courses, dance movement therapy and body image work. And we help the clients achieve balance in their lives by taking advantage of festivals, art exhibits, concerts and other events going on in the community.”

One of TLC’s specialities is “Brain Paint” a new development in neurofeedback that allows the client to continue EEG entrainment at home after completing residential treatment at Mirasol.

“We incorporate many more therapy hours than most transitional living programs,” says Ryan, “so that as the clients progress beyond the initial two weeks, they can choose what works best for them from a menu of treatment options.”

The Transformational Living Center offers individually-designed eating disorder treatment programs from two weeks to three months or more. For more information, please visit our web site or call 888-520.1700.

One of the questions that seems to arise again and again is, “My aunt and my mother had an eating disorder.

• Is it hereditary?
• Am I at risk?

The high incidence of eating disorders in families has led researchers to think that there might be a genetic influence in the development of them. Studies have shown that 58% to 76% of the occurrence of anorexia nervosa can be attributed to genetic factors.

The prevalence rate of anorexia nervosa in sisters of patients is estimated at 6%. Most of our genetic evidence in the development of anorexia nervosa comes from twin studies, in which the twins are raised apart.

These studies reported substantially higher rates for the development of anorexia in monozygotic twins than for dizygotic twin pairs While recent data suggest that there is some kind of genetic aspect to the development of anorexia, conclusive data for genetic transmission are not yet available. The National Institute of Mental Health is funding a five-year study, with more than $10 million in funding, which brings together 11 groups of researchers from North America and Europe (10 clinical centers and one to analyze data) to discover the genes that influence risk for anorexia.

In 2000, researchers identified shared genetic susceptibilities to major depression, substance abuse, anxiety disorders and personality disorders. Similarly, there is growing evidence to suggest that anorexia nervosa as well as bulimia nervosa likely share the same genetic risk factors. Family and twin studies indicate that relatives are at increased risk for anorexia and bulimia because of a hereditary component between the two disorders.

A high probability also exists that there is a genetic predisposition to obesity and binge-eating disorder.

An additional question is

• Can I become cured from an eating disorder?
• Will I have to live with this forever?

The answer is “yes” and “no”.

A person can become completely well or cured and it requires a tremendous amount of hard work.

Outcome studies on anorexia nervosa have been available in the literature for at least four decades, from the 1950s.

In 1995, researchers published a review of 68 outcome studies published between 1953 and 1989 concerning a total of 3,104 patients. The follow-up results show a large variation in the main features of anorexia – weight, menstruation, and eating behavior.

They found the following:

In close to 60% of anorexics, weight and menstruation may normalize, whereas somewhat fewer (49%) show normalized eating behavior. The distinction between recovery, improvement, and chronicity (which to a great extent is based on a popular but crude differentiation between good fair, and poor outcome) shows that, on the average, more than 40% of anorexics recover, one-third improve, and 20% have a chronic course.

Another study was published that was a 10-year follow-up study of 76 severely ill females with anorexia nervosa. Five patients had died, which showed a mortality rate of 6.6%. Only 18 (23.7%) were fully recovered after 10-years. Sixty four per cent developed binge-eating at some time during the course of their illness, 57% at least weekly. A little over 25% of the patients studied had a good outcome as they were able to re-establish normal weight and regular menstrual cycles, even though they still were not eating normally.

They used a variety of anorexic-type behaviors to control their weight and showed significant body image disturbance.

Forty-five percent were unable to establish normal weight and menstrual cycles, nor to normalize other anorexic symptoms.

When we take a look at the research that has been done on eating disorders, we see that they might be genetic in origin and we also see how serious they truly are!

They found that 74% of the women reported that knitting lessened the intensity of their fears and thoughts and cleared their minds of eating disorder preoccupations. An equal number reported it had a calming and therapeutic effect, and 53% reported it provided satisfaction, pride and a sense of accomplishment.

Knitting was a popular activity at Mirasol adolescent treatment facility, and our clients created hundreds of yards of scarves during its four-year history. And yes, we found that knitting reduced anxiety and also helped the girls with social skill building among the patient population.

One of the byproducts of an eating disorder is preoccupation with what I’m going to eat, when I’m going to eat it, what I’m going to do with it after I eat it (and I’m not talking about doing the dishes!) .

“As long as I’m focused on all of my various, complex, ritualistic eating behaviors, the less I need to worry about anything or feel anything that might be going on in my “real” world.

Knitting is a simple, inexpensive and benign activity. Maybe that’s why it works? It not a formal “therapeutic intervention” that might alienate some anorexics. I always think it’s amazing that as soon as an anorexic is involved with an activity that has the potential to help her, she immediately puts up her guard and becomes fearful. It takes a long time for her to begin to trust that what we’re doing isn’t going to immediately “take away the eating disorder.”

I’d love to hear more ideas for simple and effective ways “anxiety reducers”!