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While these may be signs of an eating disorder, these conditions don’t always present in these ways. For instance, you may find yourself constantly consuming large quantities of food and feeling like you’re unable to stop. Many people have periods when they overeat, such as during the holidays, but if you experience a loss of control with food regularly, it may be a sign of an eating disorder called binge eating disorder.

What Is Binge Eating Disorder?

You may have heard about eating disorders like anorexia and bulimia, but, although it’s one of the most common eating disorders, binge eating disorder isn’t as frequently discussed. 

People with binge eating disorder may frequently ingest large amounts of food in a short time, and feel unable to stop eating. The loss of control is usually triggered by stress-inducing situations, and it may lead them to binge even when they aren’t hungry. These episodes are usually followed by a feeling of guilt or unhappiness afterwards.

Binge eating disorder commonly affects young people in their late teens or early 20s. Although the common view is that this eating disorder mainly affects women, men can also be affected. According to the US Department of Health and Human Services, about 1.6%of adolescents, 3.5%of adult women, and 2%of adult men are dealing with binge eating disorder. For men, it mostly occurs in midlife, between the ages of 45 to 59.

Some people who deal with binge eating disorder maintain a normal weight. But for many other people, binge eating causes rapid weight gain and can bring other associated health issues such as high blood pressure, type 2 diabetes, and heart disease. Although most people with obesity do not have binge eating disorder, over two-thirds of people dealing with this disorder do become obese. Binge eating disorder often also leads to depression, anxiety, and other mental health conditions.

What Are the Signs of Binge Eating Disorder?

Binge eating disorder was officially recognized as an eating disorder diagnosis in the DSM-5 manual in 2013. Before then, it was categorized under the non-specific “EDNOS” (Eating Disorder Not Otherwise Specified).

According to the current diagnostic criteria, you may have binge eating disorder if:

• You have recurrent and persistent episodes of binge eating
• You eat much more rapidly than normal
• You eat until you feel uncomfortably full
• You eat large amounts of food even when you don’t feel physically hungry
• You eat alone because you feel embarrassed by how much you’re eating
• You feel depressed or very guilty after overeating
• You experience marked distress regarding your eating habits

Binge eating disorder is often mistaken for bulimia nervosa, another common eating disorder. But unlike bulimia, binge eating disorder doesn’t involve regular compensatory behaviors after an episode, such as vomiting or other methods to get rid of calories or prevent weight gain. However, with binge eating disorder, you might try to control the amount of food you eat between binges.

What Causes Binge Eating Disorder?

Experts are still unsure of the exact cause of binge eating disorder, but it can generally be traced to a range of risk factors. For instance, painful or traumatic childhood experiences — such as critical comments about your weight — are associated with developing binge eating disorder. This eating disorder also runs in some families, and some experts believe that there may be a genetic link to it.

Certain psychological factors are also believed to contribute to binge eating disorder, such as increased sensitivity to dopamine (the brain chemical that’s responsible for feelings of pleasure and reward), changes in the brain structure that results in a higher response level to food, or other mental health conditions like depression, anxiety, or post-traumatic stress disorder that influence a person’s eating habits.

For many people dealing with binge eating disorder, these episodes bring a temporary feeling of comfort and calm that they become used to. Sometimes, they may plan a binge episode in anticipation of the feeling it brings. These episodes tend to bring regret in the long run, and the condition may last for years if left untreated. It’s best to seek professional help as soon as possible, if you’re experiencing any of the signs of binge eating disorder.

How Is Binge Eating Disorder Treated?

Making the decision to get treatment for binge eating disorder is the first step to recovery. Research shows that over 65%of people are successfully able to control binge eating after going through treatment.

The treatment options for binge eating disorder may target eating habits, weight gain, low self-esteem, mental health issues, or a combination of these. Your doctor may also screen you for any condition related to binge eating, such as depression or anxiety, or other health issues such as high blood pressure.

There are several therapy options for people with binge eating disorder, such as cognitive behavioral therapy (CBT) which helps you identify the causes of negative emotions relating to your eating habits or weight, and how to develop positive emotions to replace them. 

Interpersonal psychotherapy also helps those dealing with binge eating disorder by identifying the specific personal problem that led one to adopt binge eating as a coping mechanism, and make changes to these behaviors over the course of 12-16 weeks. Some types of medication such as antidepressants, can also be helpful in treating binge eating.

Weight loss therapy can also help control binge eating disorder by boosting your self-esteem and promoting a positive body image. However, it’s important to avoid worrying about your weight or going on a diet, as depriving yourself of food can often actually increase the likelihood of binge eating.

As you work on a suitable treatment plan with the help of your provider, certain strategies can also help you manage your triggers. These include practicing mindfulness, exercising, choosing healthy foods, keeping track of your food habits and your moods, and getting enough sleep. It’s also important to get support from family, friends, a partner, online therapy, or a support group with others who are also dealing with binge eating disorder, and can understand what you’re going through.

What Can I Do To Help a Loved One With Binge Eating Disorder?

A person dealing with binge eating disorder may come up with effective ways of masking the behavior, often making it difficult to detect. If you suspect that someone you know may be struggling with binge eating disorder, you can encourage them to have an open discussion about it by sharing your concerns and providing the necessary support. You can also help them reach out to a professional and go with them to therapy sessions or doctors’ appointments.

Dealing with binge eating disorder isn’t a character flaw. Overall, it’s important to promote a healthy body image, regardless of body shape or size. An eating disorder also won’t necessarily go away with mere willpower. Treatment from a licensed mental health provider can help prevent health problems, increase your self-esteem, and improve your quality of life. Talkspace online therapy is an inexpensive and convenient way to get the help you need — reach out today. 

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When Tribole and Resch shared their dissatisfaction with each other, the two realized there must be a different approach to eating: one that emphasized satiety, not restriction; intuition, not discipline; pleasure, not austerity. They created a philosophy of food that did just that, and Intuitive Eating was born. They published the first edition of their book, Intuitive Eating: An Anti-Diet Approach in 1995.

Centered around ten major principles, ranging from “honor your hunger” and “make peace with food” to “feel your fullness” and “cope with your emotions with kindness,” the philosophy advocates that we become more mindful and self-aware eaters, and that we work with, rather than against, our body’s natural craving for food.

In honor of the 25th anniversary of the first publication of Intuitive Eating, the pair have released a fully updated fourth edition of the book. The Talkspace Voice spoke to Tribole and Resch about how their “anti-diet” approach to eating can benefit our mental health, and how making peace with food and loving our bodies can help further the fights for gender and racial justice.

Talkspace:

Hi, I’m Reina Gattuso, I’m a writer for the Talkspace Voice. I’m here with the founders of Intuitive Eating to mark the 25th anniversary of their publication of their groundbreaking book. Could the two of you introduce yourself to our readers and audience?

Evelyn Tribole:

Sure. I’m Evelyn Tribole.

Elyse Resch:

And I’m Elyse Resch.

Talkspace:

Okay. So to begin with, for those of our readers who might not be familiar with the concept, what is intuitive eating?

Elyse Resch:

Well, Evelyn, you want to start with your definition, then I’ll go on.

Evelyn Tribole:

Yeah. I have many different definitions depending who we’re speaking with, but one definition, it’s a mind-body self-care eating framework, and we have over 125 studies now showing really promising benefits of intuitive eating.

Elyse Resch:

And we like to look at it as a dynamic interplay of instinct, emotion, and thought based on the triune brain, which is three parts of the brain. The instinctual part is for survival. The limited part is for emotions and social behaviors. And then the rational part of the brain, the neocortex, is for the thinking. And we put all three parts of that together so that we can tune into our internal signals or the wisdom that we’re born with.

Evelyn Tribole:

And then I’d say, underlying that mechanism is interoceptive awareness, which is our ability to perceive physical sensations that arise within the body. And that includes, you know, physical things like a full bladder, but also every emotion has a physical sensation. And so when we are connected to our body, as opposed to being at war with our body, we have really powerful ways to get our needs met if we listen.

Talkspace:

Great. So I’m going to ask the big question, is intuitive eating a diet?

Evelyn Tribole:

Absolutely not. In fact, we even have that in the subtitle now, anti-diet, and the first principle of intuitive eating is reject the diet mentality. And one of the things Elyse and I have seen over and over and over again, that when someone comes in from the lens of diet culture and dieting, there’s a tendency to turn intuitive eating into absolutes, and to diets, and to rules, but it is not. You are the boss and these are guidelines for connection.

Elyse Resch:

And what’s connected to that is that most diets are geared toward weight loss and intuitive eating is the opposite of that. It’s geared toward creating a healthy relationship with your body, tuning in, as Evelyn says, to your food and eating.

Evelyn Tribole:

And bringing the pleasure back to eating, right?

Elyse Resch:

Satisfaction is the driving force of intuitive eating. It’s actually the motivator for most people. They’re really happy to learn that they can start to enjoy food and find pleasure in eating again, which is something that’s been taken away from them by diet culture.

Talkspace:

Take me back 25 years, how did you two actually come together to create this.

Evelyn Tribole:

Well, you’ve heard of the term parallel play — you know, toddlers in the sandbox playing — and they’re there, doing the same thing, but they’re not really integrating yet. So Elyse and I were separately in private practice in the same building, in Elyse’s office. And we were working in a very traditional model that wasn’t effective and not feeling right. And we were really experiencing cognitive dissonance because we were creating these beautiful meal plans.

The short story is that we went into the research and really took a look at what the research says in terms of connecting with the body, what’s going on also in the public realm in terms of popular psychology. And we also factored in our clinical experience. So we can say, 25 years ago, this concept was research inspired. But fast forward today, we have a validated assessment scale and a lot of research showing there’s merit to this process. And that people’s lives change.

Elyse Resch:

And given that we were in the same space one day, we just started talking about our frustrations and what each of us had been working on; we found that we were right there together. And we started writing the book.

Talkspace:

Yeah. I’m just thinking 25 years ago, this was 1995.

Elyse Resch:

Published. So this was about 1993 when we started writing.

Talkspace:

During my quarantine here in New York, I went on a television binge, my favorite being Sex in the City. And I love it to death, but oh my gosh, the way that they talked about eating in that time period. What you guys started doing was really unique. Where did that dissatisfaction come from? What were those sort of cultural standards in terms of diet? What was really mainstream and where did you both get that impulse to depart from that?

Evelyn Tribole:

You know, I remember reading the Susan Faludi book Backlash, and it really, really impacted me on a feminist level, and on many other levels. I just remember thinking what Elyse and I, and now you’re witnessing, is diet backlash. In fact, a lot of people don’t know this, but that was the original title, the working title, the book, Diet Backlash. So it was partly that, and also Naomi’ Wolf’s work that when we become a slave to conformity of dumped diets and being told what to do, we’re not living our lives.

Evelyn Tribole:

And now fast forward, there’s a book that has had a big impact on me that just came out about a year ago, called Fearing the Black Body: The Racial Roots of Fatphobia showing that this body hierarchy is really rooted in racism and patriarchy and religious dogma went back to the 17th century. And so it goes back even even further. So it’s been with us all along, but it’s even more profound now. And sadly, what I’m seeing is, well, on the one hand, there are a lot more health professionals really doing this work with intuitive eating and health at every size — we’re seeing diet culture has hijacked healthcare. And now it’s like, “Oh, we have a bigger, a bigger thing that we need to do.” And that’s cracking the policy that dictates some of these mandates that put our patients in harm’s way.

Elyse Resch:

And going back to that era, I had been reading Susie Orbach’s Fat Is a Feminist Issue. And I was also reading Overcoming Overeating, by Jane R. Hirschmann. So both of those really spoke to me. I’ve been a strong feminist since back in the seventies, sixties and seventies, and, the psychology of deprivation and not being able to have what you want and telling people what they should eat, just spoke to me. That this was wrong. And that was what was leading to the dissatisfaction I was feeling in my work by, as Evelyn was saying, giving meal plans, helping people lose weight, because that’s what we had been taught in graduate school. And we’re both very humble about that. And that’s 25, 27 years ago. It wasn’t on our radar.

Evelyn Tribole:

That was such a toxic suggestion for people. And we look at intuitive eating as a social justice issue today. We see it as part of all of the oppression in the world. So promoting weight loss would be part of that. And we are anti-that.

Talkspace:

There’s so much there in what you just said. I love the point about this being a social justice issue broadly, and the connections to race. And of course, gender. I’m wondering when you were sort of first working through intuitive eating as a concept, what were some of the ways in which you were seeing diet culture affecting the people that you worked with and this emphasis on weight loss?

Evelyn Tribole:

You know, I could tell you one thing I was seeing a lot. I ended up doing a segment on it on a national news program, and it was something I call primal hunger. And that is when you’ve had this biological deprivation combined with the psychological deprivation. There’s this profound, urgent, true need to eat. And no matter who you are, how smart you are, how successful you are, it hijacks you in the moment and leaves you feeling really disconnected from your body. And also feeling less than because I have a lot of patients describing shame in terms of the kind of eating they do. And what I tell them now, it’s no different than if you hold your breath for a long time. We know if you hold your breath for a long time, when you finally breathe, it’s going to be a gasp.

Evelyn Tribole:

You’re going to inhale ginormous amounts of air and no one says, “oh my god, you’ve lost control of your breathing. You are addicted to air, you’re a binge breather.” You know, and we laugh, but we need to have that same perspective with eating. And I think that’s one of the things that really took me away, that combined with some research from Herman and Polivy on restraint theory. They talked about, in all this scientific garb, that when people have really restrained rules around eating to suppress their body weight, there’s this phenomenon where the restraint gets broken, but they called “what the hell effect.” And that’s when I became a fan of their work, “what the hell.” It’s like, yes, that’s what I hear my patients say all the time. When that happens, this all or none, there is a profound disconnection to the body.

Evelyn Tribole:

And it’s also as if I’m never ever going to eat again. And so the amounts of the food can really be quite quite high in the moment. Those are the kinds of things that really impacted me and they still do.

Elyse Resch:

And for me, everyone used the word shame. I was finding that my clients were walking around with elation when they were able to fulfill the suggestions, the food plan, lose weight. And then when they inevitably couldn’t anymore, because of course, now we know why, they walked around with shame. They blamed themselves. They said there was something wrong with themselves. And it just felt awful to see that. It was something I had never wanted to do in my work, but I got thrown into it because it was so ubiquitous. I finally just knew that I could not lead people down a path where they ultimately are feeling bad about themselves.

Elyse Resch:

So that was a big trigger toward finding a different way and understanding the psychology eating. Yeah, go ahead.

Evelyn Tribole:

I would add to that, the thing that’s so encouraging now, there weren’t very many health professionals working in this arena, but now fast forward, we’ve been training and certifying people in this process. And we now have over a thousand health professionals in over 24 countries doing this work and helping facilitate and be a witness to lives changing. And that’s what blows me away is how often I hear “my life has changed.” When you start connecting to your own truth and authenticity and trusting, because dieting is a profound trust disruptor, that needs to get healed. And every time you honor hunger, you are repairing that trust.

Evelyn Tribole:

And in time that trust crosses over to other areas in that person’s life. And it’s incredibly beautiful to be a witness of that.

Elyse Resch:

I want to say something cute. I have a 15 year old boy client who said to me, “Oh, this is kind of like a movement, isn’t it?” I said, “you are right. It is a movement. It’s all over the place.” It’s being written about, we do so many interviews and podcasts and it is a movement. It’s a movement to heal some people’s trust in themselves and their relationship with their bodies and food.

Evelyn Tribole:

It’s getting your power back, your agency back. And this idea that we hold our humanity with unconditional positive regard, regardless of the bodies that we occupy, we’re so much more than a body.

Talkspace:

First of all, I love the gen-z teen, your client. Awesome. Second of all, I’m about to tear up: this idea of holding your humanity and unconditional positive regard.

I write a lot about gender or gender-based violence for the site. I write a lot about consent and boundaries and how, when you’ve experienced abuse, or even just the routine abuse of living as women, feminine people, queer people, people of color in our society, we get so alienated from those really natural body signals, right? “I’m uncomfortable. I don’t want this, or even I do want this.” And it sounds like there are so many parallels between eating and that sort of cycle of restraint, and not being in tune with what we’re actually desiring and with other aspects of bodily autonomy, like sexuality. It’s so striking.

Elyse Resch:

Yes, and it’s really an issue of boundaries as well. Nobody has the right to cross our boundaries, our inner wisdom and tell us what we should eat, when we should eat, how much we should eat. And we help our clients learn how to speak up. And, in fact, intuitive eaters have less self-silencing, that’s been shown in studies. So they do speak up for their needs and their boundaries. It’s a big part of it.

Evelyn Tribole:

And related to that, there’s this term that I love that was created by Sonalee Rashatwar, she’s known as The Fat Sex Therapist on Instagram, and she calls it nonconsensual dieting. And that’s when children are put on diets early in their life, when they have no concept of this. And when I’m working with adults, who’ve been put on diets, this message of “you can’t be trusted with your appetite.” So your body can’t be trusted, goes way, way back, and there’s more healing to be done.

And I say this not to shame the parents of the patient, because many times the healthcare practice nurse practitioners are the ones urging them to do this, but there’s an impact and there’s harm with this, which is why I get really concerned with a lot of these public policy health campaigns that are shaming the bodies of children. Shaming anyone’s body is wrong. But especially with children, you don’t even have this agency, you talk about a boundary violation. That is a boundary violation. That’s a really early age for something like that. That’s become somewhat normative in our culture. Unfortunately.

Elyse Resch:

What I’m really excited about is that I’m right now involved in reviewing a book from a couple of our colleagues, How to Raise an Intuitive Eater, and they’re addressing all of these issues and it needs to be out there. Evelyn and I have been very busy in other ways, so we haven’t written it, but I’m so grateful they are. And they’re intuitive eating certified, intuitive eating counselors, and right on with our philosophy.

Evelyn Tribole:

Well, and that’s kind of an exciting thing to see also is the burgeoning of our work, other books are coming out and building on or adding in another voice. I think that’s actually really exciting to be seeing this because we really need to change the culture so that we can thrive and flourish and engage in activities that are meaningful to whatever they are for you. If you’re stuck worrying and thinking about your body and your eating, that’s not living, you’re being pulled away from your present moment. And you’re not, you’re not flourishing.

Elyse Resch:

We are changing the world, Reina. We are, we’ve had a big impact. And part of my spiritual path is to try to, every day, do something that changes the world in a positive way. And we’re doing it, I believe.

Evelyn Tribole:

We’ve got a long way to go though. Now, when we start looking at all the realms of social justice issues, we have so far to go.

Elyse Resch:

Yes, Evelyn, but it has to start somewhere. We have to, I think be so grateful that many people are hearing our message and our healing as a result.

Talkspace:

I want to back up for a second, you folks have a couple of core principles of what intuitive eating is, right? Could you share those with us?

Elyse Resch:

Well, there are 10. We don’t have time to go through them all. The core, core issue is rejecting diet mentality. You have to start there because if you still have the idea of going on another diet after “I’ll give intuitive eating a try,” it’s not ever going to be something that you can embrace. And then, as I mentioned earlier, satisfaction is a key core principle of intuitive eating. As is honoring your hunger and your fullness and making peace with all foods. Evelyn, you want to take the rest of them?

Evelyn Tribole:

I actually want to build on something that you said and then I’ll take on the rest of them. Aiming For satisfaction, as we’ve described, is the hub of intuitive eating. And I find that if you’re looking for an action point: Where can I start? Where can I guide my clients, when you ask someone, “what would a satisfying meal be like to you?” It’s a very personal question. And sadly, I’ve had a lot of patients really not know because they have abdicated their eating decisions to some kind of diet plan. So it’s a way to get curious and also down a path towards pleasurable connection, because ultimately it’s not satisfying to under eat. Ultimately it’s not satisfying to eat past fullness to a point where you’re not feeling well.

Evelyn Tribole:

So where is that sweet spot? And in order to answer that question, we need to go inside. We need to connect with what’s going on with you, not going to external measures. And sometimes I describe this to my patients. It sounds ridiculous, but it helps I’m going to share it. I can’t get over how often people are comparing their eating to someone else’s eating. And I’ll say, “you know, do you do that? When you go to the bathroom, do you compare how much you pee to someone else? Do you think you should pee more because they pee more.” They’re like, “of course not.” I go, well,” it’s the same kind of idea.” And I wish we had that revulsion about the idea of comparing our or even commenting on other people’s foods and bodies.

Evelyn Tribole:

It’s not that I want the revulsion, but not, but for it not for it to be normative, you know? So it’s, it’s taking back our power. And so respecting your body is also a very key principle. And this is moving beyond the objectification that we are human beings and just that alone, we should have dignity and respect for all living beings. Then looking at joyful movement, looking at coping with your feelings with kindness and our 10th and last principle, which is ironic cause Elyse and I are both dietician-nutritionists is on your health with gentle nutrition. And I didn’t realize when we originally came up with that, with that principle, how prescient it would be because it has become such an evangelical issue in terms of nutrition and eating identity.

Evelyn Tribole:

And it’s like, let’s pause for a moment and see if we’re even ready for going down this path. Let’s make sure you’re at least mostly healed your relationship with food, mind, and body. And then we can, we can look at this. So sometimes people have the misunderstanding that intuitive eating has nothing to do with health when actually it takes a broader vision of what health is — because health includes our mental health, as well as our physical health, psychosocial health. So we’ve got these 10 principles, but the thing I like to stress — they’re not rules. You can start in any order, whatever makes sense to you. And they’re interdynamic, so you can’t just cherry pick and say, “Oh, this one principle defines intuitive eating.” Some people have said, for example, “Oh, it’s just eat when you’re hungry, stop when you’re full.” It’s like, Oh no, no, no, no. It’s so much more nuanced than that. There’s a lot of grays in here.

Talkspace:

One thing I feel like I wonder about when it comes to people being reacquainted with their own bodily needs and desires and satisfaction is this fear of “if I stop restricting, if I start actually eating what I want to eat, will I ever be able to stop?” I feel like that’s so tied to what you all said earlier, gender and race, and this idea that certain people in our society, including fat people, are just endlessly glutinous, or we have no discipline. We have no limits, and so much of that is tied to this idea of “if I really start listening to myself, Who am I, what is that? That’s scary.”

Elyse Resch:

And I think that is actually the biggest fear that I hear from people. And so helping them understand the psychology of taking away the forbiddenness of something, leads them to feel more comfortable with it. They can have it whenever they want it. This is called habituation. The more you have of something, the less the charge of it. So the greater, the stimulus, the less, the response. We’re helping people understand that when you fully and truly make peace with all foods, so that your emotional reaction to what you eat is equivalent, regardless of the food, then habituation can take place.

I said something earlier about making sure that you’re not going to go on another diet because, if habituation doesn’t take place, you’ll then still have some internal fear of future deprivation. So when I help people understand the psychology of this, and there’s a lot of psychology in intuitive eating, it calms them down some. And it’s so interesting how prevalent it is, that they say, “you know, you’re probably right. I could just never have ice cream in my house because I would eat all of it. And I’ve got four flavors in the freezer and when I want it, I have it.” And that’s just an example of what I’m being told on a regular basis. So that’s how you respond when someone is so afraid that they’ll never stop eating.

Evelyn Tribole:

And what I would say to that, a couple of things. One, it’s a real common response. It’s an understandable response. And what I find, it’s usually in direct proportion to the amount of deprivation the person’s had in their lifetime, the more that they’ve dieted, they can’t even imagine this because then you really don’t habituate. Someone who’s chronically dieting or going on food plans, they’re constantly having rules to rein them in. And then, when they can’t stand the rules, they have all this false evidence. “Oh my God, I can’t control myself with eating.” And what ends up happening is food stays exciting and scary. So that emotional ability stays there.

But with this habituation, it’s the urgency and the excitement that stays. If it’s a food that you normally loved, you’re still going to like it, but it’s not this, “Oh man. I’m never going to get to eat this.” It’s a profound thing. When you have permission to eat. It’s a paradox that happens. Because you finally get to ask, for the first time: Do I really want this food? If I eat this food right now, am I going to enjoy it? And, as I’m eating it, do I like how it feels in my body?

I have a significant number of patients who have discovered, “Oh, I don’t really like this.” I’d like to see a study on this because I see it happening a significant amount of the time and they don’t understand, but when there’s guilt happening or shame happening with the eating, there’s not this pure direct experience of the impact of the eating. And so we remove all this excitement, remove the judgment and they get to decide: Do I like this? Does it taste good? Do I like how I feel? Will I choose to do this again? And there’s no wrong answer.

Elyse Resch:

It doesn’t take anything away however, the excitement of enjoying food. Trying a new restaurant and tasting new foods and delight. Life is sitting with people that you love and enjoying food. So it’s the forbidden excitement that is diminished. The idea that I can have it now, but I won’t have it. I haven’t had it and I won’t have it again. But there’s still a joy and some excitement that can be attached to eating.

Evelyn Tribole:

Absolutely. That’s a good point. It’s absolutely true.

Talkspace:

So we’re almost out of time. I think the last question we’ll do a little round-robin style. So in the 25 years since you have published this first book, what is some change that is really positive in the way that our society views food and eating and our bodies? And one thing that you feel like we still really have some ways to go on.

Elyse Resch:

I’ll take the second part. I think that the culturally thin ideal as it’s called still needs to change. I have a new client who has a severity disorder and she said, “but everybody, all the guys I date all like me thin. All my friends.” It’s just so prevalent, this idea that you have to be a certain size and shape to be acceptable.

And on the other side of the fence is that there’s such an openness to intuitive eating now. People are so eager to learn about it. So they both kind of coexist for me.

Evelyn Tribole:

I completely agree with that. You know, as Elyse was saying earlier, intuitive eating has morphed into a bonafide movement, which I find encouraging. And I think one of the complexities as we the movement has gained steam is recognizing the intersectionality of oppression in the social justice realm, in terms of people in marginalized bodies, whether it’s gender based, race based, or whatever it happens to be, that this is where we need to combine our resources. And when we can help with the liberation of all bodies, we all benefit, we’re all free. And I find that incredibly, incredibly helpful.

Talkspace:

Well, I have chills now. Thank you so much. And you, have a new 25 year anniversary edition of the book out, too, right? So our listeners can learn more.

Elyse Resch:

It’s the fourth edition. It does celebrate the 25th anniversary. We have more things coming out too, actually. We have an intuitive eating workbook. That’s a couple of years old. There’s an intuitive eating workbook for teens that came out last year. Next year, there’s an intuitive eating journal book and a deck of cards. And Evelyn, you have a book coming out as well.

Evelyn Tribole:

I do. Intuitive Eating for Every Day. And I think for the professionals listening, they might be interested in getting ad certified, we have a whole certification pathway towards that, and you can just check out our website, www.intuitiveeating.org, because that’s how we want to change the world. When we train others, they help in this process, you know?

Talkspace:

Yeah. Well, thank you both so much. This was truly a delight. And again, I’m Reina Gattuso, here with the founders of Intuitive Eating, and we’re going to sign off. Thanks.

Evelyn Tribole:

Alright. Thank you so much for having us.

The post Intuitive Eating: Interview with Evelyn Tribole and Elyse Resch appeared first on Talkspace.

Eating Disorders Do Not Discriminate

The documentary highlights the trajectory of her career from her preteen years as a singer-songwriter and follows her through August 2019. Through old footage along with current interviews, viewers see Swift’s hard work, personal beliefs, struggles, and growth as an adult within a very unique bubble. In watching the film myself, I was particularly struck by her comments about her beliefs. She said from a very young age, she held the belief that it was important for her to “do the right thing” and “be a good girl” and that she was “trained to be happy when you get a lot of praise.” The combination of these beliefs along with her work in an industry that is hyper-focused on appearance, success, and surpassing your previous projects, created circumstances in which an eating disorder can develop.

Eating disorders do not discriminate — no one is immune — money and fame do not protect someone from struggling with an eating disorder, depression, anxiety, or any mental illness. In fact, being in the public eye and facing constant scrutiny creates a unique experience of stress. Facing judgement for everything you do, say, wear, or who you are — especially from a young age — is a large contributing factor of stress.

Fame’s unique impact on mental health

Unfortunately, people in the public eye who seemingly “have it all” may have confusing feelings about being depressed, anxious, or struggling with a mental health concern. The confusion exists because if they “have it all” how can they possibly feel sad or anxious? It can be perceived by others that they can’t possibly struggle, because they have money, fame, and success. But as mentioned, eating disorders — among various mental health conditions — don’t discriminate.

Oftentimes, the outside trappings of the “good life” can get in the way of accessing the help one needs. Fortunately, with increased awareness and more people in the public eye speaking out, the de-stigmatization of mental illness is possible. With people like Taylor Swift speaking out about her eating disorder and struggling with the impact of negative feedback, an increase in awareness is possible, likely increasing the number of people reaching out for help.

Warning Signs of an Eating Disorder

While we can’t necessarily protect our favorite celebrities from mental illness, we can help those around us. Being well educated about mental health and knowing warning signs, is the best way to make an impact. While signs and symptoms of many illnesses can be found on the Talkspace blog, let’s explore the signs and symptoms of an eating disorder.

There are common warning signs and symptoms to look out for with eating disorders, these signs can be emotional, behavioral, and physical.

Emotional and behavioral signs

• Attitudes that indicate that weight loss, dieting, and control of food
• Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
• Appears uncomfortable eating around others
• Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
• Skipping meals or taking small portions of food at regular meals
• Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
• Withdrawal from usual friends and activities
• Frequent dieting
• Extreme concern with body size and shape
• Frequent checking in the mirror for perceived flaws in appearance
• Extreme mood swings

Physical signs

• Noticeable fluctuations in weight, both up and down
• Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
• Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
• Difficulties concentrating
• Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)
• Dizziness, especially upon standing
• Fainting/syncope
• Feeling cold all the time
• Sleep problems
• Cuts and calluses across the top of finger joints (a result of inducing vomiting)
• Dental problems, such as enamel erosion, cavities, and tooth sensitivity
• Dry skin and hair, and brittle nails
• Swelling around area of salivary glands
• Fine hair on body (lanugo)
• Cavities, or discoloration of teeth, from vomiting
• Muscle weakness
• Yellow skin (in context of eating large amounts of carrots)
• Cold, mottled hands and feet or swelling of feet
• Poor wound healing
• Impaired immune functioning

Keep in mind, only a professional can diagnose an eating disorder, but watching for the early warning signs will assist your loved one in seeking professional help. For further information on eating disorders, check out these resources:

• NEDA: National Eating Disorder Association (Helpline: 800-931-2237)
• Eating Disorder Referral and Information Center
• National Association of Anorexia Nervosa and Associated Disorders
• Academy for Eating Disorders

The post Speaking Out On Eating Disorders: Taylor Swift Propels the Conversation Forward appeared first on Talkspace.

Body positivity is getting more attention in the media these days, and that’s a good thing. Despite this, it’s still not uncommon for a negative body image to impact our lives at one time or another. In general, that’s okay. It’s normal to occasionally fixate on a stubborn zit, a bald spot, or a roll of belly fat.

However, this can become a problem when we start obsessing over a feature we dislike, making it a bigger issue in our mind than it might actually be in reality. Those who experience this fixation, or obsession, may be dealing with what’s known as body dysmorphic disorder (BDD). BDD is also often linked with eating disorders. If you think you may be suffering from it, knowing how to deal with body dysmorphia (another name for BDD) means you’ll be able to recognize what this disorder really is, how it can affect your life, and how you can deal with it to begin healing.   

What is Body Dysmorphia? 

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), body dysmorphic disorder involves a “preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.” 

About one in 50 people are affected with body dysmorphic disorder, and it occurs at roughly the same rate in both men and women. Body dysmorphia is classified under the same categorization of disorders as obsessive compulsive disorder (OCD), based on the criteria that, like OCD, those with body dysmorphia often perform repetitive behaviors like “checking” their body, either in the mirror or with their hands. It’s common to obsessively poke, pick, or squeeze the perceived “problem” area. Those with body dysmorphia often expend a lot of mental energy thinking about the part (or parts) of their body they see as defective. Those who are affected with BDD can sometimes also suffer from gender dysphoria. Though these two are sometimes confused with each other, there is a big difference between dysphoria vs dysmorphia. 

Common body dysmorphia symptoms can include:

• An incredibly strong belief you have a physical defect
• Being preoccupied with that perceived defect (despite it largely being seen as minor or nonexistent to others)
• Avoiding social interaction
• Partaking in repetitive behaviors to try and hide, or fix, the perceived flaw
• Seeking out near-constant reassurance from others
• Believing that others are mocking you for your flaw
• Acting from perfectionist tendencies
• Checking the mirror repeatedly
• Picking at the skin
• Obtaining medical cosmetic procedures, typically with little to no satisfaction
• Trying to hide flaws with makeup or clothing 

How Body Dysmorphia Affects Your Life 

Body dysmorphia can affect many facets of life. It can become a guiding factor in virtually every situation you face, from school, to work, to home life, and more. Aside from the fact that it’s a mental health disorder that can be completely exhausting, body dysmorphia symptoms can also cause clinically significant distress (not just mental distress), resulting in extreme anxiety in several areas of life. 

• • Social Impact: Those who haven’t yet figured out how to deal with body dysmorphia may struggle with a tendency to isolate themselves out of fear or shame. They might worry about others seeing the flaws they’re trying so hard to hide. This can lead to avoidance of social situations and low-self esteem, both of which can have a negative impact on relationships and often resulting in what’s known as a social anxiety disorder.  
• • Professional Impact: Studies have shown that beautiful people tend to be paid more at work, are better liked, and are often more successful. But beauty isn’t just what other people see – it’s also what you see and how you feel about yourself. Those with confidence are generally more successful at work. So it makes sense that some people with body dysmorphia, who are preoccupied with their body “defect,” have less mental capacity to focus and excel on their work tasks.

• • Physical Impact: Though body dysmorphia is not a physical disorder, many people experience physical symptoms. According to the Anxiety and Depression Association of America, it’s common for those with body dysmorphia to engage in skin picking, excessive grooming, and over-exercising, all in an attempt to “fix” their flaws. This can lead to hair loss, abrasions, and other serious side effects. Body dysmorphia can also result in such an extremely negative body image that it leads to eating disorders, which can be incredibly dangerous for physical health.

• • Financial Impact: Spending money on (typically unnecessary) clothing, cosmetics, diet foods, plastic surgery, or drugs and alcohol to self-medicate can affect financial situations. Rather than investing in seeing a therapist, who can challenge perceptions about a negative body image, many are willing to spend exorbitant amounts trying to “fix it” on their own.  

• • Emotional Impact: According to the International OCD Foundation, those with body dysmorphia are more likely to attempt suicide or have suicidal thoughts. They’re also more likely to suffer from depression, social anxiety, and a decline in self-esteem. The feeling of being trapped in a body we dislike can be deeply linked to the actual thoughts we have about our bodies. Many people find that cognitive behavioral therapy (CBT) can be tremendously helpful in easing the symptoms of body dysmorphic disorder.

All of these factors contribute to a reduced quality of life that you don’t have to live with. The best thing you can do if you’re struggling with body dysmorphic disorder is to talk to someone you trust. This can be a family member, a friend, a partner, or a therapist. With help, you can eventually see yourself as the beautiful person everyone else sees.

How to Deal with Body Dysmorphia 

If you’re wondering what is body dysmorphia, or if you think you may be experiencing it and want help, it’s important to know that you’re not alone. Online therapy and specialized teen therapy options can connect you with a therapist who understands what you’re going through. This easily accessible format means therapy can be available to you when you need it, how you need it, and where you need it. If you feel that a more traditional format of therapy might  work better for you and your personality, you can always seek out a therapist who offers in-person appointments, too. 

Therapy and Medication: There are several types of therapy that can be beneficial in treating body dysmorphia. Some therapists suggest a combination of talk therapy – like cognitive behavioral therapy (CBT) – and medication. Medications that have proven effective are in a category known as serotonin reuptake inhibitors (SRIs) or selective serotonin reuptake inhibitors (SSRIs). SRIs/SSRIs are antidepressants that can help treat body dysmorphia symptoms like compulsive behaviors and obsessive thoughts. 

Self-Help Tips: There are also a number of self-help tactics you can use to begin healing from body dysmorphia too. Either on your own or in combination with therapy and medication, you may want to try: 

• Journaling
• Practicing yoga or other physical activities
• Eating healthy
• Finding support groups
• Meditating
• Focusing on stress management 
• Working towards identified goals
• Avoiding isolation
• Creating (and sticking to) a sleep schedule
• Staying hydrated
• Seeking support from family and peers

Anything that helps you feel healthy and strong can be a positive way for you to move forward on a path to life without body dysmorphia.

The post How to Cope with Body Dysmorphia appeared first on Talkspace.

Societal norms have been born out of “diet culture,” a $60 billion dollar industry that continues to convince society that the “perfect body” is the key to being likable and successful. Diet culture continues to reinforce the irrational belief that your value as a person is determined by the shape of your body.

Body-positive messaging, however, struggles to overcome these harmful norms and encourage a positive body image.

What is Body Image?

Body image is how you perceive your own body and what it looks like. It includes what you believe about what you look like, including assumptions, generalizations, and emotional feelings. Body image also includes how you feel about your body shape, height, weight, how you move, and more. All of these aspects of body image can be affected by society and the messaging put out about how people should feel and view their bodies. Having a healthy body image where we’re not too negative about ourselves is important to our mental health!

What is Negative Body Messaging?

As a therapist, I specialize in those struggling with eating disorders, poor body image, or both. I am all too familiar with the negative body messages people, and especially women, hear day in and day out. “You’re fat,” “You ate too much today,” “You need to lose those last 10 lbs,” and “I am never going to be good enough,” might sound all too familiar.

Although it may seem easy to spot negative body image, there are some signs to help tell if you or someone else is struggling with body image issues. Some signs of negative body image include obsessively looking at yourself in the mirror, making negative comments about your own body or comparing yourself with others, frequent feelings of envy for others’ appearances or body type, and generally feeling like your body isn’t good enough.

Your self-esteem and belief that you are worth more than your physical appearance can be harmed by these body-shaming messages. Finding peace and a positive body image can feel impossible while being surrounded by these messages or being plagued by these thoughts yourself. Unfortunately, this negativity is reinforced multiple times a day through magazines in the checkout line, social media, daily conversation, and beyond.

What is Body Positivity and How Do You Work Toward it?

Body positivity goes beyond what your body looks like physically. This positivity comes from several different factors, including:

• Believing in yourself — when you believe in yourself, you might not need the constant reassurance to validate your decision-making. You own a sense of confidence that no one can take away from you.
• Trusting your body — when you trust your body, you trust that taking care of your body means it’s going to take care of you.
• Feeling proud of what you accomplish each day — this may sound silly, but feeling proud of yourself is leads to feeling positive about your body. When you feel proud you feel accomplished, strong, and believe in yourself.
• Having a happy and balanced relationship with food and exercise — when you don’t feel like you have to control what you are (or aren’t) eating, and you don’t hold the belief you have to stick to a workout schedule no matter what, a balanced relationship with food and exercise is much easier.

Tips for Creating Body Positivity

Now that we’ve established what body positivity is, here are some tips for creating body positivity in your day-to-day life:

Replacing negative thoughts

Although it can be difficult to replace negative thoughts, being mindful and aware of those thoughts can help make a habit of challenging them. For example, reminding yourself of things like: “I am going to do my best today and that’s enough,” “It’s ok to skip the gym tonight if I’m too tired,” and “I don’t have to order the salad, I can order what I am feeling hungry for,” can help diminish negative thoughts about your body.

Letting go of the ‘shoulds’

Pay attention to how often you are saying “should” and “shouldn’t” to yourself. “Should” statements are full of judgment, potentially setting you up to feel like you are not good enough or have failed at something. “Shouldn’t” statements can keep you from doing what is best for yourself physically and mentally.

Permission to feel proud

Practice allowing yourself to fully feel proud about something you accomplished and own it. This remains true for accomplishments of any size, like just getting through a tough day.

Practicing gratitude

Find something each day to express gratitude for. Research has found that being grateful and practicing gratitude increases your overall well-being. It decreases the chance of depression, anxiety, and substance abuse. Gratitude can increase your satisfaction with life and allow you to experience an increase in happiness. Practicing gratitude can influence how positively you feel about yourself.

Although we started off talking about “bathing suit season” and the impact of societal messages, body positivity is an important practice throughout the year. Recognizing how society continues to impact how we feel about ourselves and being aware of negative thoughts is a huge step forward toward finding peace.

Body positivity is about loving and appreciating yourself everyday. It means talking kindly to yourself, listening to what your body is telling you, and fully believing in yourself. Doing this year round can help you feel happier and more positive in every season. It’s about simply being comfortable being YOU. And remember, there’s no wrong way to have a body. 

Body positivity can be hard to develop, though, if you’ve been struggling with body image issues. Finding a therapist who specializes in body image issues or eating disorders can help you develop strategies to think more kindly about yourself and be more body positive.

The post Body Positivity is More Than Just Appearance appeared first on Talkspace.

Unfortunately, research suggests that feeling not so great about the way you look or a negative body image can have a big impact on our mental health — it can even lead to eating disorders. It’s hard for all of us to figure out what’s normal and what’s not, but especially during these years when we’re changing so rapidly. Maybe even more importantly, what can you do about poor body image?

What Affects Body Image?

Everyone has things about their bodies they’d like to change, but we’re usually too hard on ourselves. We want to fit in and be “normal,” attractive to ourselves and others.

People with a persistently negative body image often misread, or distort, their features in a way that other people don’t see. In other words, you don’t see yourself realistically compared to how other people see you. What you see in the mirror might not correspond with what’s actually there.

Distortions are a common problem with body image, and we tend to judge ourselves unfairly based on many things. Consider the following issues that influence how you think about your body image:

Cultural expectations

“Ideal” body type varies considerably depending on background. Some cultures value thin people, for example, while others favor a fuller figure.

Peer differences

If you feel you look different from most of the people you hang out with or go to school with, your body image might suffer.

Overall self-image

People who tend to have a general negative opinion of themselves, who suffer from low self-esteem in many other areas, may also feel unattractive or uncomfortable in their bodies.

Gender

Gender expectations pose challenges. Whereas girls are often expected to be thin and lithe, boys are expected to be muscular and strong. Society’s distorted expectations for your gender can cause body image worries.

How Does Body Image Relate to Eating Disorders?

If you’re not happy with something specific about how you look, naturally you might try to change things. You may buy new clothes or color your hair, perhaps add some new accessories to your look. If you’re not happy with overall appearance, however, you might try changing through diet and exercise.

Because body image concerns can reflect distortions in your thinking — say, you might think you look overweight when you’re actually within a healthy range for your height — then sometimes the changes you’d like to make also might not actually be healthy.

When your body image isn’t based in reality, you’re at risk for using extreme measures to take control. What starts as a simple diet or a plan to hit the gym a couple of times a week can develop into obsessive eating restrictions or extreme exercise.

As your body image gets less realistic, so do your thoughts about diet and exercise. People who suffer from eating disorders often view extreme eating or exercise habits as “normal,” because their view of themselves has gotten skewed. It’s as if they’re looking at themselves in a fun-house mirror, but they believe the warped unrealistic image they see. It doesn’t help that our culture is so focused on appearance and provides so many negative messages through TV and the media.

Keys to Positive Body Image

Good body image is key to good health, so don’t let inaccurate assumptions about yourself and your body lead you down a path toward an eating disorder. Consider these tips to feel better about your body.

Keep it realistic.

Be aware we’re prone to seeing our bodies a bit inaccurately. It can be hard to get an objective view from friends or family. But, if your doctor says you’re healthy, then you might have a self-esteem problem, rather than a body problem.

Focus on healthy, not artificial

Remember, advertising images and celebrities’ perfect selfies are often exaggerated, edited, or enhanced. Find legitimate ways to be healthy instead of striving to meet artificial standards.

Practice positive self-statements

If you’re constantly criticizing your body, in time you’ll believe those messages. Find things you like about yourself and think about those often. Practicing the positive will improve your confidence.

Find some support

Friends and family can be great supports, but sometimes they have their own unrealistic body image standards. If you consistently feel worse about your body rather than better when talking to them, consider talking to a trained and licenced therapist instead.

The majority of teens who struggle to feel good in their bodies will not develop eating disorders, but we know that most people who develop eating disorders struggle with distorted, negative body image. We also know that teens are particularly vulnerable to eating disorders. Developing a positive body image during this time of physical change can really protect you from a difficult road — so don’t be afraid to reach out for help from a professional if you have any questions.

The post What Every Teen Should Know About Body Image and Eating Disorders appeared first on Talkspace.

In middle school, one of my best friends stopped eating. Though she was a notoriously picky eater, suddenly her penchant for munching on trail mix for every meal became less quirky and more concerning as the ziplock baggies of nuts grew smaller and smaller.

Exacerbating the issue, she competed in an image-based performance sport, in which size and appearance were paramount. One day, we were sitting in my living watching the movie Center Stage for the millionth time, when we reached a scene in which an aspiring ballerina battling bulimia throws up a meal in a bathroom stall. I tensed up, wanting to pause the movie and say something, anything, but I didn’t know how.

Therapy as Preventative Measure for Eating Disorders

With time, I found a way to help her (more on that below), but to this day I still wish I had acted sooner. My 13-year-old self hadn’t been equipped with the knowledge I now have about the many benefits of therapy.

I have been fortunate to have never struggled with an eating disorder, but like many other women I’m not impervious to difficulties involving body image. At times, this has manifested itself into unhealthy or disordered eating patterns. From dabbling in the occasional fad diet and extreme calorie counting, to bouts of restrictive eating, my relationship with food has been fraught.

When I first started going to therapy for depression and anxiety, I discovered it helped alleviate long-held negative thought patterns connected to my body and self esteem. Therapy has helped me confront issues that, left unchecked, could have the potential to materialize into more serious conditions.

It also helped me feel less alone. Eating disorders, as with many other mental illnesses, can be incredibly isolating. According to Talkspace therapist Jill Daino, LCSW-R and director at The Center For The Study of Anorexia and Bulimia, it is this sense of isolation that often prevents people from getting help in the first place.

“Many patients feel like they’re odd and the only one struggling in their particular way,” Daino said. “This sense of isolation increases their shame around their disorder and makes it even harder to initially seek help. It takes great strength to ask for help and is an amazing first step in healing.”

Therapy’s Role in Eating Disorder Recovery

In the United States, 30 million people suffer from an eating disorder, a condition that has the highest mortality rate of any mental illness. Eating disorders take many forms — including anorexia, bulimia, binge eating, and restrictive food intake disorder — and span across gender, age, race, and body size.

According to Daino, while treatment is typically a multi-step process, talk therapy is an instrumental first step to seeking help for an eating disorder.

“Oftentimes patients enter talk therapy not ready to address their eating disorder. Being able to safely explore and discuss concerns with a knowledgeable therapist, who also keeps their medical safety at the forefront, is crucial at all stages of treatment,” she said.

A good therapist can also assist a patient in finding additional resources they may need — including medical doctors, nutritionists, treatment centers, and psychiatrists in cases where medication for binge eating may be beneficial. 

“A common example of how talk therapy integrates with the treatment team is when the patient is working with a nutritionist on a meal plan and the patient is really struggling with the food choices,” Daino said. “The nutritionist can focus on the food and the patient can have the time and safe space with the therapist to explore all the concerns that are coming up around the meal plan and expectations.”

Helping a Loved One Seek Therapy for an ED

When it comes to helping a friend or loved one seek therapy for an eating disorder, Daino said the key is to be sensitive and compassionate, but also not to delay.

“It is important to remember that eating disorders can have very serious — and at times life threatening — medical consequences, so you should not hesitate to speak up if you are worried,” she said. “Keep it simple and express that you are concerned about a possible eating disorder and have noticed changes or that she seems more stressed, worried, and/or depressed.”

In the case of my friend, a few weeks after I almost confronted her while watching Center Stage, I finally gathered the courage to sit her down to express my concern and encourage her to get help. It was an incredibly challenging conversation, filled with tears and heartache, but it served as the catalyst to helping her get the treatment she needed.

Daino said not to get discouraged if the person becomes visibly frustrated of they refuse to admit there’s a problem. She added that it’s important to recognize you don’t have all the answers, and to explain the importance of working with a therapist trained in treating eating disorders and body image.

“An example of what to say could be ‘I want you to know how much I care about you and our friendship, and you can talk to me about anything. I also think it would be important to talk with a therapist who knows about these complicated topics,’” Daino said.

How Therapy Helps Long Term Recovery

Daino emphasized the importance of ongoing talk therapy appointments to stave off negative thought patterns, and avoid returning to old behaviors.

“Just as talk therapy is vital at the outset and throughout eating disorder treatment it certainly has a crucial role in maintaining recovery,” she said. “It continues to provide a safe space for the patient to explore and consolidate her new skills and get support around challenges as they arise. Many patients describe that the eating disorder symptoms go away long before the eating disorder mindset does, so to have talk therapy over time strengthens long term recovery.”

Similar to most mental illness, there’s no magic cure for an eating disorder. Even after a patient has made visible strides toward recovery, there is still a long road ahead to maintain the progress made during treatment and prevent relapse.

The post How Therapy Helps With Eating Disorders appeared first on Talkspace.

If you’re familiar with EDs, you know they can result in chaotic outcomes for the individual: drastic weight loss, binge eating, or obsessive exercising are just a few possibilities. What you might not know is this chaos often has a very different starting place — control.

Illusions of Control

We usually think of control as a good thing. When our lives are “under control,” everything is ok, right? Our habits, goals, and accomplishments drive our sense of who we are. Unfortunately, trying for too much control can have the opposite effect, wreaking havoc instead of bringing peace.

Unhealthy controlling habits often come from childhood experiences with caregivers. Research suggests controlling parenting styles are more strongly associated with EDs. When children believe their parents only love them for achievements such as grades, or external factors such as appearance, they learn that they themselves aren’t valuable as people. Only outward factors matter.

Not only do overly controlling parents make children question their self-worth, they dominate kids with rigid rules. They discourage the independent thinking and self-reliance kids need to manage life’s challenges.

As a result, kids in these situations often lack coping skills, which can make them anxious or depressed. They rely instead on rigid control over things such as grades, sports achievements, or even diet and exercise, to feel competent or loveable.

We all need goals and routines, but when control leads to perfectionism, worry, and self-doubt, the risk for eating disorders rises. In fact, studies have shown perfectionism is not only associated with higher risk for EDs, but it also makes EDs harder to treat.

Underlying Chaos

Unfortunately, with EDs, the harder people try to control their lives, the more things fall apart. The following factors add to this brewing storm.

Rumination

Thinking about negative things over and over, or obsessing over certain ideas is common for those suffering from EDs. Those thoughts often revolve around low self-worth and failure. It’s hard to contain this type of thinking, which grows more scattered and disruptive as the illness progresses.

Eating and exercise behaviors

Rituals around food or exercise become more rigid as the person adopts unrealistic, unattainable standards. Trying harder to control exercise and eating, they find it difficult to eat any meal without elaborate planning. Similarly, excessive exercise takes time away from other activities, so important tasks fall by the wayside. Life gets so out of balance that chaos sets in.

Self-esteem/perfectionism cycling

Low self-esteem leads to perfectionism, which, of course, dooms us to fail. The ruminating mind magnifies those failures, further damaging self-esteem. It becomes a cycle: self-esteem plummets, perfectionism takes over. Behaviors and emotions become unmanageable. Food and exercise choices grow more rigid and obsessive, making it harder for the person to see their choices realistically.

Reigning in the Chaos of Eating Disorders

Eating disorders are serious medical conditions; people with EDs need professional help tailored to their individual circumstances, especially physical health. Still, research suggests several strategies that might be helpful when working with professionals.

Reduce rumination and perfectionism

Understanding the link between these two symptoms can make people more aware of these habits. One study says therapy targeting perfectionistic tendencies directly may provide additional help.

Increase self-esteem to prevent perfectionism

Another study suggests that building self-acceptance and reducing approval-seeking could reduce perfectionistic behaviors, which may be hard to let go of when people don’t feel good about themselves.

Improve ability to regulate emotions

Some research indicates that difficulty coping with strong feelings can be a risk factor for ED, especially when paired with perfectionistic tendencies. Learning to deal effectively with difficult emotions may reduce ED risk.

Treat perfectionism early in children and teens

Perfectionism often starts young and poses a risk for EDs later in life. Individuals with perfectionistic tendencies may benefit from learning ways to keep such habits from taking over.

Understand the role of controlling family

Just like many other studies before, a 2016 study found parenting style has a clear impact on ED risk. If you are a parent who struggles with controlling behaviors, or if you grew up in a controlling home, getting help for these problems could reduce that risk.

Therapy Can Help With Eating Disorders

While EDs are complicated problems with many contributing factors, it’s easy to see how the concept of control actually facilitates chaos for sufferers and their loved ones.

If you think you have ED symptoms, consider contacting a therapist experienced in treating EDs. The therapist will need to work closely with your physician to treat the complex physical outcomes of EDs as you work on your mental health. With good treatment, peace is possible.

The post Understanding Eating Disorders: From Control to Dysfunction appeared first on Talkspace.

“As a plus-size black woman, summer time always made me nervous,” said Christian Simone, a blogger and content creator. “Being someone who developed early, wearing shorts and a tank that looks so comfy was always a struggle…As an adult, I feel like a magnifying glass is over me when I opt to wear things like a bikini or shorts.”

“I was the girl who ‘got fat’ when I went away to college and my body anxiety was at an all-time high,” Jaclyn DiGregorio, founder of the digital wellness community Cuspit, said. “I would go into the dressing room with a few bikinis and stare at my fat and ugly body, telling myself that I really needed to step it up and eat less to lose weight before summer began.”

What Is Body Anxiety

It’s normal to feel self-conscious about how we look, especially as we peel off extra layers of clothing during the hot summer months. But body anxiety can also be debilitating.

“I feel I am missing out on my most festive summer nights because I don’t feel comfortable,” says Christian Simone. “People who don’t deal with body issues can’t understand the intensity of someone who has been cat-called or told to sit the summer out as there is no place for hippos.”

While some people “can continue with ‘normal’ activities,” according to Dr. Ariane Machin, a clinical psychologist and co-founder of the Conscious Coaching Collective, they may “be very distracted by thoughts related to their body size/shape, perceptions that they are typically much larger than they are in reality, or constantly comparing themselves to those around them.”

Sometimes a little reassurance from loved ones, and traveling with people who make us feel loved and comfortable, is enough to keep the worry at bay — even on the beach or poolside. At other times, body anxiety is tied to deeper issues.

“[Others] may begin to isolate and/or reduce the activities that they are involved in,” Machin said. “Someone who once loved to do group workouts now feels too self-conscious and isolates, which in turn may enhance feelings of depression and anxiety.”

When To Seek Help

Body anxiety at the stronger end of the spectrum may lead to low self-esteem, other mental health issues, and eating disorders. Those who have also experienced trauma will likely have a complicated relationship with their body.

“Sometimes the anxiety has nothing to do with the body at all,” Philadelphia-based licensed psychologist Robin Hornstein said. “It [could] be some trauma that happened [or] you’re waiting for test results from a medical test, and you’re scared, and so it’s so much easier to fight a part of your body at that moment then to just say, ‘Damn, I’m grieving,’ or, ‘I’m scared,’ or, ‘I don’t know how to handle this stress for too long.’”

If body anxiety starts to take over by exhibiting symptoms such as not eating right, poor sleep, isolation, avoidance of previously enjoyed activities, or trouble keeping up with obligations like work, it may be time to reach out to a mental health professional.

“If you can’t do it on your own, reach out to somebody else,” Hornstein advised. “Whether that’s a therapist, or whether that’s somebody you trust — a mentor, a family member, a friend, a partner, a spouse — and say, ‘Hey, help.’”

Ways To Combat Body Anxiety

In the meantime, we have a few ideas to help reduce body anxiety as we head into the dog days of summer.

1. Reduce Media Consumption

Hornstein asks clients to reduce the amount of media they consume. These unrealistic portrayals of bodies and beauty aren’t realistic (and are often a work of camera and editing magic). In addition, Hornstein helps clients identify favorite activities, like swimming, they no longer enjoy due to anxiety about their body and figure out how to work those back into their life.

2. Reframe How Your View Your Body

Teaching clients to reframe how they view their body is one of the first steps Machin takes, by using mantras such as, “My body is an instrument, not an ornament.” From there, Machin finds clients regain their power and confidence through body movement by taking up walking, yoga, weight lifting, or any other activity that “brings you joy in moving your body and reaffirms that your body is strong.”

3. Focus On The Positives of Summer Skin

New York-based clinical psychologist Dr. Sanam Hafeez suggests refocusing our energy on the benefits of showing more skin, a cognitive shift that can help mitigate the impact of anxiety. She recommends asking questions such as, “How would it feel to savor the sensation of warm sun on my skin?” or “How might swimming help me relax or exercise more?” Take this a step further, she said, and try: “What three things can I appreciate about my body right now?”

How Others Empower Themselves

In addition to these practical strategies, find creative ways to reduce body anxiety that work for you. Sometimes these pursuits are the most empowering.

Start a Blog or Journal to Tell Your Story

For example, Christian Simone took hold of her anxiety by creating a body positivity blog, The Christian Simone, where she posts about her journey to health and acceptance.

“Last year I created a post that showcased me in a bikini. I did this again this year because I feel if I own who and what I am then I can move forward,” Simone said. “I still have moments of anxiety but I just tell myself that these moments are temporary and who cares if someone doesn’t like it? What has been more important is to allow myself the mental flow to accept me at my size and to not stop living because of anxiety.”

Create Clothes That Fit Your Unique Style and Body

Erin Weisbart, owner of the sewing and pattern company Tuesday Stitches, uses another creative outlet to overcome body anxiety — sewing. Weisbart encourages others to bring clothing to life that flatters their favorite features through customizable patterns. By sewing her own clothing, she’s found a path to confidence, and she shares that message with others through her company.

“I sew pretty much all my own clothes at this point,” Weisbart said. “Sewing empowers people to love their bodies because you learn that with any sewing pattern, you’re going to make changes to it to fit your body perfectly.…If you learn to sew your own clothes, then you can learn to embrace, accept, and celebrate your unique body.”

Above All, Self-Love is a Key Component

Regardless of the journey, with self-love and support from loved ones and a therapist as needed, self-acceptance can replace body anxiety.

“I loved the stretch marks on my legs because they signified the transition from child body to adult body,” Jaclyn DiGregorio said, on where she is now, “No one has the perfect body, but turning your imperfections into gratitude for the many blessings in your life can truly make a huge difference in finding body positivity in a world of body anxiety.”

This summer, we’ll leave you with these final bits of advice:

“A beach body is a body that puts on a bathing suit and goes to the beach,” Robin Hornstein said.

Christian Simone tells it frankly. “Wear whatever you want and live your most festive life!”

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