Studies conducted in the last three decades have repeatedly shown that psychotherapy is more effective in treating bulimia than antidepressants, placebos, or control conditions where people do not receive treatment (e.g. Lindardon et al., 2017). However, most people who are seeking treatment want to know more than just whether therapy is better than taking a pill-- they also want to know what the odds are that they will recover fully and what they can do to maximize their chances of completely beating bulimia.Read More
Instead of mercilessly judging and criticizing yourself for various inadequacies or shortcomings, self-compassion means you are kind and understanding when confronted with personal failings – after all, who ever said you were supposed to be perfect? --Neff, 2018 (1)
If you are like most Americans, you often view your body as an object, rather than as an aspect of your whole self. Most of your body focused thoughts may revolve around changing, depriving, comparing, cajoling, punishing, or improving. The problem is that self-criticism is seen in a variety of psychological problems such as panic, social phobia, PTSD, depression, generalized anxiety, and eating disorders. (2) Take a moment to notice your thoughts. How often are your they based on appreciating and accepting the body that carries you through each day? How often are they gentle? While there is nothing wrong with seeking improvement, when change is paired with acceptance and kindness rather than disdain it is more likely to improve your mental health as well. That is, adding in self-compassion on the path to reaching your body based goals can make you feel better even if you choose to continue striving.
In an ideal world, our eating would be determined only by our hunger. In reality, however, eating is often related to our emotions-- that’s why we call some foods “comfort foods” or talk about “stress eating.” In fact, negative emotions like sadness, anger, or stress are common triggers for a binge (Leehr et al., 2015). When moods go beyond normal day-to-day fluctuations and cross into the territory of depression or mania, we often see that eating patterns also get disrupted and can morph into binge eating. As many as 10%- 28% of people with bipolar disorder also have binge eating disorder (McElroy et al., 2013; Schoofs, et al., 2011).Read More
“Darwin argued that we are a profoundly social and caring species. This idea... that our tendencies toward sympathy are instinctual and evolved (and not some cultural construct as so many have assumed), and even stronger than the instinct for self-preservation.” --Keltner 2017
People tend to want to relieve the suffering of others. However, when the other is a member of an outgroup, empathy may fail as a result of non-altruistic motivations. Love, Simon isn’t just another a rom-com set in a suburban high school. The themes -- of inclusion, bullying and coming out-- are especially relevant to teens, young adults, parents, schools and mental health professionals. If it is considered a critical and box office success it may be evidence to those struggling with oppression, suicidal thoughts, and the closet that they are not alone. It may even inspire other similarly themed films. It may inspire some of us to be kinder. It may reduce shame.Read More
As I enter my third trimester, very visibly pregnant, I’ve been thinking a lot about the challenges moms-to-be face in maintaining a body positive attitude. First off, it’s astounding the number of people-- friends, coworkers, family members, and strangers-- who feel emboldened to comment on the size of a pregnant woman’s body. Is her stomach too big? Not big enough? Is she really as pregnant as she says she is? Is she “about to pop”? Whoa! And many people continue lean even harder into the common mistake of thinking that a woman’s weight or shape is an indicator of her health or the health of the baby. The constant weigh-ins at the doctor’s office can also be a trigger for body insecurity for many women. Negative media chatter about pregnant or postpartum celebrities also contributes to negative body image for women, even those who are not yet pregnant (1). Plus, there’s no way around the challenge of adjusting to an entirely new figure confronting you in the mirror (and sometimes seeming to change from day to day!).Read More
Most of us have found ourselves looking to food as a way to soothe a negative mood. Although it can work, hopefully it is not your go-to or only strategy to make yourself feel better. You’re better off if you can rely on it as only one of many ways of coping with feeling down. Some alternative possibilities include feeling and accepting the emotion, reaching out for support, problem-solving, exercising, taking time in nature, meditating, completing a task, or distracting yourself. The options are nearly endless. But, some people use eating as a primary means of dealing with feeling bad which can cause even more upset later. Does this describe you? A new study provides hope for interrupting this cycle.Read More
From an early age, we’re taught by parents and teachers to “try our best”, and many of us carry this lesson with us as we grow older. Intuitively, focusing on doing the best we can with the skills we have makes a lot of sense. The problem with trying your best, however, is that it can actually leads you to accomplish less and feel less satisfied than you would if you set a more concrete goal. In fact, the failure of “try your best” goals has been proven in studies of more than 40,000 people working on 88 different types of goals.Read More
For people trying to recover from eating disorders, the pervasive, socially acceptable increase in diet talk --as spring break and summer vacations approach-- can be very stressful and risky. Additionally, listening to the weight loss compliments bestowed upon family and friends who embark on fad diets and quick weight loss can lead them to idealize aspects of these illnesses, minimizing the potentially devastating consequences.
We are all potential helpers and healers. In every interaction and conversation with family, friends, partners, and strangers, we can either increase light or cast shadows. Yet, sometimes we are unaware of the impact of our actions, especially when cultural norms unintentionally lead us to do harm. We have settled into a destructive normalcy around conversations focused on cutting out food groups, weight loss goals and body size & shape comparisons. Complimenting someone's adherence to strict food rules or weight loss may seem kind and supportive, but it is not.Read More
Negative thoughts about one’s weight, shape, and body size are a common thread across eating disorders. For anorexia and bulimia, placing excess importance on one’s appearance is an essential component of diagnosis. Although overvaluation of weight and shape are not required in binge eating, placing a lot of value on one’s physical appearance is associated with more severe binge eating patterns, along with depression and lower self-esteem (1). One key to overcoming eating disorders may be body image flexibility, the ability to experience and tolerate a wide range of thoughts and feelings about one’s body without letting body image get in the way of engaging in important life activities (2).Read More
Did you hear the recent announcement that Weight Watchers will be offering free services to teens (ages 13-17) starting this summer? They have cloaked the program in a language of wellness, calling it a way to guide healthy behaviors. (1) The primary problem is they are a for profit company trying to sell their product … and their product is weight loss, otherwise known as dieting. At weekly meetings and check-ins, Weight Watchers does not check glucose levels, blood pressure, vitamin deficiency or other health markers. They check, track, validate, and celebrate weight loss.
This move has struck a chord with the National Eating Disorder Association and with medical/psychological/dietetic professionals in the world of eating disorders who recognize it as potentially getting teens hooked on dieting, body shaming, internalized self-criticism, calorie counting and scales during critical years of self-development. Even after the immediate outpouring of concern, Weight Watchers maintained their position with a tweet saying “they take their responsibility seriously” and that the program “is not a diet.” (2)Read More
Psychologists have long known that early traumatic experiences increase the risk of developing an eating disorder later in life. For example, people who were sexually abused as children are more likely to show signs and symptoms of eating disorders in young adulthood (1). Other studies following people from childhood into early adolescence have found that other kinds of childhood maltreatment, particularly problematic parenting behaviors by fathers, predict the development of eating and body image problems (2).Read More
It can extremely scary, overwhelming and frustrating to provide assistance to a friend or family member who is trying to recover from an eating disorder. These illnesses are stubborn, life threatening and characterized by ambivalence. If you are wondering what to do to help, recent research sheds some light.Read More
For people with binge eating disorder (BED), nighttime is an especially high risk period for experiencing a binge episode. New research published in the International Journal of Obesity sheds some light on the role of stress and hunger hormones in driving this nighttime eating. Higher body weight individuals with or without BED were brought into the lab either in the morning or the evening after they had fasted for eight hours. They were put through a stressful experience and then given a large buffet meal. The researchers found that adults were hungrier in the evening than the daytime, even though both groups had fasted for the same length of time, and that stress increased hunger hormones more later in the day than it did earlier in the day. The increases in hunger hormones in evening were particularly pronounced among the group who had BED. The participants with binge BED also reported lower fullness in the evening, even after eating the buffet, and higher feelings that their eating at the buffet was out of control. Basically, biology and the increased risk of experiencing stress as the day goes on interact to place individuals with BED at risk for binge eating episodes at the end of the day.Read More
Most of us love to share fun times, joys and pleasures with the people we hold most dear. Those euphoric moments can bond us together and create happy memories.
"In the sweetness of friendship let there be laughter, and sharing of pleasures. For in the dew of little things the heart finds its morning and is refreshed” -Khalil Gibran
But what do you do when life feels burdensome? What heppens when you are stuck in eating disorder behaviors? Do you isolate yourself? Do you enter into a shame spiral? Do you put on a mask and wait until you feel better or stronger to authentically show up with your friends? If so, I hope you’ll try reaching out, without self-judgment instead. Regardless of how open you choose to be, reach out. Allow a friend to be your warm landing. Let her or him be your bridge. Communicate the problem and what you need...Read More
By Danielle Keenan-Miller, Ph.D.
Exercise is, undoubtedly, a generally healthy enterprise and many people embark on new exercise routines at this time of year. While most people are striving to meet the Department of Health’s guidelines of 150 minutes of moderate intensity or 75 minutes of vigorous activity per week, some people go far beyond those recommendations. In a world of “insanity” workouts, encouragement of “double” spin classes, and nonstop news articles on the harmful health effects of being sedentary, it’s easy to assume that more is always better when it comes to exercise. However, in too large of a dose, exercise can have negative effects for both body and mind.Read More
Vaping is very much on the rise in adolescents and adults. (1) While early research shows that e-cigarettes are less dangerous to health than traditional cigarettes, there is no published data yet on cancer risks or the potential long-term impact on our lungs or heart. Here are some of the potential health risks we do know -- insulin resistance, type 2 diabetes, increase in heart rate and blood pressure and may impair prefrontal brain development in adolescents. In addition, there’s an increase in the risk of addiction to other drugs, flavored types may cause permanent damage to bronchioles, and certain vaporizers may generate large amounts of formaldehyde and other toxins. (2) Though better than traditional cigarettes, e-cigarettes are far from risk-free.Unfortunately, people with eating disorders are particularly vulnerable to the allure of vaping -- now using e-cigarettes to suppress their appetites.Read More
“If you just sit and observe, you will see how restless your mind is. If you try to calm it, it only makes it worse, but over time it does calm, and when it does, there's room to hear more subtle things - that's when your intuition starts to blossom and you start to see things more clearly and be in the present more. Your mind just slows down, and you see a tremendous expanse in the moment. You see so much more than you could see before. It's a discipline; you have to practice it.” (Steve Jobs)Read More
By Danielle Keenan-Miller, Ph.D.
The holidays are often a time for gathering with people we don’t see much during the year-- distant relatives, neighbors, and friends of the family that by chance or by choice are not part of our everyday lives. At its worst, negotiating the several hours of a holiday dinner can feel painstaking or repetitive. But having a handy list of the questions that avoid causing conflict and instead open up the door to engaging and meaningful conversation can turn those long holiday meals into a time for joy and connection.Read More
A new study in the American Journal of Health Education looked at the impact of a popular wearable lifestyle technology on teen exercise habits. At first, the 13 and 14 year olds reported being more motivated -- by guilt and competition to meet the fitness goals. But the positive trend in their desire to improve exercise habits did not last. The study revealed, it’s not that simple.Read More
By Dr. Danielle Keenan-Miller
The holiday season comes with an onslaught of requests for your time and money: envelopes from non-profits arriving to ask for donations, soup kitchens requesting volunteers, and even the ringing bell of the Salvation Army santa. In the midst of the stress, lack of sleep, and (let’s be honest) grumpy mood that can accompany the holiday season, it’s easy to tell ourselves that we don’t have the time, energy, or resources to give. However, the science of altruism suggests that accepting some of these requests, rather than depleting us, would likely improve our well-being (in addition to contributing to the social good).Read More