FB and your diet, weight, fitness & happiness: A cautionary post about comparing.

Everyone is so happy. And doing so well, always having a great time. They’re all eating amazing food and managing their weight. They all look so healthy, too. And their kids are always smiling—they have the perfect families. Everyone else is so good at exercising—Map My Ride/Run and other apps prove they’re doing so much better than you running and cycling and walking. Yes, by comparison you hardly rate.

Hardly his happiest or his best mug shot.
Posted with permission.

Or so it seems.

It was quite timely that my patient whom I’ll call Beth, described her frustration having spent too many hours on Facebook. (Imagine that. Spending too much time on social media.)  She saw far too many ‘friends’’ photos displaying beach-bound bodies with a confidence she doesn’t possess. Like those ‘before and afters’ from diet ads from Diet Center and Weight Watchers (where the print too small to read confesses that these images are of rarely occurring weight loss that normal people don’t usually experience nor maintain in the real world) they showed what everyone else was capable of—except for her. These photos of Beth’s friends and acquaintance were beautiful—looking slimmer, happier and more fit than her for sure. 

Or so it seemed.

These pictures of friends struggling
 hardly get seen.

Ok. Raise your hands if you post pictures of yourself that you'd rather destroy. Right. We only post our best shots, the ones that get the ‘likes’, right? And we surely don’t see people throughout the day, at all times, when they may be looking their worst—like we see ourselves. No early morning “I-just-rolled-out-of-bed” shots posted on FB.  And did you know that some ‘friends’ even use apps which photoshop their pictures, like they do in magazines with airbrushing? Yes, it’s even possible that some pictures you’re thinking are real have been touched up. 

Comparison is a tricky business. You only see a small slice of a person’s life, of what’s really going on. The rest, no doubt, is projection. They ‘seem’ happy, or healthy, or content. But maybe it’s just how it appears. Their exercise level may be awesome, or excessive or a rare event advertised to their Facebook friends.

No, these imperfections don't make
it to FB.

Your friend who’s lost all that weight may have cancer, or may be struggling with anxiety and depression, causing her to feel anything but happy. Or fit. Or relaxed. The bikini clad acquaintance may be so preoccupied with what she believes she can and can’t eat that she hardly enjoys herself at the beach, or when she dines out, or even when at home deciding what she could possible have for lunch.

Yet another recent study showed that using social media can have a negative impact on our eating behaviors including binging, purging and using diet-pills. “Both online physical appearance comparison and online fat talk were associated with greater disordered eating” the study by Dr. Bulik and colleagues showed. Without the comparing, however, greater Facebook use was associated with decreased disordered eating behavior. So it’s all how you use it. "Comparison is the thief of joy"--I can't agree more with this quote attributed to Theodore Roosevelt.

Looking neither happy, nor energized.
I was actually quite miserable here.

Maybe it’s time to challenge your Facebook and social media friends. Are they capable of posting a picture where they don’t look so awesome? Can they post the ride or run where their speed was less than impressive?  I doubt that most can bring themselves to do so—but wouldn’t that change things?

I’d love to hear what you think. So please leave a comment! And thanks for reading.

It's your mom's fault? Words and genes: what we can do about eating disorders

It's all your mother's fault.

Really, it's about lack of approval from your dad.

If you're a boy or a man, it must mean you're gay.

If you aren't underweight you certainly don't have anorexia.

As long as you're eating healthy foods, you're okay.

It's simply a choice.

Once you've had it, you'll never truly recover.
It's all about appearance and weight.
You have to be ready to recover.

True statements? Not at all. These commonly held misbeliefs about eating disorders do only harm. They minimize the complexity of eating disorders and the struggle of those suffering with anorexia, bulimia, and binge eating disorder. 

They prejudice everyone from those living with an eating disorder, to providers treating those they may or may not know have eating disorders. 

They lay guilt on parents who may be among the best supports for their kids in recovery, as evidenced by the FBT model. 

They stereotype people based on weight--as if BMI alone determines severity of eating disorders! My normal weight patients who subsist on 400 calories surely know better. As do those of my disordered obese patients who have struggled with size discrimination for most of their lives and are no less free of obsessive thoughts, patterns of severe food restriction and symptoms of starvation. Yes, weight, size and appearance mislead.

And if we wait until someone is "ready" to recover, it just might be too late. Yet just these past weeks I've heard that this was the guidance conveyed by a therapist 'treating' a patient with an eating disorder--"you've got to wait until you're ready" they were foolishly advised; no, undernourished people don't tend to make the wisest and healthiest decisions. That's right up there with the wisdom of the cardiologists who recently minimized the very serious risk of severely restricting intake; suggesting no need for worry because Sara was not actively purging (simply overexercising and restricting) or that Dan's low heart rate must just be a result of being an athlete (a starved one, that is, with a low metabolic rate).

Yes, there is work to be done.

Eating disorders need science, not stigma

Here's yet another brilliant idea from Cate Sangster (the first I'm familiar with is her suggestion for an eating disorder recovery cookbook, which we created to great acclaim--food to eat). This time, in recovery, Cate puts her social media savvy and creative thinking to great use with this ice bucket alternative to help us get answers about eating disorders. Like Cate, I support Dr. Cynthia Bulik's move to create a genetic database to better understand eating disorders, and the organization, Charlotte's Helix which was created to help make it happen. In the US, check out this link to ANGI to donate. Please check out the resources on this site as well, to arm you with correct information about eating disorders.

"Learn From Genes, Not Jeans, About Eating Disorders."

I have followed Cate's lead with my educating arm (pic on right), and encourage you all to do the same--and to donate $20 to Charlotte's Helix or ANGI or other worthy eating disorder organizations. Share your pics  on Twitter, Pinterest and Facebook, too! 

I Had No Idea! Secrets About Eating Disorders

We can't always tell just by looking at someone 
that something isn't right.

There are no excuses for perpetuating misinformation about eating disorders. No justification exists for minimizing eating disorders based on BMI, for generalizing them by age or gender, or for continuing to blame parents for causing them. While the news media may sensationalize and sometimes distort research, social media can fight back to correct misinformation. So read on, and please share!

Today starts a week devoted to spreading the word about eating disorders with the theme “I had no idea!” Thank you NEDA, the National Eating Disorder Association and promoter of Eating Disorder Awareness Week, for inspiring this post.

Random thoughts come to mind when I consider what this theme means to me—and what it might mean to you.  My beliefs and knowledge about eating disorders have evolved over many years, to which I credit the Academy for Eating Disorder listserve, the FBT researchers and Laura Collins and FEAST, blogs like Carrie Arnold’s  and my many, many awesome patients and colleagues. 

What I’ve learned over the decades

Got your period? This doesn’t minimize your diagnosis of anorexia, if you meet the other criteria. And resuming menses after being without a period does not mean you have fully recovered. No, the work is not yet done.

Obese and anorexic? How can that be? You do not need to be below the BMI chart to meet criteria for anorexia. Really. Unfortunately, you are the ones who most often fall through the cracks. And you are continually subjected to messages that your weight is the issue. I am truly sorry for this. Health care professionals need to be educated! 

Eating disorders are quite common in males, straight and gay. Males get anorexia, and struggle with bulimia and binge eating. Their focus on bulking up their muscle mass may seem like a cultural norm, but may be the sign of an underlying disorder. Check out Roberto Olivardia’s work on men and eating disorders.

Time to look at eating disorders a bit differently.

Over 30 or 40 and struggling with an eating disorder? You are not alone! Eating disorders are not just a teen thing. You can be living with an eating disorder at any age—an eating disorder that never resolved, one that reared it’s head again after previously recovering, or one that developed later in adulthood. Check out Dr. Cynthia Bulik’s work on this population. 

Parents don’t cause eating disorders. And parents shouldn’t be sidelined in the treatment of kids with eating disorders. They play an integral part in recovery, particularly when your poorly nourished brain fights you on eating. Learn more about how families can help from FEAST, from scholarly articles and other from resources.

Barbie didn’t cause your eating disorder. Sure, the media may impact how we see ourselves but eating disorders are much more complicated, involving genetic predisposition, environmental triggers and support for maintaining the disorder. We don’t know exactly what causes eating disorders, but it won’t be long before we understand the genetics. See what research is underway and how you can help the study of eating disorders and genetics.  

People don’t plan to have an eating disorder. It’s not a decision sufferers made. Individuals with anorexia, bulimia and Binge Eating Disorder aren’t simply refusing to change when they maintain their behaviors. Change is complicated—by fear, anxiety, and hard wiring of behaviors. My patient shares some wisdom we can all learn from here. 

It’s not so easy to just do it as this post describes. In spite of my many years of working with clients with eating disorders, I don’t think I fully grasped how many obstacles to change there can be—that is until Cate. Writing Food to Eat and feeling I was living her struggle with her was beyond enlightening; it heightened my sensitivity to things I had taken for granted—the planning to eat, shopping, cooking, and ultimately eating. 

Let's work to not live by diet rules and restriction, 
but to trust what our bodies both need and enjoy.

Recovery is possible, even for those who have lived with an eating disorder for many decades. But it has to start with the belief that change is possible. Connect with a treatment team-a therapist, an eating disorder dietitian and an MD, and reach out to friends and family for support. I now know that it is not too late to.

Want to help others recover? Share this post to increase awareness of eating disorders, and check out this awesome new eating disorder support by Cate. 

Oh, and please tell me what you think! Thanks for reading.