Goal is to provide hope to people who are impacted by eating disorders. They engage with stakeholders across the eating disorders continuum, including people who have experienced eating disorders or disordered eating, loved ones of those with eating disorders or in recovery, eating disorder treatment providers, and those interested in learning more about eating disorders.
Eating Disorder Awareness Week (EDAW) is upon us. Join the Waterloo Wellington Eating Disorder Coalition’s effort to de-stigmatize eating disorders this February 1-7, 2018.
Almost 1 million Canadians are living with a diagnosed eating disorder. Unfortunately this means there is an even higher number of people struggling with undiagnosed eating disorders or disordered eating. The purpose of EDAW is to decrease stigma around eating disorders and encourage individuals who are struggling to reach out to local support systems.
During EDAW, we are reminded that eating disorders impact people of varying race, gender, sexuality, ability and age. We are reminded that despite the unrealistic images depicted in the media, bodies are not born as “one size fits all.” EDAW is a reminder that our bodies deserve gratitude and nourishment instead of body hate and deprivation. Finally, we are reminded that despite the efforts of countless programs and advocacy groups around the globe, system issues remain and more needs to be done. More support, more advocacy, more programing and more funding.
Food for thought:
The population of people struggling with an eating disorder or disordered eating is diverse, nutrition during recovery should accommodate for this and also be diverse. Just as there is no “one size fits all” body or one perfect recovery journey there is no one perfect nutrition plan to meet the needs of all people.
When I assess an individual’s nutrition intake and discuss a nutrition plan with them I cannot definitively determine their nutrition needs for recovery. Defining “normal eating” is a challenge amongst professionals in the eating disorder community. But, if there is no conclusive definition of “normal eating” then what are you striving for with nutrition in recovery? The answer is that it looks different for each individual.
What I do know is this: “normal eating” in recovery involves regular nutrition intake, a balance of nutrients and challenging food avoidances. For some this may include rice and lentil dosas with chutney for breakfast while for others it may be a pastry with butter and jam and a glass of juice or even a typical American breakfast of eggs, bacon and toast. It may require exposing yourself to eating alone, eating out at a restaurant or with your family at a holiday meal. Reflect on a time in the past when you may have had a better relationship with food. What were the things you enjoyed eating then? You may benefit from talking to family and friends about what you ate together in the past. Developing a nutrition plan involves collaboration between your team, your friends, family and yourself. It will require some deep soul searching to understand which foods are a challenge for you and why. Just as eating disorders are diverse in nature, nutrition needs in recovery are also diverse.
Just some food for thought - Michelle Johnson, RD
We are proud to be partnering with @theNEDIC and @NIEDCanada for Eating Disorders Awareness Week. Join us in raising awareness about Eating Disorders and breaking down stigmas.
#EDAW2018 (#SemTA2018 in French) #7billionsizes #PurpleforEDAW #lightitpurple #CMHA100
Here is what is happening in the Waterloo Wellington region:
Guelph City Hall & Cambridge City Hall will be lit up in purple to raise awareness. Watch for social media posts to also raise awareness.
University of Guelph’s Wellness Centre is hosting various organizations at the annual Eating Disorder & Body Image awareness Exposé displaying boards, media and cookie decorating on February 6th from 10am to 3pm
Join the University of Guelph’s Wellness Education Centre for a screening of Sisterhood of the Travelling Pants Wednesday February 7th. For more information, please email email@example.com
Join on-campus registered dietitian Lindzie O’Reilly and counsellor Samantha Durfy for an All Food Fits cooking class Thursday February 8th from 5:30-7:30pm. Class will be held in MINS 214 at the University of Guelph. The cost of the class is $3. Please register in advance by emailing firstname.lastname@example.org
Wilfrid Laurier University is hosting a Food and Your Mood Workshop on February 13th and 14th with Caroline Valeriote, RD and Carrie Pollard-Jarrell, MSW RSW. This workshop will discuss emotional eating and outline eating disorder resources in the community. Also look for Laurier social media posts to raise awareness.
The holidays are a time for connecting and celebrating, but they can also bring pressure and stress. Normal routines can be disrupted with social and family gatherings which are often oriented toward gift giving and eating. There can be pressure to get the ‘perfect gift’ or stress related to being around larger groups of people or having to navigate family “issues” (we all have them!). This is also the time of year when people often feel the loneliest, whether it be to losses of significant people in their lives, or feeling alone in a world full of people who don’t understand them.
For people who struggle with disordered eating and/or body image issues, the holidays can be challenging for all of the above reasons and more. Many celebrations are oriented towards food which can trigger a multitude of fears, and family functions can feel like they expose (or risk exposure) of eating disorder (ED) related struggles or behaviours.
The challenges associated with the holidays can trigger our inner critics, and cause us to overextend or even isolate ourselves. However, to help manage (and possibly prevent some of) the stress, we could give ourselves a special gift this holiday: self-compassion. Self-compassion means being kind to ourselves and understanding that we, like all people, are imperfect and that sometimes our life situations are not how we want or need them to be (Neff, 2011). We can practice self-compassion by changing the way we talk to ourselves. Instead of judging ourselves for what or how much we ate, or how much we spent on a gift, we can remind ourselves that it’s okay to enjoy treats, say “no”, and give what we can afford. If you struggle with compassionate self-talk, think of how you might talk to your best friend who is hurting or struggling in that same type of situation. We can also practice self-compassion in how we care for ourselves. It is easy to get caught up in pleasing others and doing what is expected. During the holidays it’s important to pause, and mindfully ask yourself what you need. If you need time to yourself to relax and turn off your phone—then give it to yourself. Self-care is not selfish, instead it will allow you to recharge. With self-care, you will have the energy to show caring, compassion and patience with others.
Comment below on your favourite ways to care for yourself during the holidays!
Carrie Pollard-Jarrell, MSW RSW
Reference: Neff, K (2011). Self-Compassion. New York, NY: HarperCollins.
As a professional with a career as a school psychologist and a parent whose daughter developed an eating disorder (anorexia) in her late teens, I have remained active in retirement, including supporting families struggling with the devastating effects of eating disorders. One such activity for me over the last ten years has been the facilitation of a twice-monthly Family and Friends Support Group through the Canadian Mental Health Association (CMHA).
On September 30, I was fortunate to be invited to attend a day-long conference at Homewood Health hospital organized to celebrate the 25th anniversary of their establishment of the Eating Disorders treatment program. The focus of this excellent conference in September was managing ED Therapy-Interfering Behavours within a DBT Framework. I agree with Samantha Durfy (a therapist and the main organizer of this conference) that the presenter, Dr. Anita Federicic, PhD, is such a helpful resource person that you would want to have her in your ‘back pocket’ when facing the complexities of treating ED.
My framework when listening to the presenter was frequently that of the ‘family’ which I think often parallels what therapists need to attend to. Of the many parallels I saw, the following are highlights:
A) ‘interfering’ behaviours exist both in the client/loved one as well as the therapist/family and need to be addressed openly. This means that parents must talk with their loved one and not ignore behaviours such as non-responding, lying, not following thru on agreements. Parents must discuss how some of their own behaviours such as over-emotional reacting and lack of skills in communicating interfere. The intention is not to blame but rather to openly deal with such behaviours while respecting the person; the goal is to move towards making a collaborative plan to reduce these
B) the assumptions within DBT treatment ring true for ‘successful’ treatment as well as ‘successful’ family functioning. Read ‘loved ones’ for ‘clients’ into the following key DBT assumptions: -
Clients are doing the best they can
Clients want to improve
Clients need to do better, try harder, be more motivated
Clients may not have caused all their problems, but they have to solve them anyway
Clients’ lives are currently unbearable
Clients must learn new behaviours
So what does this mean for families?
As difficult as it is at times, rather than staying angry at loved ones, the family needs to embrace the notion that their loved one is doing their best; finding out as much as possible about eating disorders is one way families can achieve this shift; increased understanding underlines that, in fact, anorexia is considered THE most difficult mental health disorder to recover from; anger may reduce and turn to compassion when learning that their loved one is struggling with overwhelming issues.
At the same time, believing that their loved one does indeed want to improve, despite behaviours like denial and refusing to follow through on helpful strategies, is a challenge for the family but important to do; in our Family and Friends Support Group, we often reinforce with families the small cues their loved one gives that indicate this desire; understanding the stages of change also helps to see that even when a loved one moves away from denial there are still many stages before they will take action; and we often comment that if it were easy for their loved one to make those significant steps to recovery, eating disorders would not be the devastating disease it is known to be.
The apparent opposite assumptions that clients/loved ones are ‘doing the best they can’ and that they also need to ‘try harder/be more motivated’ reflect the many opposites that exist within the complexities of an eating disorder. Indeed, loved ones’ lives are ‘unbearable’ but that doesn’t mean they will naturally want to leave their eating disorder behind (as rational thought would suggest). In our F & F’s Group, we regularly advocate seeking therapy for their loved one (if not already involved), and especially therapy with a specialist in eating disorders – given the huge hurdles a loved one experiences in order to become more motivated to ‘do better’; we also advocate parent(s) seeking help to deal with the huge stress of supporting their loved one wrapped up in so many contradictions.
Another of the major hurdles is for the loved one to begin taking some responsibility for making their recovery happen, even despite having little responsibility for the contributing causes; in our Family and Friends Group, we have regularly discussed Emotion Focused Family Therapy (EFFT) as a treatment strategy which focuses on strategies to deal with emotions which drive an eating disorder; part of EFFT teaches critical communication strategies (for families) which reduce our typical tendency of advice-giving and increase our recognition / affirmation of our loved one’s feelings before any problem-solving follows; with this affirmation, the loved one may not only feel more capable and but is often freed to do their own problem-solving.
We all do things that can sometimes get in the way of recovery. The main thing is to be aware and talk about them, whether in therapy, within the family or in a support group. If you are located in the Wellington-Duffering area, feel free to access CMHA’s Family and Friends Education and Support Group regarding eating disorders. Regular Meetings are held on the 2nd and 4th Thursday of the month from 6:30 to 8:30 p.m. at CMHA WWD, 130 Weber St. West (at Breithaupt Street) Suite 201, Kitchener. Enter from back parking lot to take elevator to 2nd floor. More information can be found here.
Eating Well with Canada’s Food Guide (originally called Canada’s Official Food Rules) has been around since 1942 and is meant to provide guidance when it comes to making healthy and nutritionally adequate food choices. There has been much talk recently about the state of the Food Guide and many calls for an update.
As a science, nutrition is not new. Nutrition is, however, constantly evolving. Additionally, because we all eat, we all have our own opinions about food and nutrition. Combined together, this has created a very complicated and, in my opinion, often toxic food environment.
How is the average person supposed to make sense of all of this information? Is the Food Guide still a useful tool for Canadians?
In many ways, the Food Guide can serve as a source of guidance, but in my opinion, should not stand alone.
I believe that Health Canada will always struggle to develop a Food Guide that depicts the natural variety of a healthy diet. We eat for many different reasons, we all have different likes and dislikes, and we have each been raised in a unique food environment (i.e. the foods you were exposed to and the messages you were provided with as a child). From the Food Guide, one can learn that a serving of meat and alternatives could be two eggs or 75g of chicken, but what if you have never cooked an egg before, or are terrified of purchasing and touching raw chicken? I believe that in order to bring about healthy change in our society, we need to spend a little more time looking at issues such as busy schedules or lack of cooking skills, rather than debating whether to include 75g or 100g of chicken with dinner or feeling guilty if we include three tablespoons of peanut butter instead of two.
We have forgotten about balance, and instead have begun an unrealistic pursuit of perfection
I will admit that, when building a meal plan for clients, I typically include a bit more protein and a bit less carbohydrate than the Food Guide suggests. I also believe that the Food Guide does tend to emphasize more processed grains (i.e. cereals, granola bars, and breads) and neglects the awesome variety of tasty and unprocessed whole grains (have you tried millet, amaranth, buckwheat or teff??). That said, following the Food Guide “as is” will certainly not make you unhealthy and I work very hard to fight against many of the extreme approaches that continue to pop up in the media and in social circles.
Cutting out entire foods or food groups and labelling foods as “good” and “bad” has the potential to have a very harmful effect on health and a very destructive effect on one’s relationship with food. Instead, if I feel that an individual is consuming more carbohydrate or processed food than is ideal for their health, I believe in giving them the knowledge and skills necessary to increase their intake of fresh healthy food, rather than shaming them for eating processed food or establishing rules against it.
The Food Guide focusses on individual food choices, rather than the overall picture
All in all, I believe that debate around the content of the Food Guide has led us to become caught up in the nitty gritty details. We look to the Food Guide to provide rules and guidance and, in doing so; have forgotten the importance of enjoying delicious real food. When working with clients, I often keep the Food Guide in the back of my mind, but would almost never pull it out and use it in a session. Instead, I am more likely to talk with clients about trends in their intake and set specific and individualized goals around variety and balance at meals and snacks.
I believe that we should always have a Food Guide that provides guidance regarding balanced and nutritionally adequate choices. I believe that our current Food Guide could use some updates to reflect a greater variety of fresh whole foods. I also believe, however, that the Food Guide should never serve as a stand-alone document and that, if you have concerns about your food habits, you should work with a qualified health professional to find a routine that works for your body, that you enjoy, and that you can maintain long term.
Questions, thoughts or concerns? Feel free to contact me at email@example.com
On January 1, 2017, The Healthy Menu Choices Act will come into effect in Ontario. This Act requires restaurants with twenty or more locations to list calorie information for foods and beverages on their menus. Moreover, fast food joints, movie theatres, supermarkets and convenience stores that serve hot food must post the calorie counts of each item – including alcohol – on their menus, menu boards, tags in display cases and at drive-thrus. Then there’s the definition of ‘menu’ which includes not only paper table menus, but online menus, menu apps, advertisements and promotional flyers – all in the same size and prominence as the name and price of the food item. The act will make Ontario the first province in Canada to require calorie information to be displayed on menus, with the goal of providing consumers with information that will allow them to make more balanced food choices, along with the (hidden) agenda of obesity prevention.
While it is true that Canadians need help eating well, I have significant concerns about the proposed approach. In recent months, many articles have discussed the potential pros and cons of this approach and I expect the conversation will continue to increase as we head towards January. Articles I’ve read thus far discuss downsides that mostly focus on the costs restaurants will incur in testing their products and changing their menus to display calorie information. Here are just three of the many potential down sides that I see, and that no one seems to be talking about.
Calorie counting is a distraction from internal cues that our body provides us with
In most situations, hunger and fullness are great ways to gauge portions sizes that are right for you. The trouble is that we often fail to listen to these cues. We often eat quickly, while on the go, or in front of a screen. Some of us may push off or ignore our hunger. Many of us finish entire meals without even tasting them. Rather than setting a calorie target for meals, experiment with mindful eating. Trust your body; it’s smarter than you think! We trust our bodies to breath when needed and to control our body temperature for us, so why do we feel the need to count and control calories?
Calorie counts are a fear tactic, not an educational tool
Many of our nutrition-related health issues stem from the fact that we are over-worked, over-stressed, lack cooking skills and are out of touch with where our food comes from. We are already bombarded with a ton of nutrition information that leaves us feeling confused. Our society makes assumptions that individuals with a body weight above the ‘normal range’ eat too much or move their bodies too little. Rather than addressing underlying issues, encouraging individuals to choose lower calorie menu options and shaming those who choose higher calorie options is likely to make the situation worse. It promotes a toxic relationship with food, an unhealthy approach to weight and weight loss, and greatly increases one’s risk of dangerous and disordered eating behaviours (and for those already struggling with these illnesses, constant exposure to calorie counts can only serve to increase obsessiveness and exacerbate eating disorder behaviours). Instead, I’d love to see a societal shift that provides education on how to purchase, store and prepare nutritious food options and that helps individuals reconnect with natural hunger and fullness cues.
Calorie counts look at foods in isolation
We all have different calorie and nutrient needs, but we also all have different schedules and routines. There is no ‘right’ or ‘best’ menu option. The option that you choose on the menu should depend on how hungry you are, what you like the taste of, and what you feel like eating, not its caloric value. If you overhear the person at the table beside you ordering chocolate cake for dessert, you have no idea if they order it once a day or once a year. You have no idea what they’ve eaten so far today or what the rest of their day will look like. A single meal is simply a snapshot in time, it does not define you and it should not be used to pass judgement on others.
Calorie counts are coming to menus at chain restaurants in Ontario January 1, 2017. We may not be able to stop them, but we can work to control the effect they have on us. Challenge yourself to slow down, to listen to the cues that your body is giving you, and to use those internal cues to make food choices rather than being drawn to calorie counts. We are more than food, and food is more than calories.
Written by Lindzie O’Reilly, MAN, RD with contributions from April Gates, MSW, RSW
Eating disorders impact diverse people – but if you were to rely on the representations we have available to us around eating disorders, you might assume that they only happen to young, white, cisgender, heterosexual, thin women. While those of us in the eating disorders field in a research and/or clinical capacity are often aware that people who are marginalized along any number of lines, including race, sexual orientation, gender, and more, get eating disorders, the dominant representation of eating disorders remains this very narrow portrait of a person. The problem with this portrait is not that it is not true – people who fit this image do get eating disorders. However, this portrait creates what Chimamanda Ngozi Adiche refers to as a “single story.” It does not leave room for recognition for those whose disorders look different, which can lead to under recognition, misdiagnosis, and a lack of appropriate care for diverse people experiencing eating disorders.
One of the most serious issues facing us as a field is the lack of training for primary care physicians and others at the front line of recognition for eating disorders. These individuals may only have dominant representations of eating disorders available to them. Resultantly, they might assume that people in larger bodies, men, racialized people, LGBTQ+ people, and otherwise marginalized folks are somehow “immune” to this kind of distress. The implications of this are twofold:
We need to improve training for “first responders” for eating disorders, including general practitioners, nurse practitioners, teachers, coaches, and more
We need to broaden our lens on eating disorders to incorporate and represent a wider array of experiences. This means being more proactive in conducting research that is sensitive to and designed with marginalized folks, and making space for stories to accompany the numbers used to inform eating disorder diagnoses and treatments.
Beyond these points, we also need to be working at a societal level for change in which bodies are welcome not only within eating disorder research and treatment settings, but also in society in general. Many of those who don’t fit the stereotype of eating disorders are also facing countless other obstacles in their lives that can make recovery challenging and that can make talking about their experiences of an eating disorder – and recovery – unsafe. Eating disorders are treatable and recovery is possible, but we can do better to build a world where diverse bodies are honoured and welcomed in; this is the kind of world that might make recovery less of an uphill battle against an oppressive cultural current.
The Waterloo Wellington Eating Disorders Coalition is proud to support the 1st World Eating Disorders Action Day. #WeDoAct for systems-level change for eating disorders, today and every day.
When I was twelve years old I started to fully understand the impact of my mom’s eating disorder (ED) on her health and mind, and, on our family. For several years she struggled with her weight and was frequently on diets and involved in various dieting programs. Although she promoted healthy messages regarding food and body acceptance to me and my sister, she described struggling internally with critical messages about herself. Her diet at this particular time had helped her lose a significant amount of weight and people praised her for it. They looked at her ‘thin’ body and equated that with health, not realizing that in fact she was struggling with an ED and that she was at her physically (and psychologically) unhealthiest. Her life, which had previously revolved around her relationships, her children and her hobbies, became even more obsessed with calorie-counting, exercise and the numbers on the scale. I was aware of some of this at the time, and other things I learned and understood more when she was in treatment and as I got older. For several years she received both inpatient and outpatient treatment for her eating disorder; she is a survivor and I’m proud of her resilience, determination and openness to seeking help.
Eating Disorders are not always visible, but they are treatable. They can affect sons, daughters, sisters, brothers, aunts, uncles, friends, cousins, and parents. Today is Eating Disorders Action Day— promote ED awareness and treatment.
How often do you think about what you should or shouldn’t eat, or about your body size? For some this may only represent a small percentage of their experience, whereas others describe it as consuming nearly every waking moment of their lives.
Twenty four years ago, Mary Evans Young (a survivor of an eating disorder and bullying), created No Diet Day. Now recognized as International No Diet Day (INDD), May 6 is a date that encourages people to challenge weight prejudices, raise awareness of the ineffectiveness (and risks!) of dieting and to celebrate body size diversity and the health at every size movement.
How will you celebrate INDD? Many people celebrate by eating mindfully and for pleasure, and by engaging in activities that allow them to enjoy their bodies. The Waterloo-Wellington Eating Disorder Coalition is collaborating with local businesses (and universities) to display positive, empowering messages on signs in shop windows and decals in change rooms. Messages include, “Distorted body image comes from a distorted culture”; “Don’t fight your genes, just change your jeans”; and “Your natural weight is your best weight”. Look for the signs this week!
Billions of dollars are spent on the dieting industry yearly. Industry is the key word. Diets are meant to yield profit and despite the research demonstrating the ineffectiveness of dieting many people are currently on a diet. With children and adolescents, dieting and other weight control behaviours increase the risk of physical health concerns, and the development of eating disorders and other mental health issues.1
Why don’t diets work? Dietician, Caroline Valeriote, offers the following facts:
1. Goal weights for many diets may be unrealistic for you. Diets don’t often take into account your genetic structure, your body type, how much time and effort you can afford to devote to managing lifestyle and food style changes and your overall health.
2. Diets that promote unrealistic weight loss goals of greater than two pounds per week means the following:
a. You are eating too few calories and are at risk of becoming deficient in nutrients
b. You may be feeling tired and hungry and have a difficult time concentrating and making decisions
c. The rate at which calories are used (metabolic rate) slows down which is not beneficial to your overall health
3. Diets don’t often promote physical activity which will increase overall muscle tone and overall fitness. Regular physical activity will increase/maintain your metabolic rate.
4. Diets will often eliminate certain foods and food groups found on Canada’s Food Guide. Diets eliminating these foods or food groups creates unbalanced intake and often does not recommend healthy substitutions.
5. Diets usually recommend repetition of several foods. Without variety, the diet will be boring and very difficult to adopt for the long term.
6. Diets likely promote drastic changes to your overall intake. If this is the case, it will be more difficult to follow because you will have to make too many changes.
7. Diets are not usually monitored by a registered dietitian or medical professional.
8. Diets likely recommend very low calorie intake making it very difficult to obtain all the macro and micro nutrients your body needs to be healthy.
9. Diets often recommend special supplements or foods which can be more costly than regular food. Most often supplements are not well researched for their effectiveness and safety. Supplements cannot replace a well-balanced intake.
10. Often a diet will discourage you from thinking positively about yourself. A positive sense of self-worth increases your motivation to take good care of yourself and your body though healthy food choices.
- Caroline Valeriote, RD and Carrie Pollard-Jarrell, MSW RSW
For more information on eating disorders, body dissatisfaction and the problems with dieting, visit: http://nedic.ca/know-facts/statistics
Hey downtown Guelph and Kitchener-Waterloo, check it out!
Friday May 6th, 2016 is International No Diet Day, and when you stroll on the downtown streets of the above cities, you will see signs in some of the storefront windows that promote positive body-image or anti-dieting messages. Make sure to take some time and look for the signs! You may even find a decal or two in a change room. Let's change the message in our culture, conversations and minds!
Here are 10 suggestions of ways to participate in International No Diet Day:
- Take a break from dieting. Try eating when you are hungry and stopping when you are full. Listen to your body’s signals.
- Stop thinking about foods as “good,” “bad” or “junk food.” Taste, savour and enjoy allfoods to the fullest!
- Make health, not weight loss, your lifestyle goal.
- Give up, or better still, smash the scale
- Clean out your closet and get rid of all your “thin clothes” - donate these items to charity
- Ask local bookstores to display anti-diet and “Health At Every Size” books this month
- Stop focusing on appearance. Don’t make comments like “You look great! Have you lost weight?” Look for other praise-worthy comments to highlight other than personal appearance.
- Engage in physical activities for pleasure and health benefits, rather than regimented exercise for the primary purpose of weight loss
- End weight discrimination by celebrating size diversity. Beauty, health and fitness come in all sizes
- Check out downtown store windows hosting slogans promoting positive body image and size acceptance. Don’t let the fact that International No Diet Day is only one day of the year stop you from practicing the above on a daily basis.