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Eating disorders can begin for many reasons – whether it is from insecurity of not meeting society’s unattainable standards of beauty, or the feeling of not being “enough” – a lot of factors can contribute to the development of these conditions. For many, a common theme for their eating disorder is control. When your dream college rejects you, or your parents tell you that they’re getting a divorce or you did not get the job that you wanted, life can feel like it is out of your hands. Women living with eating disorders often feel as though they are regaining control when they manipulate their weight using unhealthy behaviors. These maladaptive behaviors are concrete and demonstrable—and can be controlled by one’s own actions. This sense of achievement and reward—though gained through unhealthy means – can perpetuate the eating disorder.

Taking that into consideration, it is no surprise that females in the Orthodox Jewish population experience a high occurrence rate of eating disorders. For many young women adhering to principles of this religion, it can feel as though their futures are outside of their control. Shidduch – a matchmaking process within the Orthodox Jewish community – is an expected part of female maturation. Traditionally, a young man’s mother picks a woman for him to marry. Women are expected to marry this man that they might not even know – or particularly like.

In addition to the heightened bodily awareness that young women may feel as part of the normal development into adulthood, females living in this community may feel added pressure to look a certain way so that they can be deemed “more desirable” for suitors looking for a life partner. Often, the idea that the women must be skinny comes from expectations within the community. Here, we can see the glorification of thinness as well as the devaluation of anyone who does not meet the thin ideal.

While Shidduchim can be an enjoyable experience for some, others find it to be an extremely uncomfortable and anxiety-ridden time spent obsessing over perceived physical and psychological flaws. This life experience can be especially difficult for those actively living with an eating disorder and for those predisposed to developing the condition.

As eating disorders are often a function of uncomfortable emotions or situations, it makes sense that this would be a time that many eating disorders are either activated or exacerbated. With the hope of alleviating some of the internal / external pressures felt by many women in this community, many women begin using eating disorder behaviors as coping skills to manage emotions and/or control a situation that cannot be altered.

Although it is easy to see why this process can be dangerous for many women living in the Orthodox Jewish culture, I think it is also important to understand that this tradition does not cause eating disorders. Biological, psychological, and social factors, along with many external influences all have a great impact on the development of these illnesses.

Philo, a Jewish philosopher, once said, “The body is the soul’s house. Shouldn’t we therefore take care of our house so that it will not fall into ruin?” Perhaps one day observant Jewish women and families will begin to see the correlation between Shidduchim and eating disorders, thus beginning to make strides to alleviate the social pressures and physical standards associated with this important life event.

Resources:

• The Renfrew Center in Philadelphia has a treatment track for observant Jewish women.
• Relief Resources opened a helpline for those struggling with an eating disorder
• The Hadassah Foundation funded the creation of “Bishvili: For Me,” in hopes to help strengthen girls’ self-esteem.
• The Reconstructionist Rabbinical College and the KOLOT Center for Jewish Women and Gender studies established Rosh Hodesh: It’s a Girl Thing. This establishment aims to teach teen and preteen girls positive body imagery and other Jewish values that relate to their lives.

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Ashley Sawyer, LCSW is a clinician in the adolescent IOP and the Free to Be program in Milford. She provides individual, family, and group counseling to adolescent and adults with eating disorders. She received her bachelor’s degree at Bridgewater State University in sociology and her master’s degree in social work from Simmons College. Ashley is particularly interested in eating disorders and the Jewish population. She incorporates Dialectical Behavioral Therapy, Cognitive Behavioral Therapy, and Exposure Therapy in her work with patients and families.

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For those who haven’t experienced anorexia, it can be difficult to understand the function of the illness. As such, people often think that there is a simple solution to the condition. “You just have to eat,” they often say matter-of-factly.

Although these comments probably come from a place of good intention, they can often be painful and frustrating for those living with anorexia and other eating disorders. As providers, we hear over and over from our clients, “If I could decide to just change my behavior, I would.”

Lack of education or awareness of the illness can often lead friends or family to ask “is anorexia a choice?” For those not living with an eating disorder, it can often seem that it is. While some eating disorders may develop out of a conscious choice to improve health (eating “healthier” foods, increasing exercise or cutting out certain food groups) for those predisposed to eating disorders, these lifestyle choices can become obsessive and spiral out of control. By the time someone’s behaviors have escalated to the point of a diagnosed eating disorder, they no longer have much choice in their own actions.

The effects of long-term malnutrition were explored in a study known as the Minnesota Starvation Experiment that was conducted in 1944. At the time, the study was initiated because the problem of starvation was occurring so frequently in the context of WWII, and there was a lack of knowledge around the issue. The men in the study were asked to lose 25% of their overall body weight and were placed on dietary restrictions; they were also assigned regular exercise. As the study progressed, researchers found that the participants were engaging in many of the same behaviors that those with anorexia nervosa often exhibit; ritualized eating, deconstructing foods to take more time eating, excessive gum chewing, and obsession with cooking and recipes (Kalm and Semba, 2005).

The reason this study is important for the conversation around the “choice” involved in developing / maintaining eating disorders, is because it establishes that there are common behaviors that seem to emerge from the starvation process itself.

Finally, there has been a significant amount of research implicating genetics in the development of anorexia nervosa. This study revealed that anorexia is associated with genetic abnormalities linked to chromosome 12. Additionally, there have been other studies finding a link between chromosome 1 and anorexia detailed in a study by the American Psychological Association in 2002. It has also been found that the chance of someone developing anorexia is 50-80% genetic. Therefore, developing anorexia is largely associated with one’s genetics—and those cannot be chosen.

By the time someone has reached a point that they require therapeutic intervention for their eating disorder, they have often lost control over many or all of the related behaviors. However, this does not mean someone cannot choose to start the road to recovery. The way we empower someone to do this is to meet them where they are and understand that they are not necessarily functioning cognitively or psychologically at their typical baseline. We help them start to fight back against the damage of malnutrition by replenishing vital nutrients and most importantly, we hold hope for them when they are unable to do so for themselves.

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Rachel Drummey PMHNP is a nurse practitioner working in PHP and outpatient providing care to adolescents and adults with eating disorders. She received her master’s degree in nursing with a specialty in mental health across the lifespan from MGH’s Institute of Health Professions. Eating disorders are Rachel’s main area of focus, and she also works with clients with various comorbidities, including PTSD, depression, anxiety, and personality disorders. In her free time she enjoys running, biking, and yoga.

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HYANNIS, MA, February 7, 2018 – Walden Behavioral Care, a system of specialized care for individuals and families affected by all types of eating disorders, today announced that it will be opening a new clinic in Hyannis, MA on March 1.
The 2,000-square-foot facility will be the first of its kind in Cape Cod offering dedicated eating disorder treatment to individuals 12 years and older. The clinic, located at 310 Barnstable Rd., will offer evening intensive outpatient programming and outpatient care and will staff six to eight specialized professionals including a dietitian, nurse practitioner, therapists and mental health counselors.

“Approximately 10 percent of people in the United States have had or will have an eating disorder at some point in their lives,” said Stu Koman, president and chief executive officer of Walden Behavioral Care. “This means the impact is felt by more than 2,000 residents living on the Cape and Islands. We are thrilled to finally have a home on the Cape and look forward to serving the residents of this community.”

Programming will be centered on evidence-based treatment interventions, nutrition education, therapeutic meals and the building of skills to cope with eating disordered thoughts and urges.

“While eating disorders are difficult and can create a great deal of distress for individuals and their families, recovery is absolutely possible with appropriate care and support,” said Kimberly Wick, program director for the Braintree and Hyannis clinics. “We provide the unique clinical expertise, welcoming environment and the individually-tailored care necessary to give individuals the best chance for lasting recovery.”

Since 2013, Walden Behavioral Care has treated more than 17,000 individuals living with eating disorders. In addition to the Hyannis facility, Walden operates 11 clinics, two inpatient units and two residential facilities throughout Massachusetts, Connecticut and Georgia.

An open house will be held on Thursday, March 8 from 4:30 – 7 p.m. To RSVP or to learn more about the Hyannis clinic, please visit https://www.waldeneatingdisorders.com/hyannis/

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You may have read heaps of literature helping you to assess whether or not your loved one has binge eating disorder. From your research and time spent observing any changes in their behavior, you have determined that there is a strong likelihood that your loved one is living with binge eating disorder. And you’re now ready to get them the support they need.

Before you can put on your superhero cape and refer them to potentially life-saving eating disorder treatment, you need to have the uncomfortable conversation with your loved one to adequately express your concerns and help them understand why treatment is in their best interest.

While you should probably expect some defensiveness, denial and/or anger, do your best to enter this conversation confidently, knowing that they will one day thank you for your support and bravery. Below are some dos and don’ts to help you best frame a productive dialogue:

Do:

1) Explore observed behaviors with compassion and curiosity. Binge eating can elicit intense feelings of shame and guilt. Moving rapidly into problem-solving or outlining consequences cannot only potentially increase the frequency and intensity of binging, but is likely to also escalate shame and lower mood. Feel free to use specific incidences that you have personally observed in order to reiterate your concern over the behavior.

Example: “I’ve noticed that you have been taking your dinner to your room and not eating at the table with the rest of the family for the past couple of weeks. When I went to your room to vacuum, I noticed wrappers hidden under your bed. I love you and am concerned. Is everything okay?”

2) Listen. Allow for your loved one to be as open to you about their struggle a feels comfortable for them. Show them that you hear what they are saying, will do your best to understand and are open to discussing further when/if they want to talk.

3) Ask what would be helpful. Nobody knows your loved one better than they know themselves, so allowing them to have agency over how you may be involved in their struggle can reduce feelings of shame. It can also increase awareness around what kinds of things can be triggering for them and help them to start thinking proactively about the types of changes that would be helpful.

Example: “I’m sorry that you’re having a hard time. I’d like to support you in any way that you think would be helpful. I remember you told me one time that evenings are hard for you. Would it be helpful if I came over to cook dinner with you a few times a week after work? We could catch up on Grey’s Anatomy!”

4) Focus on emotions/feelings rather than food. When it comes to binge eating disorder, the food itself is not necessarily the problem. Rather than saying, “If you’re worried about gaining weight, why don’t you just eat healthier,” try doing your best to understand the behaviors around the food. You will probably realize that your loved one’s issues are way more about coping with their feelings (sadness, stress and/or anxiety) than the actual food itself.

5) Take some time for self-care. It can be difficult to support loved ones while they are struggling. Making sure that you taking care of yourself needs to be a priority too. If you are rested and emotionally stable you will be in a better position to be there for them when they most need you.

Do Not:

1) Blame/Shame. It is no one’s fault that your loved one has an eating disorder. Allowing for them to share their experience and struggles in a judgement-free zone can foster insight and reflection on the events, how they impact their life and the aspects they’d like to change.

2) Be the “food police.” Taking away food or pointing out what your loved one is eating will only breed more shame and guilt, increasing the likelihood that they will engage further in disordered eating. Again, asking them how they’d like to be supported is most important.

3) Force them. Recovery from binge eating disorder is possible, but it takes work! That work can only be done when someone is ready to do it. Pressuring treatment can prolong the issue. If you have a hard time sitting back, you can help your loved one by better informing yourself about the disorder and present any resources that you find for them to look over when they are ready.

If your loved one is ready for treatment, or you’d like to learn more about what kinds of treatments are available, please don’t hesitate to reach out to us! We’d love to hear from you.

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Sarah-Eve Hamel, MA is an adult clinician in the PHP and IOP programs in Worcester and the Binge Eating Disorder Coordinator in Milford. She provides individual, family, and group counseling to adults with eating disorders. She received her bachelor’s degree in psychology from Concordia University and her master’s degree in counseling psychology from Assumption College. Sarah-Eve incorporates Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) in her work with patients. She is also passionate about research and education around the topics of mental health and eating disorders. In her spare time she enjoys spending time with family, rock climbing, and running outdoors.

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People who really, really like food might say that they’ll eat anything. Still, that turn of phrase usually means anything that is actually food.

Sure, there are plenty of non-food items that look good enough to eat, like fancy soaps or candles. That being said, most of us know we should steer clear of things our body can’t digest.

However, there are people who suffer from a rare condition that gives them the urge to eat things that aren’t food. The National Eating Disorders Association explains that the condition is called pica, an eating disorder that involves swallowing items that don’t contain significant nutritional value.

Dr. James M. Greenblatt of Walden Behavioral Care Center in Massachusetts talked with LittleThings to break down the key facts surrounding this highly unusual condition.

People commonly affected by PICA:

  • Pregnant Women

It’s no secret that pregnant women often have strange cravings (for instance, suddenly wanting to eat pickles and peanut butter together).

However, pregnant women have been recorded as having cravings for non-food items since as early as antiquity, according to Dr. Greenblatt.

He explained: “Although the exact etiology has not been determined, iron deficiency is often the cause in pregnant women, and there is the thought that the body craves nutrients it is lacking.”

  •  Young Children

Children are known to put almost anything in their mouths. This is not an unusual behavior, but if your child makes a long-term habit of this, it could suggest pica.

Dr. Greenblatt points out that 30% of pica cases worldwide involve small children.

He goes on to explain that the presence of an abnormal gut bacteria called dysbiosis is often connected to pica.

However, just because small children exhibit this behavior does not necessarily suggest that the problem will persist as they grow older.

“It is important to note the young child’s age — infants and toddlers begin to understand their surroundings by using their senses, which often includes taste,” Dr. Greenblatt says. “It is a normal practice for infants and young toddlers to put things in their mouths and ingest as a way of exploring the world around them.”

  • People with Certain Mental Health Conditions

Pica is often seen in tandem with other health conditions in adults.

Dr. Greenblatt points out that people with autism, schizophrenia, and obsessive-compulsive disorder will often experience pica.

“For those with pica and OCD, trichotillomania (hair pulling) and excoriation (skin picking) are common and the hair and skin is commonly ingested,” he says.

  • People Who are Malnourished

As you might imagine, pica has a tendency to affect people who have nutrient deficiencies.

“Malnutrition is the most consistent risk factor across all ages,” Dr. Greenblatt points out.

As a result, pica rates are much higher in developing countries where people frequently suffer from food scarcity.

Additionally, he says that pica cases have been recorded after people have had gastric bypass surgery. “Although gastric bypass surgery is an effective procedure for weight loss, the surgery results in malabsorption and malnutrition,” which can result in these non-food cravings, he says.

  • People Who are Developmentally Disabled

Pica can affect those with developmental disabilities in many of the same ways it does children.

A lack of a clear understanding of the world around them can cause certain people who don’t know better to ingest substances that shouldn’t be eaten.

Common Substances Consumed by People with Pica

  • Clay or Soil

Health-E News explains that clay eating has become somewhat widespread in South Africa among women who have iron deficiency.

In fact, it’s even been sold on the streets in bags specifically for consumption.

Nutritional deficiency on its own is a source of concern, but so are the other infections that ingesting dirt can cause.

According to the National Eating Disorders Foundation, people could ingest animal feces and harmful parasites along with it that could cause conditions like toxoplasmosis and toxocariasis.

  • Paint

When it comes to ingesting paint, lead poisoning is the immediate concern. Luckily, paint contains less harmful amounts of lead these days.

However, Poison Control outlines that even paint deemed safe to use indoors can have serious side effects when ingested.

Choking, skin irritation, upset stomach, nausea, and dizziness are just some of the complications someone who ingests paint can expect to experience.

  • Metal Objects

If someone suffering from pica has a taste for metallic objects, they are definitely doing themselves a lot more harm than good.

Not only can the object obstruct your stomach physically and cause harmful tearing, it can also cause serious metal poisoning that can be fatal, according to the National Eating Disorders Association.

Dr. Greenblatt also lists soap, hair, string, wool, chalk, rocks, and charcoal as items commonly ingested by those with pica.

How to Get Help

If someone you know or love is affected by pica, it’s important that they seek the right kind of help.

Dr. Greenblatt reiterates that “pica is a potentially serious psychiatric illness with underlying medical complications.”

Patients should be evaluated by their physician, who will be able to determine whether they are suffering from any deficiencies that could be contributing to their cravings.

From there, the doctor will be able to determine the best line of treatment and what kind of specialists the patients may require in the future.

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Recovery: Return to a normal state of health, mind, or strength

That sounds simple right? Imagine if the process was as clean and clear cut as this definition. Recovery is anything but simple. Recovery is overwhelming, chaotic, stressful and challenging, but recovery is also wonderful–and so worth it.

Recovery is a BIG word with a lot of meaning. Recovery for one person might not mean what recovery represents for me—and I think there’s beauty in that. We are all different. We’ve all walked down different paths, weathered different storms and have our own unique goals and dreams.

For me, recovery is a new chapter in my book.  My struggle with an eating disorder was one long chapter, but I finished it. My plan is never to return to this chapter again. Recovery has brought me freedom–Looking back, I can really say that I was a slave to my disorder. Not one second went by when I was free from negative thoughts about myself or my body. There were no days off from this relentless disease. Sometimes I would try to fight back, but most days my eating disorder won the war.

Until I was recovered, I never realized how much time I wasted obsessing over ridiculous things. Who has time for that? *Sigh of absolute RELIEF*

My eating disorder was a very dark and lonely place. I felt ashamed, depressed, and miserable. Recovery has brought me back to life. I am happy, healthy, and motivated. I try to see the positive in every situation and I walk through life with a smile. The simplicity of not having to revolve my entire life around when I’m going to eat or not eat has been so calming. I no longer ruminate on details that used to bring me so much anxiety on a daily basis. I do what I want, go where I want and I don’t have to worry about the voices or the backlash of taking my eating disorder with me.

Recovery has taught me that I literally can do anything I set my mind to. While I was living with an eating disorder, there were many days that I thought I would never get better – when I didn’t even want to get better. I was hopeless and I felt weak. My disorder drained everything from me and my journey to recovery has brought me from the lowest of lows to the highest of highs.

I now have 3 beautiful children who need me, a loving husband, incredible friends and family, an awesome job and a supportive community who all want to see me at my best. My recovery has brought me to a place where I am healthy enough to be the fun loving, strong and compassionate person that I am without my eating disorder.

Recovery has shown me that my passion is recovery. I have always wanted to “change the world.” Cliché I know, but my recovery has me actually doing it. Sharing my story brings me so much joy– it’s the most amazing feeling. I don’t think I will ever get tired of it. Being able to educate the community about eating disorders and the stigma that surrounds them helps me feel stronger in my own recovery. It helps me remember that my story is important. It’s brave, it’s bold, it’s meaningful and it matters. Your story matters too.

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Brenna Briggs is an eating disorder survivor. She battled Anorexia, bulimia, and depression for well over a decade.  Today she is a full time medical assistant, mother of two young daughters and has been in recovery for nearly 7 years. She is a motivational speaker, mentor, recovery advocate and group leader for others living with eating disorders. The raod to recovery has been long and challenging, but with the help of caring and supportive treatment team, friends and family, her goal to beat her demons has been accomplished. Brenna is passionate about her recovery and is dedicated to helping others on their recovery journey.

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Overeating and binge eating are terms that are often used interchangeably – yet the distinction is important. While both types of eating can certainly cause increased stress and may require additional help or support, people who engage in frequent binge eating can struggle with decreased mood, low self-worth and their pattern of eating may affect relationships or productivity at work or school.

Binge eating disorder will impact an estimated 2.8% of American adults, more than double the cases of anorexia and bulimia combined. It can lead to a variety of emotional (anxiety, depression, social isolation) and medical (high blood pressure, high cholesterol and heart disease) complications.

Dr. Kate Craigen, Ph.D., Clinical Director for Binge Eating and Bariatric Support Services at Walden Behavioral Care explains the key differences between an overeating episode and a binge eating episode.

What Is The Difference Between Overeating and Binge Eating - YouTube

If you or someone you love are experiencing any of the symptoms described in this video, help is available.

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Romper
January 2018

There’s a reason why foods like buttered noodles and chicken fingers are clichéd children’s menu staples: Lots of kids aren’t particularly open-minded when it comes to eating, and some of them are downright picky. But as common as this behavior can be, it’s also a little scary for parents. After all, frozen waffles and cheese sticks don’t exactly constitute a “balanced diet.” A child whose daily meals revolve around five foods can’t possibly be getting all the nutrition she needs for proper growth, can she? So what are some signs your picky kid isn’t getting enough nutrients?

While kids who live on bland, processed fare might be taking in enough calories (then again, they might not be), that doesn’t mean they’re getting all the other stuff they need to grow. Research published in the American Journal of Clinical Nutrition found that 3-year-old “picky eaters” had lower levels of carotene, iron, and zinc than “non-picky” eaters. (Interestingly, picky eaters were shown to have higher “free sugar intake,” which perhaps isn’t that surprising when you consider how processed some “kid-friendly” foods can be.)

“As a pediatric feeding therapist, I work closely with Registered Dieticians when I suspect that a picky eater may getting poor nutrition that’s impacting his health,” pediatric feeding specialist and author of kid-friendly cookbook Adventures in Veggieland Melanie Potock, MA, CCC-SLP tells Romper.

“Adequate amounts of zinc and iron are always in questions for me, especially if I see kids who appear tired, cranky or have low appetite.”

Any of that sound familiar? Read on for more info on what to watch for if you suspect your child’s diet isn’t diverse enough (and what it means). But bear in mind, not all nutritional deficiencies are easy to spot. As James M. Greenblatt, Chief Medical Officer at Walden Behavioral Care (a national eating disorders treatment provider) tells Romper, “It is difficult to detect vitamin deficiencies simply by looking at your child. If you are concerned because your child has had a restrictive diet for an extended period of time, it is best to follow up with your pediatrician who can do a simple blood test to assess what vitamin and mineral deficiencies are present.”

And when you call your pediatrician, be sure to mention if any of the following symptoms listed below are present.

Lethargy

Little kids are known for having boundless energy, but if your child is more interested in binge-watching Paw Patrol on the couch than playing at the park, it could be a sign that he’s low on iron or even anemic.

“Early signs of iron deficiency could physically present [itself as] fatigue, lack of motivation, apathy or even depression,” says Dr. Greenblatt, “though all of these symptoms could also be indicative of different diagnoses, so it’s important to be continually monitored by your pediatrician.”

Trouble Paying Attention

If getting your kid to focus seems like mission: impossible, a lack of foods containing zinc could be partly to blame. Research published in the American Journal of Clinical Nutrition suggested that low levels of zinc in kids may be linked to deficits in attention (as well as activity and motor development). Zinc-rich foods include meat, certain vegetables, beans, and whole grains…all of which might be things your kid refuses to eat. Thankfully, zinc is present in lots of fortified cereals, too, and chances are, that’s something they’ll gladly eat seconds of.

Dry Skin

If no amount of lotion seems to soothe your child’s dry skin, don’t assume that the winter weather is necessarily the cause — a vitamin deficiency could also be the problem. As Susan Evans, M.D., wrote for DoctorOz, “Dry skin can either mean you’re chronically dehydrated, or it means that you need to increase your essential fatty acid intake, vitamin A, and vitamin E intake. Potassium and vitamin D need to be added too.” Of course you should always check with your child’s pediatrician before starting him on any supplements, but it’s definitely something to consider.

Weight Loss

“Dramatic poor weight gain, or weight loss, is a worrisome symptom in a child of any age,” Katherine Noble, M.D., of the CT-based practice Sound Beach Pediatrics tells Romper, and the causes can be simply because your child is picky, or can suggest something more serious.

“This can result from poor nutritional intake, malabsorption of nutrients, or less commonly a health condition which increases metabolic rate (a ‘hyper metabolic state’),” she says. “Poor caloric intake is most common and we discuss strategies: nutrient dense power-packed foods (proteins and healthy fats), nutritional supplements (Pediasure), and others.”

If this is something you’re observing in your child, make sure to bring it up to your doctor earlier than later.

Constipation
As you may be all too aware, picky kids tend to focus on just a few different foods… and they’re not usually of the high fiber variety.

“Often, picky eaters are getting too much of a good thing, like whole milk,” says Potock.

“It’s filling and parents are comforted by thinking ‘At least he drank his milk.’ But kids who drink too much milk are often constipated, causing a drop in appetite for other foods, and making them irritable.”

Your pediatrician might recommend a fiber supplement, or tricks like adding fresh fruit and veggies to smoothies (or milkshakes, or whatever you need to call them so your kid will drink them!). But, once again, how you treat this particular symptom depends on your child’s health and age, and the severity of her pickiness.

“The best way to obtain nutrients is through our food, not through vitamin supplements because most vitamins are excreted,” says Dr. Katy. “But, for super picky eaters, I will suggest a multivitamin daily (with or without iron depending on intake of iron rich foods).”

So, as ever: When in doubt, ask your doc!

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It was binge eating that made me deny having any sort of eating disorder.

As a runner, I thought anyone but athletes had issues with food. After all, weren’t we the epitome of health? Lean and strong, thanks to exercise? I had to be the broken, I thought. I had to be the one with the lack of discipline around food.

These thoughts, unfortunately, are what landed me in binge eating disorder in the first place.

It all began with this thought that my appetite was “broken,” that maybe if I just adjusted what and how much I ate, I would be “right” again. I made these changes and lost weight. With weight loss, came the fastest times I had ever run in my life.

Unfortunately, this “success” only caused me to hide the pain of restricting food further. What could possibly be “wrong” if I was running so well? What could be “wrong” if no one was addressing my period loss, if no one was even talking about eating disorders and how prevalent they really were in athletes?

And, I thought, this obsession with food couldn’t possibly be an eating disorder. I ate three meals a day. As a runner, I knew I had to fuel properly. I knew I needed nutrition from all of the food groups. However, I wasn’t allowing myself to eat enough. I didn’t trust my body, didn’t think it could eat “right” unless I controlled it “properly.” I began to believe that any extra bite of food wasn’t true hunger, but emotional eating. I worried more about broken bones from not eating “perfectly,” rather than the unknown eating disorder that would develop from here, one that no one talked about: Binge eating.

After years of denying what I thought to be emotional, greedy, gluttonous desires, my body began to fight back.

I ran in silence, but my body spoke up for me. Occasional binges turned into weekly binges, turned into daily binges. I found it difficult to stop thinking about food, and the food cravings were more intense than I had ever experienced in my life. I couldn’t sleep at night until I gave in to what my mind obsessed about, and I couldn’t concentrate on my studies until I was full with food.

I panicked and tried to exert more control by restricting food to compensate for all I had eaten. This began a vicious restrict-binge cycle that only worsened the eating disorder, but I was sure my problem wasn’t “bad enough” because I was now gaining weight, not losing it. Weren’t people with eating disorders emaciated? And no one in the sports world talked about food issues, let alone this side of eating disorders. Anorexia, for a while, seemed “better” and easier to bring up than binge eating.

Now with clarity for what happened and how, I see that bingeing, or eating more than I deemed “appropriate,” wasn’t a result of emotional eating. My emotional eating (or rather, non-eating) began with the anorexia I had unknowingly developed. The binge eating was a result of that emotional non-eating, and the intensity in which I binged was out of fear of my loss of control and desire to regain the “success” I had tied to running faster at a lower weight.

These issues surrounding food were not resolved by finding “discipline” and “willpower” (as I thought they would). They were healed by realizing that binge eating was an eating disorder and that restricting food had played a role in its development. They were fixed by going through a long, intense recovery process to accepting my body as it was, and understanding that happiness couldn’t just be found in fast performances or my sole identity as a runner. They were fixed by learning to trust my hunger, and that my body was never “broken.”

I had to dive into what made me even think that in the first place.

Combined with therapy, seeing an eating disorder dietitian, and being open about my struggles through my website www.RunninginSilence.com and self-help book Running in Silence (Koehler Books, 2016), I began to heal. I was also messaged by many other athletes imprisoned in this same lonely, confusing and career-ending experience (it turns out I wasn’t the only one running in silence). Yet many athletic programs weren’t talking about it—especially not binge eating—and not enough people were aware of the mental and physical consequences. If an athlete “looked” healthy and fit, wasn’t everything “fine”?

It has become my mission through Running in Silence to bring awareness to those who can help make improvements for the mental well-being of athletes, as well as offer resources for those in the eating disorder recovery process. It is encouraging when athletes raise their voices about all sides of eating disorders, their consequences, and create a new definition of success beyond numbers so that athletes after them don’t remain silent—and trapped—as long as I did.

If you’re an athlete seeking support for an eating disorder, know there are many resources available today.

####

Rachael Steil, author of the self-help memoir Running in Silence, writes articles about running and eating disorders for her website www.RunninginSilence.com (awarded Top Eating Disorder Blog), and is a speaker and advocate. She was 6th and 7th place NAIA All-American in cross country and track for Aquinas College, and now coaches at Grandville High School. Steil’s work has been endorsed by Nancy Clark, registered dietitian and board certified specialist in sports dietetics, and Suzy Favor Hamilton, Olympic middle distance runner and mental health advocate. Steil’s greatest achievement was not breaking a physical barrier, but a mental one.

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I had this epiphany the other day as I was waiting in line at Chipotle. I was listening to a conversation between two businessmen. “I have two kids—my oldest is getting scouted by [insert renowned school here] and holds the record in passing yards for his high school football team,” one of the gentlemen proudly explained. “My youngest…” he continued looking embarrassed, “is struggling to keep his GPA above 2.0 and would be lucky to get five minutes of playing time.”

Both of the gentlemen laughed and proceeded to lament about the number of calories in the burritos they were planning to order.

“Yikes,” I thought to myself. How sad that these men had placed so much value in a series of numbers– GPA, minutes of playing time, calories in a burrito and passing yards in a high school football game.
 
 
This exchange got me thinking about the significance of numbers in my own life.

Just this past weekend:

• One of my friends was bragging about how many steps they took
• My parents celebrated their 35th wedding anniversary
• Someone at Panera changed their original order because they were “horrified” by the number of calories posted on the menu
• While on a walk, I overheard a group of teenagers make an inappropriate comment about a young woman running – rating that person’s looks on a scale of 1 to 10.
• My friend just completed a marathon and was dissatisfied with her finishing time of 3 hours and 38 minutes

For those who haven’t hit these milestones, or who don’t reach an ambiguous point that has been deemed by society as worthy, these numbers can have detrimental effects on self-esteem and self-worth. Who cares how many steps you take in a day? If a human being was able to run 26.2 miles, who cares how long they took to do so?! Why are my parents celebrated because they stayed together for a greater amount of time than someone who got divorced after ten years of marriage? In a world where having the highest (or best) number is some invisible trophy in life, it almost seems as though we’re setting ourselves up for failure and disappointment.

Being in the eating disorder field, I am surrounded by the “weight” of numbers (pun intended). Our clients place an extreme amount of importance on the number displayed on the scale, are consumed by thoughts of calories, and base their worth off of how many minutes of exercise they finished and an ambiguous measurement of their body mass index (BMI).

We can’t blame society for emphasizing numbers like this. We, as humans have an innate desire to compete and compare as a way for us to relate to one another and, unfortunately, assign a value to ourselves.

The Social Learning Theory, developed by psychologist Leon Festinger in the 1950’s, suggests that there is an internal drive within individuals to understand how they “stack” up against the rest of the world to gain a more accurate reflection of self. We do this in all areas of our lives including relationships, education, health/fitness and careers.

So what can do to combat this human tendency that we are all basically hard-wired to experience?!

Well it’s certainly tough. Being a type-A person myself, I struggle to accept a world that doesn’t involve striving for perfection, certainty and control. If the only way that we can understand ourselves is in terms of measurable numeric milestones, we are doing ourselves a disservice. We are all far more than a combination of numeric standards put in place to minimize our own anxieties. I am not just a number. I am a writer. I am a daughter and a sister. I am a dog mama. I am kind and loyal–empathic and witty. I am worthy of disconnecting my worth from my weight, my IQ, my age, the amount of hours I spent at the gym and how many calories I consumed.

As I continue my journey into adulthood, I realize that I am not working to “better” myself. Rather than focusing on more numbers to rank myself arbitrarily in the world, I am learning how to better understand myself. Could I loosen up a little more? Absolutely. Would it benefit me to learn to accept that I don’t have control over everything? Of course. Instead of using comparison as a way to experience belonging and acceptance, I am going to try being more self-aware.

I will notice when I am minimizing myself to numbers. I will appreciate characteristics in others rather than diminish myself for not possessing them. Finally, and perhaps most importantly, I will accept where and who I am in life. My journey is unique, my journey is my own and I will certainly not allow my journey to be reduced to numbers and amounts.

####

Natalie Cohen is the Senior Marketing and Community Relations Associate as well as the Social Media Coordinator for Walden Behavioral Care.  She earned her Bachelor of Arts degree in Journalism from the University of Maine in Orono. Her favorite part of working at Walden is being able to act as an advocate for clients living with mental illnesses and interacting with other eating disorder professionals in the community. In her free time, Ms. Cohen enjoys practicing yoga, exploring the restaurant scene and spending time with her dog, Bella.

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