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Building a Healthier Relationship with Food by Having Unconditional Permission to Eat

Monte Nido Newport Beach Registered Dietitian Courtney Toya, MS, RD discusses building a healthier relationship with food in this week’s blog post. Courtney dives into the idea of giving ourselves permission to eat. She shares the importance of listening to our bodies instead of applying external rules that dictate our behavior.

We live in a world of conditions:

You are beautiful if you look like ____________.

You are doing enough as long as you _______________.

You are healthy if you: eat cleanly, exercised, restricted your cravings.

You are “good” if you’ve practiced self-restraint with food.

You are “bad” if you like desserts or fast food.

You are accepted in society if you ____________________.

…and the list goes on and on. In the diet and body-focused world we live in today, society attaches our worth and value to our food consumption and physical appearance. While every human being requires food for fuel, life, and sustenance, oddly enough our value and worth is judged by our food choices. Individuals are perceived as healthier, more attractive, and overall better if they follow the latest diet rules. And yet, it isn’t that simple- these rules change with each fad diet, newest exercise program, latest superfood, and ideal body shape. In a world where people are never satisfied with their appearance, the conditions will continue to torment us.

In my work within the diverse population of individuals battling an eating disorder, I’ve found that one of the most significant disturbances in one’s relationship with food is their permission to eat. I have yet to meet a client who gives themselves unconditional permission to eat- an Intuitive Eating concept initiated by Evelyn Tribole and Elyse Resch, authors of the book, “Intuitive Eating.” This concept stems from the idea that we as humans have the right to honor our cravings, enjoy our food, and eat to the point of satisfaction regardless of how we are feeling, our weight, our appearance, or whether we’ve exercised or not. While this unconditional permission can seem frivolous with a lack of accountability, it is not a “free for all” with food. Rather, it acknowledges that you can give yourself permission to eat that same food today, tomorrow, and the day after- if you want. That you can have a handful of chips instead of none at all or the whole bag because you can have more tomorrow. This isn’t the “last supper.” If you are craving a cookie during snack time, this approach encourages you to have the cookie despite not following the conditions or rules you may have around food.

To many with an eating disorder, having a cookie requires following many food rules. For example, doing a certain amount of physical activity to compensate, eating a lighter meal prior, having “healthy” and “clean” foods for the rest of the day, or self-inducing vomiting after to get rid of it, to name a few. Following these rules bring a false sense of security that encourages a life based on conditions, lacking freedom and flexibility around food.

Living a conditional life completely takes one out of the driver’s seat to their own life, where external rules and conditions overtake one’s preferences, cravings, and desires. The work done at Monte Nido cultivates a relationship with food where everyone can one day be in charge and conscious of their eating- to provide nourishment and sustenance with a variety of foods. It acknowledges that sometimes nourishing your body looks like having fruit with nut butter or a cookie with milk. There are no conditions to meet to honor those preferences and needs. To honor and nourish your needs is to be human and in charge instead of manipulating them.

 

To learn more about our newest eating disorder day treatment center opening in early 2018, Monte Nido Eating Disorder Center of  Westchester, visit our website or call an Admissions Specialist at 888.228.1253.

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Treating Adolescents and Adults in the Same Milieu

At Monte Nido, adolescent-specific programming for teens is offered at the day treatment locations. Chief Clinical Officer Doug Bunnell, PhD, FAED, CEDS explains when adolescents benefit from this type of mixed milieu and when programming should be separate in this week’s blog post.

The average age of onset for most eating disorders sits squarely in early to middle of adolescence. Even with early detection and treatment, many individuals move from adolescence to adulthood with their eating disorder in tow. Many things about the eating disorder shift in this developmental transition. These include the nature of medical risks of the eating disorder, the role of the family in treatment, the tone and content of motivation and ambivalence about change, and the degree to which the individual is free and capable of making their own decisions regarding treatment. But in many ways the eating disorder effectively resists maturation; that is, the symptoms, behaviors, anxieties, and core cognitions remain similar across the developmental range. 

There are certainly advantages to structuring intensive treatment programs along developmental lines. Separating adolescent from adult clients allows programs to tailor clinical content and core treatment interventions. One common rationale in favor of separate programming is that separation allows for more focus on family work and support. These issues are particularly important at the residential level of care. I believe, however, that there are strong arguments in favor of providing opportunities for adolescents and adults to work together in treatment as they move to lower levels of care such as day treatment programs.

Adolescents with eating disorder are generally more overtly resistant to treatment than adults. As a rule, adolescents minimize the impact of the eating disorder on their lives and tend to see the eating disorder as something that enhances them in some important way. This can make treatment engagement particularly challenging because adolescents often see treatment as a process that will take something precious away from them. Adults – by virtue of maturation – may often have developed a greater perspective for what the eating disorder has cost them in terms of their physical and relational wellbeing. Even young adults have a greater capacity to look forward and begin to wrestle with the implications of moving through their lives without fully resolving their eating disorder.

Combining adolescents and adults in day treatment programs helps bridge this motivational divide. Teen-only groups can coalesce around a negative or resistant view about treatment. Young adult and adult groups are less likely to stay stuck in a defiant stance. This openness to the possibility of recovery and change can have a powerful impact on a adolescent that isn’t sure they are ready to engage. Hearing from an older peer about the impact of their eating disorder can break through the defiance in a way that a therapist or a family member can’t. These moments, where an adult patient connects and emotionally touches an adolescent on this issue of desire for change, can be enormously powerful, even transformative. Mixing adolescents and adults can also minimize group comparisons and competition. These dynamics can flourish in adolescent-only groups and inhibit recovery. Many adolescents and adults tell us that they often feel disconnected or set-apart in their relationships. Treatment environments that provide a range of healthy relationship opportunities, with staff and with fellow clients, increase the chances for a meaningful connection that can help build the momentum for change and recovery.

It takes a strong and experienced treatment team to create and manage these interactions. Teens do need their own separate spaces to address their unique developmental issues. They need specialized family therapy services and support. The group therapy content in mixed groups requires thoughtful monitoring by staff. Day programs that mix adolescents with adults must provide these separated program elements. Programs that mix adolescents and adults need to have distinct models and goals for family therapy and support.  With careful and thoughtful attention to these modifications, mixed day treatment programming for adolescents and adults can take advantage of the power of connection between an adolescent with and eating disorder and an adult who can recognize where that adolescent is now and, perhaps more importantly, provide a glimpse of where they are headed.

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Part One: Group Therapy in Eating Disorder Treatment

Monte Nido Philadelphia Primary Therapist Kate Funk begins a three part series opening up about some of her journey in eating disorder treatment. In the series, not only does Kate share her personal experience, Monte Nido alumni contribute as well. We are thankful to Kate and all of our alumni who offered some of their personal recovery journey in the hopes of helping others.

Twelve years ago this fall I began my eating disorder treatment and my journey towards recovered. I was terrified to go to treatment; the food, the therapy, the other clients, I wanted none of it! Little did I know I was about to meet some of the most talented, warm hearted, creative, and loving people I’ve ever met. Some of which I still keep in touch with. I truly believe meeting those people changed my life for the better. I was no longer alone, people understood me. Prior to entering treatment I was convinced I was defective, too weird to make deep connections let alone friends. But there I was, creating relationships that healed so many old wounds. I found hope in those authentic relationships and thought if I could build meaningful relationships in that setting then maybe I could create relationships in my “real” world as well! It gave me the confidence to talk to people and not shy away from being my true self. That time in my life was a springboard for learning to trust and rely on others and helped shape me into the recovered person I am today.

Since becoming a therapist at Monte Nido I have witnessed something similar occur in our clients as they build relationships with each other. It is truly magical to see new clients come in quiet and nervous and transform into their true selves. I see them laugh, connect, and share their emotions with their peers. I wanted to write a post about the importance of group and relationships since I often hear prospective clients mention the fear that speaking in group causes them and when people mention feeling individual therapy is more valuable than group. Group therapy is an integral part of our program and who better to tell you than alumni from Monte Nido Philadelphia (In order to uphold their confidentiality their first initial or first two initials were used).

As I mentioned earlier, new clients often dread group therapy but we often witness them warm up to group and support one another. L shares her experience being weary of group therapy, “In the beginning group therapy terrified me. As an introvert with social anxiety, I wondered how I would open up in individual therapy, let alone in a group setting. But as time went on, and I got to know the people in the group, I felt more at ease. In fact, I began to look forward to groups as a time to learn from my peers and to feel supported and understood when I didn’t feel that way around other people in my family and social circles. Just being around other people who were so diverse yet whose struggles were similar to my own gave me a sense of community and belonging. I owe it to many of my peers for helping me make it through a very difficult treatment journey, and we continue to support each other even though we no longer belong to the treatment “milieu.” H also discussed her discomfort in the beginning of treatment, “When I first entered treatment I had been alone for so long that having people around was a little bit scary, but also relieving. It was there, that I learned what true connection felt like. I finally felt loved and cared about enough to let myself be seen. I was able to laugh and make jokes and be myself for the first time in years. I also discovered that unlike I had previously thought, I was not the only one who was feeling this way”.

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Give Back to Your Body

Jennifer Kreatsoulas, PhD, RYT 500 is the founder of Chime Yoga Therapy and specializes in eating disorders and body image. In addition to her private yoga therapy practice, Jennifer leads yoga therapy groups at the Monte Nido Eating Disorder Center of Philadelphia, is cofounder of the Body Kindness Project, and a partner with both the Yoga and Body Image Coalition and the Transformation Yoga Project. She is the creator of the home video series Yoga to Strengthen Body Image and Support Eating Disorder Recovery. Her writing on the topics of yoga, body image, motherhood, and eating disorder recovery can be found on her blog as well as several influential online publications. In this week’s post, Jennifer dives into caring for and giving back to your body.

I recently started rock climbing at a local gym. I’d been searching for an empowering activity that I can do alone and with my family. I quickly took to climbing for many reasons, one being that it reminded me of Yoga, just on a really steep, high wall. To move safely and successfully up the wall, I need to be super present and I must breathe to keep my body steady and mind alert. Rock climbing is also an opportunity for me to practice two profound lessons of my eating disorder recovery—acceptance of the moment and letting go of perfection. Let’s face it, if I am anywhere but in the moment, I will fall or even hurt myself. Every movement requires my complete attention to harness strength and determination.

I am especially excited that my 6- and 4-year old daughters are enjoying climbing. I am hopeful this activity will help them forge affirming relationships with their bodies and cultivate the virtues of resilience, confidence, and perseverance. Their expressions of amazement and pleasure when they reach a new point on the wall gives me great peace of mind, enforcing the hope that my girls will always be proud of their bodies.

Since adding rock climbing to my life, I’ve naturally been more hungry. In the past, exercise and food were complicated for me. I could never quite believe that I needed to eat more to compensate for my activity. This harmful belief caused grave problems in my years of overexercising two decades ago. Vestiges of that belief have showed up over the course of my recovery, especially with intense cardio workouts. I’ve learned to respect my truth that certain activities aggravate old ED beliefs versus view this reality as a limitation or failure. I am stronger when I engage in activities that inspire self-empowerment instead of self-doubt.

After a recent climb the words “give back to your body” came to the forefront of my mind. Expressions like “food is fuel” or “energy in, energy out” have never resonated with me. Sure, I understand and agree with the rationale of these sayings and others like them. But they aren’t my go tos when it comes to how I describe nourishing myself.

In all honesty, I think so many people used to say those sayings to me when I was in the eating disorder that I developed a visceral resistance to them. For me, and because of my history with the eating disorder, those common expressions feel empty of motivation or comfort. I believe our recovery works best for each of us when we use language that most powerfully resonates with our personalities, values, and true selves. The more I tuned into this new mantra, “give back to your body,” the more right these words felt, the more deeply they resonated with my beliefs around how I want to nourish mind, body, and spirit.

After climbing, giving back to myself meant satisfying my hunger, hydrating, stretching my muscles, and resting. When framed as “giving back to my body,” these self-care activities felt like an extension of the climb I had enjoyed, which was a palpable shift from the frustrating feeling of needing to fit in a meal or remember to hydrate on busy days. “Give back to your body” also incites a sense of permission to truly take care of myself and honors the fact that all day long I exert myself physically, mentally, emotionally in various capacities. I plan to use this language with my daughters with the intention of instilling in them a sense of responsibility to care for their precious bodies with respect, diligence, and care.

How does this mantra, “give back to your body” resonate with you? I invite you to try it out or explore other language that will foster a kind and respectful relationship with your body. I also encourage you to explore all the areas in your recovery and life you can give back to your body. Giving back to ourselves is a true act of recovery. Giving back to our bodies builds our strength to continue healing and expanding our possibilities for happiness.

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Sea Glass Grant Recipient: The Freedom Project

At Monte Nido & Affiliates, we save lives while providing the opportunity for people to realize their healthy selves. One of the ways we want to help provide opportunities for individuals to realize their healthy selves is through our Sea Glass Grants opportunity. A Sea Glass Grant aims to support small projects that create, develop or communicate a project that supports eating disorder recovery and healthy self-image. The Freedom Project is the most recent winner of the Sea Glass grant. Read this week’s blog post to learn more about this special organization and the important working being done. 

 

Tell us about the process of creating The Freedom Project?

At age 21 and 6 years deep into bulimia, Andrea promised God and herself that if she could recovery from her eating disorder she would do whatever it took to help others recover and to prevent eating disorders. Now at age 27, Andrea has 7 years of recovery and pursued a degree in professional counseling. As a leader at a local youth group with several other leaders along side, helping teens struggling with eating disorders and body image issues began. This is where the Freedom Project became her dream.

How has The Freedom Project helped you in your recovery journey?

I am held accountable by the teens and adults that I am a mentor to. It keeps me forward focused even on the hard days and I am constantly reminded of where I came from, how far I’ve come, and to be cautious.

What feeling do you most associate with The Freedom Project?

Equal feelings between excitement and nervousness as we truly lack knowledge on effective recovery techniques and would really benefit from attending an eating disorder conference.

Walk me through what you hope to offer teens in your area in the short term?

We hope to offer 1:1 sessions and group therapy with teens struggling with eating disorders. (All services free of charge.)

Long term?

My ultimate dream would be to open an 8 bed residential treatment program.

What is your favorite part of the day-to-day Freedom Project process?

Seeing my teens improve towards conquering their eating disorders, one step at a time and helping their peers with struggles.

How can people get involved?

Contact me! I am currently in the process of setting up a weekly group that would benefit from a co leader. We could also use further training. Sending a leader to an eating disorder conference would be ideal in order to increase the knowledge within our team. Leaders currently participate in 1:1 talks, weekly text check ups are always helpful for these teens. Every leader has something different and special to offer.

What advice would you give to someone in their recovery who has a dream?

When we follow our dreams, we create an opportunity for someone else that we wish we had. It is so important. Just like starting recovery, it may seem impossible but the truth is, there is a way! Suffering produces perseverance; perseverance, character; and character, hope. Romans 5:3

What are your hopes and dreams for The Freedom Project?

To help those suffering with eating disorder recover. Ultimately to build those who recover up and educate them so that they too can help others!

 

To learn more about The Freedom Project, email Andrea: freedomproject04330@gmail.com

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.

 


The Diana Effect: Princess Diana’s Legacy of Mental Health Awareness Continues

Becky Henry is trained as a Certified, Professional Co-Active Coach (CPCC) and uses those skills to guide families to let go of fear and panic, learn self-care skills and become effective guides for their loved one in eating disorder recovery. In this week’s post, Becky discusses the anniversary of Princess Diana’s passing and some of the impact that has had on mental health stigma.
The world is mourning Diana all over again on the 20th anniversary of her untimely death.

And I’m celebrating.

I’m celebrating because some of the world changing work she did in addition to helping people impacted by land-mines and AIDs/HIV was to reduce the VAST stigma associated with bulimia.

And now her brave, bold, vulnerability is helping bring eating disorders to the public’s attention again. As Brene Brown says, “Vulnerability is the birthplace of innovation, creativity and change.”

I’m so grateful to this beautiful soul for her vulnerability.

​​Don’t get me wrong, my heart breaks for these young men who long to have their mother. To listen to them say they’ve not talked enough about the trauma of her dearth all these years is so very sad. I’d always hoped that they’d been able to comfort one another. Maybe now they are.

​I mourn because we lost this incredibly generous, loving, mother of two boys that she loved more than anything.

Through Diana’s vulnerability and courage in speaking out about her incredibly private struggle with bulimia she personally impacted regular people who reached out for help with their own bulimia. She created what became known as the “Diana Effect” wherein the numbers of people reaching out for help with their bulimia increased. These people were emboldened by her bravery to speak out. ​

She gave regular folks ‘permission’ to speak about what they felt was unspeakable.  

Diana helped reduce the stigma of mental illnesses. And now her beloved sons are continuing her good work. William and Harry along with Kate have created a charity called, “Heads Together” to help educate about mental health and reduce stigma as well as increase access to care.

Recently William participated in a film about eating disorders and spoke about his mother’s bravery in speaking out about her struggles with bulimia.

William and Harry are doing so much to honor their mother’s work and continue speaking out about mental health. You can see William praising his mother for being so candid in this interview. Together we can all re-ignite the “Diana Effect” to honor her memory and help bring more attention to bulimia which affects more people than even anorexia. I’ve been waiting YEARS for Diana’s boys to do this.

I’m so grateful that this day has come. Thank you William and Harry!

Will you please join me in following @HeadsTogether on Twitter? It’s one step to help resume the “Diana Effect” that went away 20 years ago when she died so suddenly.

Just this past week a young woman in the UK died from an eating disorder. Every day 23 people die from these most deadly of all mental illnesses. We can do something simply by retweeting the @HeadsTogether tweets and supporting that organization. I invite you to also share my tweets @HopeNetworkBeck to help educate about eating disorders.

Twenty years ago the world was mourning a beautiful, remarkable princess and brave woman who made the world a better place.  As we mourn her all over again, let’s honor her memory and speak out about the most deadly of all mental illnesses, eating disorders. ​

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Times of Change and Transition

 

Shari Botwin, LCSW has been counseling survivors of eating disorders and trauma in her Cherry Hill private practice for over 20 years.  She has appeared on several national media outlets offering commentary on the connection between developing an eating disorder after living through some type of abuse. Shari has also published feature articles on the Cosby trial, the Orlando nightclub shootings, the Paris massacre and the anniversary of 9/11. In the coming months Shari will be featured on global podcasts on topics related to recovery. In this weeks post, Shari discussing the challenges that might come during times of change and transition.

A recurring theme in my practice when working with someone recovering from an eating disorder is the role of transition and change. Whether I am meeting someone for the first time as a teenager or I have a patient that returns to therapy after being in remission from symptoms for ten years, a shift in one’s life plays a significant role in the eating disorder coming to life or resurfacing.

Many people struggle with separation and change, not just patients that report eating disorders. It is not the change itself that is the problem, it is how we are equipped to deal with whatever milestone or life events that come our way.

Through the years I have met several seventeen and eighteen year old girls who are preparing to leave home and go to college. When they enter therapy they are perplexed by the recent changes in their thoughts and feelings about food. I was working with one young woman who reported having a great relationship with food until she became a senior in high school. She told me, “All of a sudden I find myself struggling with thoughts and feelings about food and weight.” After a few sessions I met with mom and started exploring how she had handled transitions earlier in her life. I remember mom saying, “She has always had trouble starting something new.” Mom told me about her separation anxiety when starting kindergarten and then again when going off to middle school. Once we began talking about her fears of leaving home to go to college Christy and I were able to make sense of her eating disorder. I remember asking her, “If you weren’t thinking about food so much what would you be thinking about? And what are you most afraid of?” Christy told me there was a part of her that did not want to grow up. We realized that if she shrunk herself up she could in some ways keep herself a child. Christy also spoke about her fear of losing her parents and that her eating disorder was a way to mask these irrational ideas. Once we reframed that she would not lose her parents, but that the contact would just be shifting once she left for school she was able to tolerate the upcoming changes.

I have worked with other patients who have had to confront significant loss during times of change. Surprisingly happy life events such as weddings, pregnancies and having children can lead to devastating affects with the eating disorder if the feelings are not acknowledged. I see a lot of trauma survivors with a history of eating disorders and some type of childhood abuse. Many of them used symptoms of different types of eating disorders as a result traumatic experiences left undigested and unacknowledged. Before I began counseling others I spent several years in therapy working through my childhood abuse and anorexia/binge eating disorder. Years went by where my eating disorder was in remission. In my late 30’s I decided to start a family and was blessed with a child after turning 40 years old. While this was by far the happiest time in my life it also stirred up some deep rooted loss and shame.

I always tell my patients no matter how much time goes by, if you find yourselves having urges to reconnect with your eating disorder most likely it is telling you that something needs attention. While I spent years grieving the loss of my family of origin, becoming a new mom brought up new feelings I had not addressed. Rather than giving into my eating disorder I worked hard with my therapist to name all the feelings and talk about what it was like to bring a child into my world and know I had no parents of my own to share that with.

I remember working with another patient, Samantha, who had been in remission from her binge eating for over 10 years. She started seeing me months before her wedding. She was thrilled with her choice of partner and expressed joy about her wedding day. But she also told me, “I do not understand why, but I am in symptoms almost every night since I picked out my wedding dress.” We explored the part of her that was avoiding grieving her losses associated with starting a family of her own. She was able to talk about the death of her mom in adolescence and the pain she was trying to push away. Samantha went to therapy immediately after her mom’s passing. She spent a few years learning how to replace the bingeing with connection and ways to manage her feelings. I remember asking her, “What is it about getting married that makes you miss your mom the most?” It was so painful for her to express the sadness about her mom not being able to share that day with her. Samantha also reflected on her desire to have children and how “more than anything I wish my mom could be here for all of that.”

Recovery from an eating disorder at times can bring up the most dreadful of feelings. The hope in what I did after giving birth to my son, or how Christy could voice her fears of leaving home, or Samantha could allow herself to revisit new feelings of an old loss is we all found ways to put words to our experience. Change, whether happy, sad, good, or bad can bring up the worst of feelings. The eating disorder becomes the comforter, the punisher, the coping mechanism to feelings we wish we could make go away. It is scary to think an eating disorder can resurface at any time, even years after being in recovery. Rather than deny its appearance or act like it is not there, the best thing we can do is use it as information and find ways to make sense of it. Times of change for anyone is stressful and triggering. Use the feelings as an opportunity to work through something in your life that still needs attention rather than spend all those hours, days and weeks destroying the most beautiful parts about you!

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Articles for the Soul

Join us in reading soulful articles we have cultivated from across the web. If you have found an article you feel is inspirational, explores current research, or is a knowledgeable piece of literature and would like to share with us please send an e-mail here.

What is Your Eating Disorder Keeping You From? Huffington Post

Raising Awareness of Orthorexia Eating Disorder Hope

Comparison is the Thief of Joy NEDA

A Meditation Ritual to Relieve Stress & Anxiety Mind Body Green 

What You Need to Know About Stress and Self-Care Psychology Care

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Treating Males with Eating Disorders

Doug Bunnell, PhD, FAED, CEDS is an expert clinician and leader in the eating disorder field. He brings over three decades of experience and a wealth of knowledge to his role as Monte Nido & Affiliates Chief Clinical Officer. In this week’s blog post, Dr. Bunnell discusses some of the differences in treating males with eating disorders compared to females.

Most of what we know about Eating Disorders is based on what we know about women with eating disorders. Most of what we know about men with eating disorders is based on what we know about conventional models of masculinity. Most of what we know about either of these topics is heavily influenced by our own gender, sexual identities, and ethnic backgrounds.

These are the limitations that we, as psychotherapists, bring to the room when working with males- an underserved population in the world of eating disorder treatment. By examining the differences and similarities between how males and females with eating disorders present clinically, we will shed light on issues to be aware of as clinicians, as well as provide suggestions based in evidence regarding how we can move towards a more comprehensive treatment of the eating disorder population.

Conventional wisdom tells us that 1 in 10 people with Eating Disorders are male, but data suggests that 25% of diagnosable cases occur in males and that males have higher rates of disordered eating (Hudson et al., 2007).  Unfortunately, the under reporting is likely a result of stigma, lack of sensitivity and detection, and gendered perceptions of eating and dieting. The lower occurrence of eating disorders in males may, however, also be attributed to gendered differences in the risk and maintaining factors for eating disorders.

Difference in biology, brain organization and temperament may insulate men against risk. Lower levels of mood disorder vulnerability also seems to put males at a lower risk as they have a greater tendency towards externalizing disorders than women.  Generally speaking, men present with less harm avoidance, less drive for thinness, and less body dissatisfaction; with what we know about eating disorders, these discrepancies should also account for the lower prevalence in the male population. There remains a profound difference in the way men and women are taught to think and feel about their bodies, their weight and their shape. The differences in social, cultural, psychological, and biological factors makes the detection, diagnosis and treatment of men with eating disorders particularly  complicated. It falls on us as clinicians to make sure that we bring a certain awareness of clinical features and differences into our female-normed assessments to work against the risk of underestimating rates and severity.

We must also maintain an acute awareness for the different clinical presentations of eating disorders in men. It is not as pertinent, for example, to assess for a “fear of fat” with a male client as males tend to pursue and overvalue a body that has less fat and more muscle. They tend to fear “softness” rather than “fatness”.  A preoccupation with the need to be “lean” might be more relevant to males with eating disorders rather than the drive for “thinness” often seen in females. Additionally, males with eating disorders may report that they are using steroids and human growth hormone to accentuate muscle development.

In addition to maintaining awareness of gender specific assessment of males with eating disorders, it is equally critical to be aware of the language we use in the treatment of males. For a clinician accustomed to treating females, it is likely common to use very emotionally charged language such as “opening up”, “sharing”, and even referring to “fat as a feeling”. Not only are men generally less familiar with eating disorders than women, but they also have been socialized by an unspoken male code to not be weak or vulnerable and to prioritize leadership, work and self-sufficiency. While it is an adjustment from the way we work with female clients, it doesn’t have to be an obstacle in helping our clients. Instead, we can work with sensitivity to issues associated with gender while assessing motivation to change and ambivalence. By leaving what works for female clients at the door, we serve our male clients better and respect their sense of masculinity- however that may look for any one individual. Based on our experience working with men in our partial hospital level of care, it is essential to address gender-based beliefs and distortions when assessing and designing a treatment plan. This includes the use of assessments that have been designed for men and careful clinical supervision to monitor the treatment and experience of our male clients.

As individuals working with an already stigmatized disorder, it is important to consider how much additional bravery it takes for a minority of an affected population to seek out our help. While we have made great strides in the treatment of eating disorders, there is always room for improvement. By using a male-specific treatment framework, we are best able to serve this population and respect their unique gender specific eating disorder challenges.

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram

 

 


The Soul’s Ingredients: How to help evolve a client’s relationship with their basic needs using the four agreements

Monte Nido presents “The Soul’s Ingredients: How to help evolve a client’s relationship with their basic needs using the four agreements” featuring Monte Nido Vista Dietitian Kym Wyman, RD.

The foundation of our relationship to self begins in our earliest experiences of how our basic physical needs are met or not met, and in what we witness from our primary caregivers. “Self care” by definition requires not only a healthy self, but also an action of care that is nurturing and consistent in supporting and affirming it. The distortions suffered by a client struggling with an eating disorder reside predominantly in how they view and define themselves and in how they define the word “care”. Using The Four Agreements, clients can begin to understand how their version of reality regarding self creates suffering. Evolving a client’s expression of care for self can be the launching point for recognizing the relationship to their basic physical needs and helping them to achieve recovery.

Attendees will be provided how to describe two techniques to help the client with their internal dialogue about food and exercise, describe the difference between responding rather than reacting to basic needs, identify three basic needs and explain how you might help a client form an intimate relationship to these needs. Accurately explain at least two beliefs and assumptions clients might hold regarding how food and exercise effects their bodies.

The presentation will take place on Friday, September 22nd at Napa Valley Grille Westwood in Los Angeles, CA. Check-in will begin at 11:30 and the presentation will be held from 12:00-1:00pm. One CE credit will be provided. Please reach out to Regional Outreach Manager Mary Andreasen at 310.721.6264 or MAndreasen@montenidoaffiliates.com with questions or to RSVP.

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