Unfortunately, there are many incorrect assumptions associated with eating disorders. One I see a lot is the assumption that in order to have an eating disorder, particularly anorexia nervosa, one has to have very low body weight.

This is simply not true.

Sadly these assumptions block those suffering from eating disorders from getting the life-saving treatment they need.

In fact, most people with eating disorders don’t necessarily fit neatly into an eating disorder category.

Eating disorders are more about how the person relates to food, exercise, and body than what a person looks like.

Let’s take a closer look at an eating disorder called “Atypical” Anorexia Nervosa (AAN). I put the word atypical in quotes because it is my understanding that more people suffer from AAN than anorexia nervosa, so there is really nothing atypical about it. Basically, AAN is the same as anorexia nervosa with one exception – those with AAN don’t meet the criteria for being underweight like those suffering from anorexia nervosa. In fact, some with AAN may live in a large body.

Symptoms of ANN are exactly the same as anorexia nervosa. AAN includes significant caloric restriction, intense fear of gaining weight, and overvaluation of body size and shape (ie. evaluating self-worth based on weight and shape).

Typical signs of Atypical Anorexia Nervosa could include:

• Extreme concern about weight and shape
• Preoccupation and worry about food
• Restriction of total calories consumed
• Avoidance of eating certain types or categories of food
• Avoidance of social situations that involve food
• Misuse of exercise or overexercising.

Often the assumption is that only white, young, female, and very thin people experience eating disorders. Because of this assumption, many eating disorders go undiagnosed. It is not uncommon for people with eating disorders, particularly those who live in large bodies, to get prescribed weight-loss diets which actually makes the eating disorder worse.

Is AAN as dangerous or serious as other eating disorders?

All eating disorders can be harmful to both physical and mental health. Eating disorders can be associated with isolation, rigid thinking, poor self-esteem, anxiety, depression, poor focus, and sleep disturbance.

What to do if you think you have an eating disorder:

Because of the abundance of misleading and harmful nutrition, weight, and exercise information, sufferers of eating disorders are often led to believe that they can recover from their eating disorder on their own. Sadly, this often prolongs the eating disorder and the suffering. If you think you have an eating disorder, here are some next steps to take:

• Find a treatment provider who has experience in treating eating disorders.
• Find a therapist and/or dietitian. This can be a good place to start. In your search make sure the clinician has expertise in treating eating disorders.
• Read about eating disorders.
• Listen to podcasts.
• Know that recovery from eating disorders is possible!

If you’re looking for more support in eating disorder recovery, I can help you make peace with food and your body. Drop me a note today.

It is normal to feel worry and fear from time to time. We all have experienced worry before a big test at school, a deadline at work, or a big event. Anxiety is a normal part of life. In fact, fear can help us stay safe by alerting us to possible danger, and a little bit of worrying can be motivating for some to take care of tasks. However, if you frequently feel and have intense worry, this could be an indication of an anxiety disorder.

Q: How common is anxiety?

A: Anxiety disorders are the most common mental health conditions. It is estimated that worldwide, more than 264 million people have anxiety, and about 40 million Americans have it. Anxiety is more common in girls and women than in boys and men. There are different kinds of anxiety disorders including generalized anxiety, obsessive-compulsive disorder (OCD), panic disorders, phobias, and post-traumatic distress disorder (PTSD), to name a few.

Q: How do I know if I have an anxiety disorder?

A: The short answer is: Talk to your doctor to help determine if you have an anxiety disorder.

Let your doctor know if you experience any of these common symptoms of anxiety, including excessive and uncontrollable worry, feelings of nervousness, restlessness, and tension, trouble sleeping, gastro-intestinal upset, sweating, trembling, rapid heart rate, or a sense of panic or impending doom. Again we all experience anxiety from time to time, but if you frequently experience some of the symptoms above, it may be time to talk to your doctor.

Q: I have an eating disorder and I think I have anxiety. Can you help me with both?

A: Studies show that 50-80% of people who have an eating disorder also struggle with anxiety. It is not always clear which comes first – the eating disorder or anxiety – or if the anxiety and eating disorder emerged roughly at the same time.

Anxiety usually makes the eating disorder symptoms worse, so it must be treated simultaneously with the eating disorder.

It is standard in eating disorder treatment to also treat co-occurring conditions whether it is anxiety, depression, or another condition. Many therapies or methods used to treat eating disorders can also be used to treat anxiety.

Q: How is anxiety treated?

A: Anxiety is very treatable. Anxiety disorders can be treated with psychotherapy as well as medication. I use Cognitive Behavioral Therapy to help treat anxiety and eating disorders. In a nutshell, Cognitive Behavioral Therapy (CBT) is a well-studied treatment that proposes that thoughts, feelings, and behaviors are interconnected and greatly influence one another.

CBT helps identify and challenge thoughts that are distorted or inaccurate that often lead to intense and pervasive feelings such as anxiety and depression.

Practicing CBT skills with “homework” between counseling sessions is something that I use regularly with clients. It has been my experience that clients like to have tools that they can use outside of sessions to help them manage their anxiety and eating disorder, plus it can speed up treatment the more the skills are practiced.

To learn more about anxiety and treatment here are some resources to get you started:

• To learn more about CBT go here.
• Mayo Clinic
• Centre for Clinical Interventions
• The Feeling Good Podcast

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If you have started to notice that your anxiety is getting in the way of your normal functioning, it may be a good time to talk to a therapist. Get in touch here!

Often, teenage girls are most associated with eating disorders. While it is true that eating disorders often develop in adolescence, they still affect people of all ages. Motherhood, unfortunately, does not immunize us from eating disorders, either.

There are three common circumstances in which adults suffer from eating disorders:

1. The eating disorder developed in adolescence or in young adulthood and the individual never fully recovered or never received treatment.
2. The eating disorder developed earlier on in life and it re-occured in midlife.
3. The initial onset of the eating disorder occurred in adulthood.

In my counseling practice, I exclusively see adults with eating disorders, and many of my clients are also moms.

Motherhood presents a unique set challenge for individuals suffering from an eating disorder. Although, becoming a mother is associated with great excitement, it also comes with some stressors.

New moms are learning how to navigate their new identify while maintaining old identities of partner, friend, employee, etc. Because of this, parents often feel like they are being pulled in a million different directions.

Furthermore, normal changes in the body that are associated with pregnancy and beyond can be particularly stressful for some with an active or history of an eating disorder.

Change is a constant as a parent.  As children grow, their needs change, and so do our roles as parent.  Change along with with other stressors can trigger or exacerbate eating disorder symptoms.

Below there three basic tips to navigating motherhood while in eating disorder recovery.  

1). Make eating disorder treatment a priority.

Moms are often pulled in several different directions, busy taking care of everything and everyone.  Motherhood does not leave much time for self-care let alone recovery.

Making treatment a priority can mean regularly scheduling appointments for yourself with your therapist, dietitian, and other members of your treatment team.    

2).  Let go of perfectionism.

Perfectionist traits are often associated with eating disorders.  Furthermore, motherhood at times can feel like a competitive sport, which can reinforce perfectionism.  

Perfectionism is a never-ending cycle of setting very high and rigid stands in efforts to control and boost self-esteem, and when impossibly high standards aren’t met, feelings of failure set in, and the cycle of perfectionism begins all over again.

Practice doing things “good enough” and focus on making progress. (I am sure you have heard the saying “progress, not perfection”).  For more tips on how to overcome perfectionism, click here.

3).  Get good at saying “no.”

Setting boundaries and limits with your schedule and your children is essential.  There are only so many hours in the day, and you have only so much energy.

It is easy to let your recovery get sidetracked with over scheduling yourself.

One important part of setting boundaries is first assessing what the most important things are to you:  where do you want to spend your energy and time? Second, once your priorities are established, get good at saying no to things that aren’t on your priority list.

So often, there is fear around saying no due to fear of hurting others, appearing selfish, or missing out.  Once you practice saying no, I think you will learn that none of these fears pan out.

Reserving energy and time to focus on your recovery is not selfish.   When you are actively working on your eating disorder recovery and taking care of yourself, you will be more available to be a stronger mother, partner, and friend.

Please call for a free 15-minute phone consultation to learn how I work with clients with eating disorders.

Don’t live in the Austin Area, but want tips about how to improve your relationship with food and your body? Subscribe to my newsletter here.

Dads play an important role in helping daughters develop a positive body image

If you are a Dad of an adolescent girl, unfortunately, you may have heard your daughter say something like, “I am so ugly” or “I hate my thighs, they are so fat”. You may have stared at her like a deer in headlights. Or perhaps offered her well-intended advice such as “just cut down on carbs if you are worried about becoming fat” or offered re-assurance to her such as “You are not fat, you are beautiful just how you are”.  Unfortunately, societal pressure to look a certain way for boys and men is becoming more common.  For girls and women, it is a

Unfortunately, societal pressure to look a certain way for boys and men is becoming more common.  For girls and women, it is a societal norm to experience & talk about body dissatisfaction. Girls and women are inundated with media images about how they “should” look.Continue reading→

Starting a new diet can feel like starting a new romantic relationship—exciting, hopeful, and thrilling at first. Dieting promises that when the weight is lost, life will really begin.

The reality of dieting.

Just like a new relationship, starting a new diet usually feels really good. There is ease in following a new diet because you don’t have to feel preoccupied about what to eat.  While there is effort in planning meals, there is this sense of relief that goes along with it. This dieting euphoria can last for a while. Just like a new relationship, starting a new diet usually feels really good.Continue reading→