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REFLECTIONS washington university in st. louis

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THANK YOU A special thank you to the contributing members listed below Design & Photography: Julia Kent, Unsplash Contributors: Active Minds, Rebecca Lester, Kim McCallum Photo Shoot Participants: Emily Alves, Fabian Barch, Rachel Catanese, Molly Chaney, Julian Duodu, Dennis Echevarria, Claire Fox, Tyler Frank, Davis Jenkins, Denise Monti, Rachel Philipp, Landis Powell, Rohan Shirali, Cara Silverman, Karisa Tavassoli, Maxine Wright

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THERE IS NO WRONG WAY TO

HAVE A BODY HANNE BLANK, “ REAL WOMEN ”

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INDEX Please note that some articles may be triggering to those struggling with an eating disorder. Readers are encouraged to use their own discretion. If you or someone you care about is struggling with an eating disorder, please reference page 9 for on-campus and off-campus resources. 6 eating disorders, signs and symptoms 7 eating disorders, statistics 8 eating disorder myths, busted 9 helpful resources 10 interview with kim mccallum 11 redirecting negative body-talk 12 how to help a friend 15 positive playlist 16 intuitive eating 18 love your body photo shoot 26 a thank you to my friends 28 stigma: society’s deadliest disease 30 dr. rebecca lester 34 why wustl students love their bodies 4


LETTER FROM REFLECTIONS Hello Wash U, First, we wanted to thank you for taking the time to look through

in the United States alone (NEDA). There is no doubt that

this magazine and supporting Eating Disorder Awareness Week (EDAW). Reflections participates in EDAW every year by

the reality of eating disorders is unsettling, and we believe that

bringing educational and body-positive activities to campus. This

are essential to triumph over these mental illnesses.

year, Reflections decided to take a different direction and created

Our goal was to share the stories of our peers and celebrate the

this magazine to help raise awareness regarding eating disorders

diversity of body types and personalities here at Wash U. We

and disordered eating and to promote positive body image

hope you find our final product informative and enlightening.

informed thought, dedicated action and compassionate support

throughout Wash U. The goal of National Eating Disorders Awareness Week is to increase public knowledge of the causes,

We hope that it encourages you to choose your words

triggers, and treatments related to eating disorders. By educating

compassionately and carefully, as anyone you speak to might be

our peers about the signs and symptoms of eating disorders,

fighting a private battle with their body. We hope that it motivates

we can make early detection more accessible and improve the

you to critically consider the world around you and how eating

likelihood of full recovery for the millions of people who

disorders continue to exist in it. Finally, we hope that it leaves you

struggle with these devastating disorders.

with the sense that it is possible to overcome eating disorders.

Many people have felt the impacts of eating disorders, whether

LYB,

through a personal experience, through supporting a friend or

Joo Lee and Kim Grunde

family member, or hearing about someone else’s story. This is an issue that affects 30 million people at some point in their lifetime 5


SIGNS AND SYMPTOMS Marilla Havens ANOREXIA NERVOSA

WORRIED ABOUT YOURSELF OR A FRIEND?

• Inadequate food intake leading to low weight

If you are concerned about yourself or a friend, please reference additional

• Self-esteem excessively related to body image

resources (page 9). These signs are typically, but not always, present in an

• Intense fear of weight gain

individual working through an eating disorder. These are guidelines for concern,

• Binge-eating or purging behaviors (binge/purge type only, not found in restricting type)

not diagnoses. Please seek professional help if you have any concerns. • Look for these early signs that someone may be struggling with an eating disorder.

BULIMIA NERVOSA

• Dramatic weight loss

• Frequent episodes of binging (consuming abnormally large amounts of food) followed by purging behaviors (self-induced

• Preoccupation with and anxiety about weight, calories, dieting, or exercise

vomiting, excessive exercise, etc.) , and a feeling of loss of

• Frequent comments about being ‘fat’ or overweight

control during these episodes

• Feelings of shame or guilt around food

• Self-esteem excessively related to body image

• Denial of hunger • Refusal to eat certain foods or food groups

BINGE EATING DISORDER

• Eating alone of secretively

• Frequent episodes of binging without purging behaviors, feeling

• Excessive, rigid exercise regimen

of loss of control during these episodes • Feelings of shame or guilt about binge eating

• Evidence of purging behavior–disappearing after meals, signs of vomiting, packages from laxatives • Withdrawal from usual activities or friends

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THE FACTS ON EATING DISORDERS Gabi Stone Statistics from National Eating Disorders Association and National

I HAD NO IDEA…

Association of Anorexia Nervosa and Associated Disorders

• As many as 24 million people in the United States suffer

It’s Eating Disorder Awareness Week, but how much do you really know about these illnesses? Numbers don’t lie, and when you are looking at eating disorder statistics, the numbers are shocking. 20 million women and 10 million men suffer from clinically significant eating disorder at some time in their life. Well-known eating disorders include anorexia nervosa and bulimia nervosa, but men and women also suffer from binge eating disorders and eating disorders not otherwise specified (EDNOS). Many cases are not likely to be reported, meaning these numbers are much likely even greater.

ACTING ONE’S AGE: • Approximately 80% of 10-year-old girls are afraid

from an eating disorder... • Only 10% of individuals with an eating disorder will receive treatment • 95% of eating disorders occur between the ages of 12 and 25. • The body type idealized in media is possessed naturally by 5% of women in the United States • Anorexia nervosa is the deadliest form of mental illness • Anorexia is the 3rd most common chronic illness among adolescents • There has been a rise in the number of incidences of the illness every year since 1930 • Approximately 10-15% of individuals diagnosed with anorexia nervosa and bulimia nervosa are male.

of being fat. • 42% of first graders want to be thinner • Over 50% of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors. • 12-13 years is the average age of eating disorder onset. 7


EATING DISORDER MYTHS, BUSTED Olivia Wolkoff Eating disorders affect millions of people across the United States and have the

a number of biological and psychological factors and are not

highest mortality rate of any mental illness, yet there remain rumors and stigma

exclusively related to body image. The messages we receive from

that alter our perceptions of these illnesses. Misconceptions about EDs should

our bodies have a significant impact on our self-image, but this is

never present an obstacle to someone seeking out help, so we’re here to clarify

not the same thing as an eating disorder.

common myths and give you the true facts about eating disorders.

MYTH 1: YOU CAN TELL IF SOMEONE HAS AN EATING DISORDER BASED ON THEIR APPEARANCE.

MYTH 4: PEOPLE WITH EATING DISORDERS SHOULD JUST GET OVER IT; THEY’RE CHOOSING HOW THEY LIVE. Fact: Eating disorders are complicated illnesses just like any other

Fact: The media tends to portray images of eating disorder

and should be taken seriously. The recovery process is much more

patients as severely emaciated, but in actuality EDs affect people

than an anorexic just deciding to eat or a bulimic deciding to

of all shapes and sizes. While individuals with anorexia may

stop purging. EDs are often intertwined with complex emotional

appear severely underweight, this is not always the case. What’s

issues and the acts of binging, restricting, or purging become

more, individuals with bulimia, binge eating, or other eating

a coping mechanism to help deal with challenging situations.

disorders likely have extreme fluctuations in weight and could

Individuals with eating disorders cannot just “get over” them;

appear overweight, underweight, or may seem to be a healthy

they require medical treatment just like any other illness. For

weight. When it comes to eating disorders, you definitely can’t

someone with an eating disorder, making the decision to pursue

judge a book by its cover.

treatment can be incredibly difficult and the process that follows takes time, effort, and commitment. Eating disorder recovery is

MYTH 2: ONLY WOMEN GET EATING DISORDERS.

much more than a lifestyle change.

Fact: It is true that the majority of eating disorder sufferers are affect men. Men represent at least 10% of all people with eating

MYTH 5: NO ONE EVER RECOVERS FROM AN EATING DISORDER.

disorders, and those numbers are even higher in certain diagnostic

Fact: Recovery is an incredibly challenging process, but that

categories. EDs can affect anyone and gender identity should

doesn’t mean it’s impossible. Treatment for an eating disorder may

never be a barrier to receiving treatment.

take years and for some an ED-free life seems like an unreachable

women, but that does not mean that these disorders don’t also

goal. However, with treatment, 60% of individuals with eating

MYTH 3: EATING DISORDERS ARE CAUSED BY THE BODY IMAGE PRESENTED IN THE MEDIA.

disorders make a full recovery and many more make partial

Fact: While body-negative attitudes promoted by the media are

promoting stigma so that these illnesses do not continue to have

certainly a serious issue, eating disorders are complex illnesses

such a high mortality rate.

that cannot be attributed to just one source. EDs develop from 8

recoveries. We need to encourage seeking out help rather than


RESOURCES Uncle Joe’s 314-935-5099

OFF CAMPUS: McCallum Place 800-828-8158

Gregg storefront walk-in hours 10pm-1am. 24/7 peer counseling

St. Louis area eating disorder treatment center for males and

by phone.

females of all ages.

SARAH 314-935-8080 Sexual Assault and Rape Anonymous Helpline. 24/7 peer-run,

National Eating Disorders Association Helpline 800-9312237

anonymous helpline.

Call for treatment options, information and referrals for you or a

Call for you, call for a friend.

friend. Confidential and compassionate.

ON CAMPUS:

SHS 314-935-6666 Basement of Dardick on the South 40. Call to make an

ONLINE:

appointment or ask questions.

www.nationaleatingdisorders.org www.nedawareness.org www.moeatingdisorders.org

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INTERVIEW WITH DR. McCALLUM Leah Cohen Dr. McCallum is a psychiatrist who is board certified in child, adolescent,

the better psychiatrist I would be. I was a neuroscience major

and adult psychiatry as well as a Certified Eating Disorders Specialist. Dr.

undergraduate and Psychiatry seemed to be the best pathway for

McCallum is the Associate Professor of Clinical Psychiatry at Washington

me to continue to be involved in the things that interested me.

University as well as the co-founder of the Missouri Eating Disorders Association (MOEDA) and the founder and CEO of the McCallum Eating

My first patient on my psychiatry rotation was a woman with

Disorder Centers in St. Louis and Austin, Texas. As an experienced physician

professor told me that I should not spend much time with her

and businesswoman Reflections asked Dr. McCallum to elaborate on her

because we didn’t really have effective treatments that could help

inspiring personal passion and successful career.

her to recover or improve her quality of life.

Leah: As college students, we are still trying to determine how

I could not accept this. It seems that such a prevalent illness that

our majors and interests can turn into careers. How did you first

affected young people in their prime deserved research attention

become interested in psychiatry and eating disorders, and when

and a plan to develop better treatment techniques. So, of course,

did you realize they would turn into your career?

I took this patient on as a Psychotherapy case and worked with

anorexia. She was brilliant, creative and talented and very ill. My

her twice a week throughout my residency. As a chief resident, Dr. McCallum: As a medical student I was interested in women’s

I helped to lead a partial hospital program that provided

health. Psychiatry was just coming into its own with an increased

intensive treatment for young women with eating disorders. I also

focus in psychosocial research; new psychotherapy techniques and

participated in educational programs sponsored by the sororities

theories about the role of neurotransmitters and brain circuitry in

on campus. There was such a tremendous need for information

mental illness were emerging. I thought that being a psychiatrist

and services. I was also lucky enough to have great mentorship.

would keep me very involved in the world. I had this idea that

Some of our faculty at UCLA were already beginning to

the more I traveled and learned about different cultures, the more

contribute to the field of eating disorders and encouraged me to

involved in my community, the more I participated in the arts,

explore my interests and attend national meetings.

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Leah: Not only are you an accomplished physician, but you are

Dr. McCallum: Finding good people with passion and varied

clearly a businesswoman as well. Can you speak to the intricacies

skills makes all the difference when you’re trying to build a

and challenges of founding and running McCallum Place as well

service organization. McCallum place is a medical home for

as the Missouri Eating Disorder Association?

patients with eating disorders. We treat anorexia, bulimia, binge eating disorder, orthorexia, compulsive exercise and behaviorally

Dr. McCallum: During my residency I committed to further

or medically complex obesity. We provide services for teenagers,

training in child and adolescent psychiatry so I could learn some

young adults and middle-aged adults males and females. Our

skills so that I could develop into specialty services for patients

programs integrate medical, psychological and nutritional care

with eating disorders. I found that within established hospital

building on evidence-based practice and skills for well being. Our

systems it was difficult to find the resources to invest in the

center in Webster Groves provides comprehensive evaluations and

extensive training necessary to provide the types of services likely

specialty group therapies. Our partial hospital and residential

to help my patients. My husband had a background in business

programs provide intensive services for those with more serious

and finance, so he helped me believe that we could develop a

symptoms.

plan and establish a center on our own. This was back in the days when it was hard to get a small business financing unless you were

Leah: How can college students get involved with organizations

starting a new dot com! We are grateful that we were able to find

like the Missouri Eating Disorder Association?

a bank that would take a chance and help us with our first loan. We believed that there was such a need so we would be able to find a way to continue to provide services. This helped us to stay

Dr. McCallum: College students can become involved with organizations like MOEDA (Missouri Eating Disorders

committed over the years.

Association), NEDA (National Eating Disorders Association) or the EDC (Eating Disorders Coalition) by volunteering for

We started MOEDA, the Missouri Eating Disorders Association

committee work for one of their projects like the Real Skinny

to address the lack of awareness about eating disorders, and

curriculum, the NEDA walk, or lobby day in Jefferson City or

family resources. Our goal was to get the message out that eating

even in Washington D.C.

disorders were serious and complex illnesses and that treatment makes a difference. We also wanted to bring tools to educators

Leah: What is your best advice for someone who is concerned

and hope to families. Over the years we have joined efforts with

about a friend who might be struggling with an eating disorder?

the National Eating disorders Association to sponsor the NEDA awareness walks and provide outreach and training during NEDA

Dr. McCallum: My best advice for someone who is concerned

awareness week. We developed a curriculum for educators: The

about a friend who might be struggling with an eating disorder

Real Skinny. This curriculum trains school professionals to

is to let him or her know that you are concerned, and that eating

identify students who are struggling and increase support for

disorders can be very serious, and treatment is important. Always

students returning from treatment.

approach them in a non-judging, supportive way. You might offer to provide them with resources or accompany them to reach out

Wanting to have a bigger impact, I have been involved in

to the RA or student health/counseling services. Let them know

professional training and lobbying/advocacy at the national level

that help is available and full recovery is possible.

for over a decade. The National Eating Disorders Association invited me to become a member of the Board of Directors eight

DR. MCCALLUM’S RECOMMENDED RESOURCES:

years ago. This had very much helped me to find focus for our

Mccallumplace.com

local organization.

Nationaleatingdisorders.org Moeatingdisorders.org

Leah: Can you take us through the capacities and services that McCallum Place offers for eating disorder treatment? 11


COMBATING NEGATIVE BODY TALK ON CAMPUS: WHAT YOU CAN DO Glenna Siegel College campuses provide the perfect environment for ideas

even objectifying, terms like “skinny” and “fat” perpetuate body

to spread–students live in close quarters, engage in constant

stigma and can trigger further negativity. Interactions online can

interaction in real life and online, and strive to improve at every

be even more detrimental since they are often more heavy-handed

chance. Whether purposefully or passively, we not only socialize,

and seen publicly.

but collaborate, on every topic from essays to dinner plans. This is not to say original or independent thoughts do not exist. There

More often than not, negative talk takes its fiercest form

is no quota for ideas; you can always start a conversation and

internally. Especially among a high achieving, perfectionist,

prompt a new chain. For this reason, we all have a tremendous

and competitive student body, we can be our own worst critics.

amount of power to determine campus conversations. Our

All of this considered, although in our heads, these are still

original idea can be introduced to peers and take on new form

conversations and follow similar patterns as those spoken out

from there, growing and changing.

loud. They can be interrupted and redirected to shine positive light instead of cast negativity on the entire day.

Unfortunately, this powerful rule of conversation also applies to negative topics, including deprecating body talk. If one person

Changing these conversations does not need to be difficult. As

criticizes his or her own appearance, the listeners might feel

discussed, you have the agency to alter tone and inspire the ideas

prompted to respond in turn, bashing their own bodies to try

to follow. It will still be just as cyclical and collaborative, but to

to ease the tension somehow. While some topics might drop by

a more positive end. No preaching or lecturing necessary; people

the time everyone looks away from the mirror or after a meal,

do not even need to notice that the topic has changed. See how

many people continue to internalize. Even one-word labels of

you can turn negative talk positive and lead by example in these

food, exercise, and people can cause damage. Oversimplifying,

common scenarios:

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WHEN RECEIVING A COMPLIMENT

GENERAL, GROUP BODY TALK

Instead of denying and refuting it by pointing out something you

Acknowledge the negative aspect of the conversation and then

don’t like about your body, say thank you and offer a compliment

try to change the subject. People love to talk about themselves–

in return.

just asking a question can smoothly redirect the course of the conversation.

WHEN DISCUSSING FOOD AND EXERCISE Avoid labels and comparisons; they are unproductive considering

IF YOUR OWN THOUGHTS ARE DEEPLY INGRAINED

“healthy” means something different for everyone. Focus on the

Use positive affirmations like Reflections’ love your body, or

memories from the meal or activity, not the calories consumed or

create one of your own that makes you feel empowered. A

burned.

favorite song can have the same effect. If you want to interrupt a negative cycle but feel too overwhelmed to arrive at a specific

WHEN GETTING DRESSED UP

solution in the moment, listen to an upbeat tune or repeat your

Encourage comfort. The stereotypical but all too common

affirmation. This will chip away at the negative thought and

question, “do I look fat in this?” can start a spiral of self-

provide you with some clarity to think of a longer-term solution.

deprecation, body labeling, and stigmatization. Respond with “wear what makes you feel good, you’ll have more fun if you’re

Changing negative conversations does not need to take the form

not thinking about your outfit the whole time” or “you’re

of an intervention or lecture. With simple dialogue and leading

beautiful, people are going to focus on you, not your outfit.”

by example, we can all make our community a healthier place.

These are true statements and move the conversation away from

It is also important to acknowledge that sometimes we all feel

the topic of bodies.

a little negative. Life is pretty dry without a little rain everyone now and then (get it?), and our faces would hurt if we smiled all

ON SOCIAL MEDIA

the time. That said, when we can, we must exercise the agency to

Like in real life conversation, people often follow the lead of

change negative talk and spread positivity. It just takes one person

the comment directly before them. Change the comment stream

to introduce a positive idea and inspire others to follow suit.

with a compliment about how happy he/she looks or about the scenery. It’s more meaningful and removes the focus from appearance. 13


HOW TO HELP A FRIEND Glenna Siegel

more important for your friend to feel appreciated and validated

By choosing to start a conversation, you create the opportunity to not just

than for you to express every detail on your own mind.

talk, but perhaps more importantly, to listen to your friend who may be

Refer your friend to professional resources. This reiterates your

struggling with an eating disorder or negative body image. Although it can feel

role as friend, not therapist, and it can help begin the recovery

uncomfortable to reach out at first, the long-term benefits outshine any potential

process if he or she chooses.

short-term downsides. Here are some tips to help you through the process: Don’t force anything. If your friend is not in an emotional place

BEFORE THE CONVERSATION:

to accept help or simply does not want it, this is not your fault.

Educate yourself. Read about the symptoms and habits that

Respect the situation and end the conversation by saying that

indicate eating disorders and disordered eating using online

you are trying to help because you care about them. Also offer to

tools like NEDA.org or speaking with a counselor. By becoming

talk later; your friend may just want to emotionally prepare and

familiar with these resources yourself, you know where to direct

process before discussing anything.

your friend if he or she needs additional support. Remember that even with this research, you are not an expert or a doctor.

AFTER THE CONVERSATION:

Your job as a friend is to show support and potentially direct to

Seek support for yourself. You might benefit from talking to

professional resources, not to “fix” or heal.

a counselor to address your feelings and hear a professional opinion on the situation. Talking about eating disorders and more

Reach out to your friend beforehand to let them know you would

generally about personal subjects is not easy; refuel by talking it

like to have a more serious conversation. This prevents springing

out with an objective third party. This will also provide you with

the conversation on someone, making it feel like an intervention

an outlet other than discussing with mutual friends, which can

or “gotcha” situation. Simply saying, “Hey, when are you free this

compromise your friend’s privacy.

week? Would love to talk” signals you have something on your mind. It’s probably on your friend’s mind too, so he or she can

Follow up with another conversation or even just a text. Knowing

pick up on the hint.

they have an ally can make a huge difference for someone who is struggling, even if they don’t seem receptive or don’t respond.

DURING THE CONVERSATION:

Eating disorders and negative body image are different for

Find a private, safe space. This will allow for more candid

everyone in both the physical and emotional sense. Conversations

conversation, maintain privacy, and can provide a sense of

of this nature are similarly varied case by case, so remember

comfort.

that these suggestions act only as general guidelines for healthy dialogue. They do not replace professional advice; as stated,

Use “I” statements and observations. This protects against

talking to a counselor can benefit both you and your friend.

accusations and ensures accuracy; all you know is what you see

By talking to a professional, you are also leading by example. In

and your own feelings.

that vein, strive to practice balanced eating and exercise habits, make time for self-care, and keep conversations body-positive in

Listen attentively. Some people might be bursting and grateful

real life and online. Be a role model and help everyone around

for the chance to open up; use this material as guidance for your

you, just like you’d like someone to support your own friend. It

conversation instead of any preconceived agenda. If you have

takes a community to redirect the dialogue about mental health

more to say, you can always have another conversation later. It’s

and body image – be part of the positive change.

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DANCE IT OUT Jason Hubsher Our 10 favorite body-positive tunes.. Whether you are getting ready for a big night out, enjoying quality “you time,” or starting your day with positive vibes, we love these songs and their body-positive, self love messages 1. INDIA.ARIE, “VIDEO” Love yourself unconditionally and do whatever feels good in your soul! 2. P!NK, “SO WHAT” Take it from P!nk: you are a rockstar, and rockstars don’t need anyone else to have a good time and a great attitude 3. SALT-N-PEPA, “BODY BEAUTIFUL” Your body is B-E-A-U-T-Y, BEAUTIFUL! You work it! 4. JESSE MCCARTNEY, “BEAUTIFUL SOUL” Jesse knows it is what’s inside that really matters. Love yourself and let your personality shine 5. CYNDI LAUPER, “GIRLS JUST WANT TO HAVE FUN” It’s all in your ATTITUDE, not your appearance! 6. ONE DIRECTION, “WHAT MAKES YOU BEAUTIFUL” Harry and Liam both are telling you that you are beautiful and it’s true! 8. SELENA GOMEZ, “WHO SAYS” Who says you’re not perfect? No one….you are your own perfect! 9. RIGHT SAID FRED, “I’M TOO SEXY” You are too sexy for negativity, too sexy for pessimism, too sexy it rocks 10. NATASHA BEDINGFIELD, “UNWRITTEN” No one else can feel it for you, only you can feel your feelings, release your inhibitions and make them positive ones! 15


INTUITIVE EATING Intuitive eating is a nutrition philosophy, not a diet plan. It rests on the principle that if you really get in touch with your own body and mind, you will eat healthy food naturally and without any particular effort. The basic summary is, “Eat when you’re hungry, stop when you’re full.” It encourages getting in touch with your body so that you can tell when you are truly hungry and truly full versus eating or restricting as a way to avoid dealing with another emotion. Intuitive eating has no “diet rules,” “forbidden foods,” or calorie counting, and the ultimate goal is not to achieve any particular body size or shape, but rather to be healthy.

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PRINCIPLES Taken from intuitiveeating.org

REJECT THE DIET MENTALITY

DISCOVER THE SATISFACTION FACTOR

Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily, and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet stopped working and you gained back all of the weight.

In our fury to be thin, we often overlook one of the most basic gifts of existence–the pleasure and satisfaction that can be found in the eating experience. When you eat what you really want, in an environment that is inviting and conducive, the pleasure you derive will be a powerful force in helping you feel satisfied and content. By providing this experience for yourself, you will find that it takes much less food to decide you've had "enough."

HONOR YOUR HUNGER Keep your body biologically fed with adequate energy and carbohydrates. Otherwise you can trigger a primal drive to overeat. Once you reach the moment of excessive hunger, all intentions of moderate, conscious eating are fleeting and irrelevant. Learning to honor this first biological signal sets the stage for re-building trust with yourself and food.

HONOR YOUR FEELINGS Find ways to comfort, nurture, and resolve your issues without using food. Anxiety, loneliness, boredom, anger are emotions we all experience throughout life. Food won't fix any of these feelings.

MAKE PEACE WITH FOOD

RESPECT YOUR BODY

Call a truce, stop the food fight! Give yourself unconditional permission to eat. If you tell yourself that you can't or shouldn't have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, binging.

Accept your genetic blueprint. Just as a person with a shoe size of eight would not expect to realistically squeeze into a size six, it is equally as futile (and uncomfortable) to have the same expectation with body size. But mostly, respect your body, so you can feel better about who you are. It's hard to reject the diet mentality if you are unrealistic and overly critical about your body shape.

CHALLENGE THE FOOD POLICE Scream a loud "NO" to thoughts in your head that declare you're "good" for eating under 1,000 calories or "bad" because you ate a piece of chocolate cake. The Food Police monitor the unreasonable rules that dieting has created.

RESPECT YOUR FULLNESS Listen for the body signals that tell you that you are no longer hungry. Observe the signs that show that you're comfortably full. Pause in the middle of a meal or food and ask yourself how the food tastes, and what is your current fullness level?

EXERCISE Feel the difference. Forget militant exercise. Just get active and feel the difference. Shift your focus to how it feels to move your body, such as energizing, rather than the calorie burning effect of exercise.

HONOR YOUR HEALTH WITH GENTLE NUTRITION Make food choices that honor your health and taste-buds while making you feel well. Remember that you don't have to eat a “perfect” diet to be healthy. You will not suddenly get a nutrient deficiency from the occasional dessert.” 17


PHOTO SHOOT

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CARA “I’m a kick ass badminton player with incredibly defined leg muscles that I’ve grown to love and appreciate. While most people laugh when I tell them I play badminton, it’s what makes me unique. Every squat, jump, and footwork drill pushes me to be faster and stronger. My team is the greatest support system and we help each other love our bodies because they let us play badminton and celebrate our victories!”

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MAXINE “My body is a home of sorts. Sometimes it’s messy, sometimes it’s a place of pain and hard truths, but at the end of the day it belongs wholly to me, and through that it has all the power in the world.”

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FABIAN “I love my body because nothing else could hold all this personality.�

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KARISA “Karisa is a person who is fascinated by how generally weird people as a whole are. They like having discussions about mixed-baby feels, gender and sexuality, and Adventure Time. They have one tattoo on her shoulder that says ‘HUMYN’ (the y is to make the word human more gender-neutral). Their spirit vegetable is a sweet potato.”

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A THANK YOU TO MY FRIENDS Katie Yun An eating disorder is more than what you are and aren’t eating. An eating

know how many calories each food would have to the teaspoon. It

disorder consumes you, your thoughts, your relationships with others, your

started out as knowing the caloric value of the food I was given at

relationship with yourself. It slowly creeps into your thoughts, and without

meals and turned into only eating foods under a certain number

warning, silently takes control of your life.

of calories. I started to restrict, and restrict intensely. On the rare occasion my whole family sat and ate dinner, I remember getting

I realized in 8th grade what I was battling was in fact anorexia.

into intense arguments with my dad, him being frustrated I didn’t

Warning signs manifested themselves by 7th grade: I spoke less,

eat the amount he wanted and my being angry that he expected

became more and more concerned with how people viewed me,

me to. I would run upstairs with my dinner, wait the time it

and developed a need to repeat everything I said out loud back

would normally take to finish the meal, and flush it down the

to myself in my head. These little intrusions squirmed into my

toilet with the most satisfying feeling of revenge, thinking how

everyday life, but they were virtually invisible to not only me

much better I was than my parents because I could trick them.

but also everybody who cared about me. That year, my parents

This went on for a while, longer than I like to admit.

talked about getting a divorce exclusively to me. As their fights got louder, I grew smaller. By the end of 7th grade, although one

My image of my body started to become distorted. I praised one

of my friends was concerned about my weight loss, I adamantly

of my friends who happened to be tall and slender and would

reassured them that I was okay; that everything was okay.

beg to look more like her, all the while my friend would tell

Nothing to worry about.

me my legs were just as thin as hers. One day, I fainted in P.E. I remember being confused because I had eaten one more carrot

But I started to not feel okay. My small compulsions turned into

and celery stick than usual so my body should have been okay. It

daily necessary routines of standing in the mirror examining every

couldn’t have been the lack of food. I told my friends it was the

inch of my stomach, weighing myself, examining my right thigh,

antibiotics I was taking, but my friend, utterly concerned, thought

then my left. My obsessions turned over to food: needing to

that it was the final straw. My friends cornered me one day after

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school and told me I had to go see the school psychologist. At the first meeting armed with a friend, I was too anxious and

witch’s costume smiling, and underneath I wrote in white crayon “I know I am not pretty enough.”) However, I grew up with my

terrified to say anything more than “I might be anorexic.” To that

mother criticizing her own body while excessively exercising, and,

the middle school psychologist responded something along the

maybe unknowingly, plopping all of her internalized insecurities

lines of “that is a big statement, and you shouldn’t mess around

onto me by criticizing my body every day.

with a statement like that. Anorexia is a big thing and has to be diagnosed at the hospital. There are weight requirements so

I can now see how much weight my cousin and her mom lost

we shouldn’t throw that word around.” The psychologist then

since the last family gathering, how my uncles make fun of their

proceeded to say that he would bring my parents in and tell them.

12 year old nephew for being so “hefty,” how my aunt pushes

I begged for him not to, shaking, and he agreed he wouldn’t.

food on the kids but doesn’t take any of her own, and how my 10

After that meeting, I sobbed with my friend. Sobbed about how

year old sister struggles with seeing herself as “pudgy.”

all I wanted was a lapband, how my life would be easier if I could

First-degree relatives of a person with anorexia are 11.3 times

never feel hunger, how lucky I would be. A couple days later, I

more likely to develop the same eating disorder than those related

saw my parents go into his office at lunch. My parents and I have

to people without the disease. While my relatives’ distorted

never talked about it since.

images of others or themselves might not meet the requirements for an eating disorder, disordered eating and an unhealthy

As I entered high school, I strengthened my relationship with

relationship with food are rampant in my extended family.

food. I cooked my own meals, started becoming obsessed with the food network, and ultimately nursed myself back to health.

Something that I don’t think is hit home hard enough is that

I dealt with my depression, worked on my anxiety, and fought

anorexia is a disease. It’s not a fad or a trend. It’s not an easy

against my previous body image all with the help of my glorious,

fix. It is a clinical psychological illness, and every day of my life

strong, incredible friends who I can’t thank enough. Looking

I have to monitor not only every single thought but also every

back, it’s easy to claim what led to my disorder. I can examine the

single behavior, making sure that I am in a good place in my

timeline and say, “Oh there’s where it started. It was my parent’s

relationship with myself. “Am I eating a salad because I want a

fault. It was the fighting, the risk of divorce, the perfection they

salad or because I know it has less calories?” “Will I feel guilty

expected from me.” But as much as I want it to be that easy,

after eating this cookie or am I able to just enjoy it this time?”

it’s not.

I can easily say without a doubt that I am the healthiest, most confident I have ever been. My relationship with my parents has

The first thing you learn in any introductory psych course is that

never been as open or supportive, and I mean it when I say I truly

mental illness is due to one’s underlying genetic predisposition

love my body. I am in a fantastic place with my recovery. But, no

interacting with external stressors i.e. the environment. My

matter how far away I am from that time in my life, there will

parents, whether they meant to or not, demanded perfection from

always be that fear. That fear that I could fall back into anorexia.

their oldest daughter. I needed to be perfect. This coupled with

So, I stick to my attempt at a 12-step plan like any recovering

my budding anxiety brought upon by violent experiences with

addict and pray it keeps working.

my childhood babysitter primed me for crippling insecurities that developed by the time I was in second grade (I recently found a picture of second grade me on Halloween in which I’m in a 27


STIGMA: SOCIETY’S DEADLIEST DISEASE Abhishek Saxena President of Acitive Minds at Washington Univeristy We are now under the scrutinizing eyes of more people than ever before. Our identities turn into a meticulous beast that must be tamed and monitored. Hours are spent determining the perfect Instagram filter, the best Facebook profile picture, and planning every character of every tweet. More time is spent making others perceive that we are happy than actually enjoying an experience. We have become so preoccupied with our perfect façades that when we are forced to accept our true selves, we only see faults. Yet we are too stubborn to accept our imperfections, and in an attempt to heal the very egos we wounded, we create elaborate lies that we readily miscommunicate as the truth, and soon the actual truth is buried under years of lies. Thus, perception becomes reality, and the truth becomes stigma. We let our egos nurture stigma, a social disease distorting reality. We make stigma contagious and if left untreated, we make stigma deadly. Often we underestimate the power of our words and the influence of our biases. When bombarded by the messages to be perfect, it 28

can be difficult to differentiate between realistic and unrealistic expectations. When that line becomes too blurred it can result in a dysmorphic disorder.

BODY DYSMORPHIC DISORDER (BDD) Focuses on the preoccupation of non-existent perceived faults or flaws with the body or unrealistic exaggerations of imperfections that are not easily perceived by others • Considered an obsessive-compulsive related disorder due to ritualistic behaviors, such as checking oneself in the mirror repeatedly, spending hours on appearance, and constant comparison between self and others • Account for 1-2% the world population and occurs at equal rates among men and women. • Mean age of onset is 16-17 years with symptoms occurring at 12-13 years • Cannot be explained by issues with body fat or weight (read: is separate from eating disorders) • Commonly co-occurs with depression, but is also associated with social phobia, OCD, and substance abuse


MUSCLE DYSMORPHIA (MD)

Unfortunately, most people blind themselves with the physicality

• A more recently acknowledged form of BDD, seen almost

and behaviors of an eating disorder because they can only

exclusively in males. • Characterized by obsession with muscularity/leanness and/or the fear of being physically too small

understand what they can see, and what they see is someone who is physically ill. For me, and many others, that meant giving my shell-of-a-self to multiple eating disorder specialists and

• Often preoccupied with thoughts of working out

nutritionists that told me how to eat food “properly.” For two

• Shame or anxiety when missing a workout session

years, I endured counselors telling me why an eating disorder was bad for me (as if I didn’t know) and physicians taking weekly

Both BDD & MD are associated with high rates of suicidal

blood samples and ultrasounds to make sure my body was not

ideation and suicide, especially among teenagers.The interesting

failing. The result was dropping to my lowest weight. To me, these

thing about body dysmorphia is that it does not have to focus on

people were trying to take the only control I had left in my life.

your weight at all. For some, body dysmorphia stems from the

So the more they tried to take control of me, the more I resisted.

having an “undesirable” skin color or hair type. For others, body dysmorphia appears due to fears of seeming too masculine as a

Luckily, I met a psychologist who during our first session asked

female or too feminine as a male. The common thread is that all

me about my weight once and never brought it up again in the

of these thoughts come from our societal pressures to fit a model

two years that followed. Instead she saw that my eating disorder

of beauty.

was a veil for the severe depression and anxiety that I was suffering from. Together we worked on dealing with the fears that

My eating disorder–I say “my eating disorder,” because every

consumed my life, and with the help of psychiatric medication,

eating disorder is extremely personal and never the same–had

I was able to take back control of my life. I was able to deal with

more to do with gaining control, or more precisely stability, than

my fears of my skin color being too dark, my social aptitude not

with eating. My internal struggle for control over my own life

sharp enough for my white peers, and feeling the pressure of both

manifested in a coping mechanism, that today we call Anorexia

Indian and American cultures pressuring me to conform.

Nervosa. I was lucky because I had someone who saw the person beyond People with eating disorders are often stereotyped as having an

the disorder and helped me survive one of the deadliest mental

unhealthy relationship with food. However, that stereotype is a

illnesses. That doesn’t mean that I don’t struggle with my eating

simplification of eating disorders. When you look beyond an

disorder from time to time or still deal with body dysmorphia,

eating disorder and find the person, it becomes much easier to see

but it does mean that I know that there is someone willing to

that the eating disorder is just the tip of the iceberg, a physical

listen, and all it takes is one listening voice to heal a hurting soul.

manifestation of real issues in a person’s life. Sources: DSM-5 (APA, 2013), NEDA, ANAD, NAMED 29


IT IS WORTH THE FIGHT Dr. Rebecca Lester Associate Professor of Anthropology

PEOPLE WITH EATING DISORDERS ONLY CARE ABOUT BEING THIN.

I am an anthropologist and a psychotherapist specializing in eating disorders,

Eating disorders are not about being thin. Or, rather, being thin

trauma, self-harm, and personality disorders. For the past 20 years I have

is just one of the many manifestations of the underlying dynamic

studied eating disorders treatment in the United States and have written

of an eating disorder, which has at its core a deep belief that

extensively about problems with our current models of care.

one does not deserve to exist and to take up space, and that one should be punished for simply existing and needing anything

I first became interested in eating disorders when I struggled

at all. Restricting food and making the body smaller is one

with anorexia as a child. I was only 11 when I became sick the first time (I had a relapse at age 18), but even then I knew that

concrete and visible way a person with an eating disorder can feel

there had to be a better way to help people with these illnesses.

not the only way. People with eating disorders regularly deprive

I decided during that first episode that I would grow up to do

themselves in all sorts of ways that are not visible to others,

something to make treatment for eating disorders better and more

restricting things like sleep, adequate covering in the cold or rain,

respectful of people struggling with them.

fluids, using the bathroom. In other words, the focus on being

confident that she is “appropriately” depriving herself, but it is

thin may be the expression of this underlying dynamic that is Eating disorders research and treatment has come a long way

most apparent to others, but this does not mean the person with

since then, but there is still a very long way to go. For example,

an eating disorder is only concerned with looks or with being

eating disorders are the deadliest of all mental illnesses, yet

thin. Eating disorders are deep, complex illnesses that go to the

they are the least covered in terms of health insurance. Eating

core of someone’s being. They are, above all, manifestations of

disorders afflict more people than autism and schizophrenia

severe existential distress.

combined, but research dollars for eating disorders is just a tends to view people with eating disorders as shallow, spoiled,

PEOPLE WITH EATING DISORDERS ARE TRYING TO GET ATTENTION.

and childish, and consider eating disorders a “choice.” The net

Most people with eating disorders struggle with a double need

result of these views is that people with eating disorders are often

that stems from their experience of living on the edge of a felt

shamed, blamed, and shunted to the side when they are most in

illegitimacy to exist. On the one hand, they want to be as small

need of care.

and as unobtrusive as possible, lest they become (they fear)

fraction of what it is for those conditions. The general public

a target of rejection and exclusion. In this sense, people with Here, I will talk about a few of the most significant

eating disorders want to fade into the background, to exist at

misunderstandings about eating disorders. As with most

the edges, to avoid ruffling feathers at all costs. On the other

stereotypes, there is a grain of truth in them, but the reality is far

hand, they crave being found worthy of existing and want their

different from the popular understandings.

sacrifices for (as they see it) others’ benefit to be recognized and acknowledged as legitimating their being. So in this regard they

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person with an eating disorder is seeking attention or praise for

YOU CAN NEVER FULLY “RECOVER” FROM AN EATING DISORDER.

being “sick.” One thing that bears considering: if someone really

Recovery from an eating disorder is a long and difficult process.

needs to starve themselves down to 85 lbs just to “get attention,”

Our healthcare system systematically denies people the care they

something is clearly wrong with the entire social network around

need when they most need it. And our entire culture, which

that person, not just with the person herself. In such cases, much

promotes dual imperatives to “count your carbs” but “supersize

more is going on than simply a bid for extra approbation–it is a

me,” presents the person in recovery with constant triggers for

desperate plea for one’s basic right to exist to be acknowledged.

relapse. How, then, is recovery even possible? What does it look

want their deprivation to be seen. This is why it may seem that a

and feel like? It’s different for every person, but I can attest to

EATING DISORDERS ARE PARTICULAR TO WHITE, UPPER-MIDDLE-CLASS YOUNG WOMEN.

what it is like for me. It has been over twenty years since I have

Eating disorders affect women and men of all ages and all ethnic

I want when I want to. I know when I’m hungry and I stop when

and socio-economic backgrounds. The perception that they

I’m full, and I am at a healthy and stable weight. But I still have

primarily afflict white upper-middle-class young women is a

many of the thoughts. I still have to fight against self-depriving

product of historical circumstance. The people who are counted

tendencies every single day. I still have a grossly distorted body

are those who show up in formal treatment settings, meaning

image, though it’s much better than it used to be.

engaged in any eating disorder behaviors. I pretty much eat what

they have gone through several processes of selection, including knowing how to seek help and being able to pay for care. It is no

I have to be very careful with my exercise to make sure it doesn’t

wonder that those being counted in such studies tend to come

become compulsive. I cannot go on a diet–ever. The part of

from higher socioeconomic statuses and that most tend to be

my brain that knows how to starve myself gets activated far too

white. Community-based studies of eating disorders have shown

easily and can take me down that road before I realize what was

that people of color and all socioeconomic backgrounds develop

happening. Most importantly, I have had to learn how to be

eating disorders at significant rates. Eating disorders remain far

aware of all of this and to recognize not only the thoughts but

more common among women than among men, although recent

the sensations that go along with eating disordered inclinations.

studies show an alarming increase in the number of young men

What I do now is use those feelings as vital information. They

struggling with these conditions.

are a barometer for me that something else is going on: maybe I’m stressed about an upcoming deadline, or need more sleep,

EATING DISORDERS ARE A “WESTERN” DISEASE

or I’m upset about something I didn’t realize had affected me.

Like the issue with class and ethnicity, this common view of

Usually the eating disordered thoughts or sensations quiet down

eating disorders is based on data that has already been filtered

once I figure out what is really going on. So now when I feel

through several layers of selection before people are even counted.

those things I make them work for me instead of against me.

Recent research has found clusters of behaviors and experiences consistent with eating disorders in places from Korea to Morocco

Do I wish I didn’t have to worry about them? Absolutely. But

to South Africa. The sense that eating disorders are western

I came through my years with anorexia whole and healthy, and

culture-bound illnesses masks the fact that what is really “culture-

I count myself very fortunate. And this is why I do the work I

bound” is our diagnostic system and terminology. Using western

do, to help others in any way I can to know that it is possible to

categories to describe what we see elsewhere and then claiming

come out the other side, to survive this illness and build a life

this as evidence of “westernization” is a circular argument that

worth living. As someone who has been there, I can tell you: it is

gets in the way of truly understanding the various ways in which

worth the fight.

systematic self-deprivation can be variously culturally elaborated in different places. 31


HANA “Body positivity can mean lots of different things to different people, and for most people it will always be a process and a journey, not a destination. It might feel easy on some days and nearly impossible on others, but being body positive means knowing that your body is amazing and you are a worthwhile person no matter what. It’s appreciating your body for what it does for you and not just for how it looks; it’s nourishing yourself with food as well as with love and self-care. At its heart, loving your body is really about loving yourself.”

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FILL IN THE BLANK Please use these prompts to write, think, or talk about how you engage with your body and your world.

I feel strong when

makes me smile My support system includes I am proud of One day, I hope to I am grateful for My favorite place to be is I learned a lot when Before I leave Wash U, I want to I love my body because Notes:

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WHY WUSTL STUDENTS LOVE THEIR BODIES We asked, and you answered. Check out these uplifting and inspiring

I love my body because it fits me just right– it’s unique to who

statements shared by WUSTL students who love their bodies.

I am!

I love my body because it lets me search for beauty in the world

I love my body because it’s my little home. It’s my temple, and it

and also in myself.

lets my heart go out and explore the world. The only thing I’ll always have and never lose.

I love my body because it lets me express myself, dance everyday and be close to the people I love. I love my body because it’s

I love my body because it lets me do whatever I want, it is the

unique to me and me alone.

shell that I live and breathe in, it’s always been there for me, and it’s healthy.

I love my body because it keeps me going (even when I have a little too much caffeine and not quite enough sleep). Also, I’d

I love my body because it enables me to make an impact on those

rather send myself good vibes than bad - I can get enough of

around me. I love my body because I did not used to. I love my

those from other places.

body because it took me years to understand and appreciate it for what it is and not discriminate against it for what it is not. I

I love my body because life’s too short to hate it. Because my

love my body because it’s mine, every inch of my height and every

runner’s legs carried me all the way through a half marathon.

pound of my weight.

Because I want to be an example of self love for my little sisters. Because a number doesn’t define me.

I love my body because it allows me to be adventurous and test the limits of what I am capable of.

My body has been with me every step of the way. It’s brought me skydiving and bungee jumping, jumping over obstacles on horses,

I love my body because without it I would be nothing. It gives me

and body-surfing in the Pacific. I’ve been able to mark it as my

the strength to stand tall and have passions.

own too, not only with colors and textures but in ways that will live with me like scars and tattoos.

I love my body because it heals itself, because it takes me places, because it lets me know when I need to slow down.

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Photo courtesy of Washington University’s Facebook page.

I love my body because it brings me joy and let’s me groove and

I love my body because it is the instrument through which the

hug other people and basically just have fun and create the world

song on my life is played.

around me. I love my body because my body is my only home, where love I love my body because it is the physical representation of me.

happens, where I feel best about myself and allows me to share that joy with others.

I love my body because I have a tongue that lets me taste delicious foods and eyes that let me see beautiful sites. I have legs that keep

I love my body because it can do so many wonderful things!

me going even when I am feeling down. I have a brain that lets me feel wonderful emotions and arms that let me hug. I love my

I love my body because it’s mine and I only get one.

body because it is the only one I have and it is all mine. I love my body because it has always been there for me.

My body is: breathing soft

loud   full

changing

I love my body not for what it isn’t, but for what it is. I love my

vessel

warm

sweet unapologetic curve

body not for how it looks, but for what it does. My body lets me

wide

firm

song thinking

hike if I want to or stay in bed with hot chocolate if it’s that kind

moist

 smooth   tasty       determined      messy poem

 strong

of day. It lets me hug and cuddle and laugh with the people I love. And because I look damn good naked.

I love my body because it allows me to interact with the world.

I love my body because only I get to choose what to do with it. I love my body because it’s stronger than it used to be. My body lets me do what I love everyday and accepting the flaws I see, just empowers me to push myself and love my body more. I love my body because it’s fit and healthy, and that is the best fashion statement.

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Reflections WUSTL  

National Eating Disorders Awareness Week is February 22-28, 2015. Join Reflections in learning about eating disorders, body image, and body...

Reflections WUSTL  

National Eating Disorders Awareness Week is February 22-28, 2015. Join Reflections in learning about eating disorders, body image, and body...