REFLECTIONS washington university in st. louis
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
THERE IS NO WRONG WAY TO
HAVE A BODY HANNE BLANK, “ REAL WOMEN ”
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: societyâ€™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
through a personal experience, through supporting a friend or
Joo Lee and Kim Grunde
family member, or hearing about someone elseâ€™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.
• 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
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 Joeâ€™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
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
Call for treatment options, information and referrals for you or a
Call for you, call for a friend.
friend. Confidential and compassionate.
SHS 314-935-6666 Basement of Dardick on the South 40. Call to make an
appointment or ask questions.
www.nationaleatingdisorders.org www.nedawareness.org www.moeatingdisorders.org
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 didnâ€™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 womenâ€™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.
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 youâ€™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
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. MCCALLUMâ€™S RECOMMENDED RESOURCES:
years ago. This had very much helped me to find focus for our
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,
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–
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
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
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.
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.
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
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!”
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.”
FABIAN â€œI love my body because nothing else could hold all this personality.â€?
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.”
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
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?”
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
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
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.”
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:
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 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.
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
I love my body not for what it isn’t, but for what it is. I love my
sweet unapologetic curve
body not for how it looks, but for what it does. My body lets me
hike if I want to or stay in bed with hot chocolate if it’s that kind
smooth tasty determined messy poem
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.
National Eating Disorders Awareness Week is February 22-28, 2015. Join Reflections in learning about eating disorders, body image, and body...
Published on Feb 21, 2015
National Eating Disorders Awareness Week is February 22-28, 2015. Join Reflections in learning about eating disorders, body image, and body...