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My Confrontation at Starbucks.

My Confrontation at Starbucks

   So I don’t usually post much about work on Facebook but I figure this is a place where a large amount of people can be reached. This is going to be a novel I can already feel it lol OH NO IT’S HAPPENING AND I’M MAD SO STRAP IN.

I’m a Dietitian working in the field of eating disorders, and it has been the most rewarding job of my life. It has also been the most emotionally taxing thing I’ve ever done.

Eating disorders are the number one deadliest mental illness. Every day, I see people muster every bit of strength they have to fight these life-threatening diseases. I see people feeling completely and utterly broken, hopeless, done, sick. I have seen people dance, laugh, scream, and curl into a ball in defeat, all in a matter of an hour.

I see people cry of happiness over their victories in treatment, only to cry of sadness and guilt immediately after. I watch their face shift as they realize this “success” in treatment is (in their eyes, right now) their greatest failure.

Anita Johnston, author of “Eating by the Light of the Moon,” said it perfectly. She describes a person falling into a river. Imagine it is storming, and they are drowning. They are terrified. They grab onto a log in the water, and it saves their life. The storm calms, the water level slowly drops, they are safer now.

Their friends and family are on the shore, waving to them to come in. They try to swim while holding the log, but it is too big and powerful, and it’s holding them back. They cannot swim to shore with the log in their arms. They cannot get to where they want to be while holding the log. But they don’t want to let go of this log. Why would they? What if the storm comes again? What if they aren’t strong enough?

They will occasionally let go of the log, to try. A wave comes and they get scared, and grab on again. One day, they summon the strength to tread water for 10 seconds before they grab back on. Another day, they make it to 30 seconds. Eventually, they make a lap around the log before fear launches them back into its’ clutches. Little by little, they gain confidence in their strength to make it to shore without the log.

One day, a long while later, exhausted and close to giving up hope, they let go of the log and begin to swim. They swim as hard as they can, until they reach the shore. They no longer need the log to feel safe. They are ready to rebuild, to renew, to create. They are free. I’m paraphrasing and putting my own spin on it, but that’s the general idea.

The log in this analogy is the eating disorder, as it has served a purpose for everyone struggling. Control, escape, accomplishment, success, identity, communication, fear, numbing, punishment, coping. These are only some. They are also often biological/neurological/genetic in etiology. The rushing river is life, the shore is recovery.

I was inspired to write this post when I overheard someone in the line at Starbucks speaking about how “selfish” and “stupid” their girlfriend was for going into another eating disorder treatment center. “She’s skinny, I’ve told her that so many times,” they said. “What does she have to worry about?” “It sucks for me because I’m never going to see her.”

Eating disorders are not a disease based in vanity or a desire for a certain aesthetic. Their symptoms manifest in food, eating behaviors, and body image, but they are serious, life-threatening mental illnesses and are not to be made light of. They are never alone or without an underlying issue.

A couple years ago, I had a client who was on the 80th percentile for weight on their growth charts, and dropped to the 5th percentile in less than a year. At one point in her treatment, when she reached the 20th percentile, her doctor told me she was “medically fine now” and no longer needed treatment, and I needed to step away from her care and let them “take it from here.” “MEDICALLY FINE”……..LET YOU “TAKE IT FROM HERE”…….oh hell no. My brain exploded.

This teenager was more depressed than they had ever been, not getting their period, heart rate 38 bpm, losing full chunks of hair, and was well on their way to osteoporosis. That doctor no longer answers my phone calls (lol that’s fine good riddance sir) but the child is fully recovered because thankfully, their family trusted me.

How do we validate the seriousness of a condition if many of our medical providers, the very people we trust with our health, are telling some of the sickest people that they are “medically fine?”

How do we help people who are feeling so deeply sad and hopeless feel seen and heard, if we are viewing their disease as “selfish” and “stupid?”

How do we slow the development of these diseases when the “wellness” industry based in pseudo-science is promoting restrictive dieting in our youth? IN OUR CHILDREN.

Why was my 13 year old client congratulated on their “willpower” when they brought a bag of raw broccoli to their own birthday party in lieu of cake?

I am writing a Facebook novel right now because this is important.

I will be going to doctors offices donating the book “Sick Enough” by Dr. Jennifer Gaudiani in hope that someone will read it. I speak to health and PE teacher meetings for Fairfax and Loudoun County public schools about how to safely communicate health and nutrition information tochildren and adolescents, in hope that someone will hear it.

I feel like that isn’t enough, though. Which is why I’ve resulted to a social media post, because realistically more people can be reached this way.

“What is the take-home message?” You may be asking if you have made it this far. I’m glad you asked!

1. Be mindful of your words. Be mindful of your judgements. You never know what people are going through.

2. When communicating nutrition information to people (especially personal trainers, health teachers, and health professionals who are new to working with eating disorders) focus on what to add instead of what to take away. 

For example: “did you get some fruits and vegetables today to give your body the vitamins, minerals, and phytochemicals it needs?” Instead of: “do not eat sugar. It is bad.” Another example: hypertension. Research shows that increasing potassium in the diet is effective in lowering blood pressure. Yes, some people need to be careful of the salt shaker and high sodium foods. However, isn’t it lovely that we can talk to them about what they should include vs. what they shouldn’t, and improve their lab values without promoting dichotomous, black and white thinking about eating?

3. Stop demonizing foods, labeling themas “good” or “bad” and putting a moral value on what people eat. Food is supposed to serve two purposes: nourishment and enjoyment. That’s it. You are not “bad” because you had a dessert. You are not “good” because you ignored your basic biological needs by cutting your calories in half.

4. Let’s stop downplaying eating disorders and simplifying their complex nature by telling people they are “fine.” Let’s listen to people when they talk. Let’s keep comments about people’s bodies in a locked vault, stored in the depths of hell. Let’s help people who we believe to be struggling get help. Let’s check in with people who are exhibiting disordered eating behaviors, rather than asking them what their secret to weight loss is. Let’s stop food shaming other people.

5. Understand that eating disorders do not have a face. They do not have a shape or size. They are not only restrictive eating, or purging, or binging. They come in all shapes, sizes, and forms and manifest in many different behaviors. Men, women, non binary, it doesn’t matter. Eating disorders do not discriminate. You cannot look at someone and determine whether or not they have an eating disorder.

6. Most importantly, let’s talk about mental health, because it’s important.

Thank you for coming to my ted talk ?

Edit: To everyone who has reached out to me, thank you. Below is a link to the National Eating Disorder Association (NEDA) website. They have a lot of informative resources, along with a treatment finder to get help in your area.

https://www.nationaleatingdisorders.org/

Prosperity Eating Disorders and Wellness Center in Herndon, VA (where I work) has a free family/friend support group for those who have loved ones with eating disorders at 5pm on the first and third Monday of every month. Anyone is welcome.

We also have a comprehensive team of therapists, dietitians, and a psychiatrist/medical director. We have a Partial Hospitalization Program (PHP) Intensive Outpatient Program (IOP) and outpatient services. We offer art therapy, yoga, and acupuncture. If you or a loved one are struggling, give us a call or visit our website.

703-466-5150

http://prosperityedwell.com

Diet Downfalls

food

These days, there are as many diets as there are types of breakfast cereals (read: too many!). Unfortunately, most diets create a false connotation of the word diet, incorporating some aspect of restriction, food/nutrient avoidance or fasting. However, the original definition of diet was simply “habitual nourishment” (Webster’s Dictionary). Any time one avoids or restricts food intake in any way, there is risk of missing out on key nutrients that are essential for health. The best diet is one that includes a variety of all foods in moderation (unless of course medical reasons prohibit one from doing so). Read on to find out the downfalls to some of today’s most popular diets.

Gluten Free
There is nothing inherently wrong with gluten, which is found in wheat, rye and barley. Yet recently it’s gotten a bad rap and has become the latest food group to avoid. For those with Celiac Disease, gluten damages the lining of the intestine causing malabsorption and a slew of other symptoms. Those with an allergy to gluten can have a variety of reactions, some of which are life threatening. For folks in these two camps, it is imperative that these individuals completely avoid gluten. Others, however, choose to eat gluten free (GF) for a variety of other anecdotal reasons. Unfortunately, those following the diet, no matter the reasons behind it, are at risk of many nutrient deficiencies.

Gluten free products are known to be low in nutrients that are typically found in whole grain, wheat-based products, such as B vitamins, calcium, iron, zinc, magnesium, and fiber. Wheat based products (i.e. bread, cereals, crackers, etc.) are mandated by law to be enriched with many of the aforementioned nutrients while GF products do not fall under such regulations. Therefore, a diet made up of mostly GF pre-packaged items will provide less nutrients than their wheat based counterparts. This is especially important for children and adolescents following a GF diet who are still growing and developing.

In addition, a lot of GF products are made with added sugars and are higher in cholesterol, calories and fat. So a 1:1 switch from gluten-containing to GF products will not necessarily bring about improved health, except when medically necessary.

Therefore, any individual on a GF diet should seek counsel from a Registered Dietitian/Nutritionist in order to ensure that their new intake pattern provides all the necessary nutrients required for optimal health.

Low Carb Diets
Low carbohydrate diets have become the go-to approach for improving health and losing weight. There are many different low carb diets out there. The premise is generally the same – reduced carb intake, increased protein/fat intake. Proponents of the low carb diets claim that carbs cause weight gain and therefore should be limited and/or avoided. Unfortunately, the science just isn’t that simple and more current research is debunking the myth that carbs are “bad.” Like it or not, carbs are essential for every bodily cell’s proper function. The brain can only use carbohydrate for energy and if you’ve ever followed a low carb diet, your brain has taken notice. Many low carb dieters complain of brain fog, headaches, blurred vision, difficulty concentrating and reduced cognitive abilities. Newsflash – it’s because the brain is in need of more carbohydrates! In addition, carbohydrates provide necessary energy to the muscles during exercise and many grain-based carbohydrate foods are excellent sources of other vitamins and minerals that one misses out on when reducing carb consumption.

This isn’t to say one should consume carbs like they’re going out of style – our culture’s portion sizes have certainly led to carb overconsumption. However completely eliminating carbs or entire food groups, such as grains, altogether isn’t the ideal response. Carbs should be present at each meal & snack (again, think about feeding the brain), yet moderation is key. Choosing high-quality, fiber-rich carbs such as whole grains, fruits and vegetables will provide required nutrients and lasting energy to help you get through your day. Low carb diet followers often weight-cycle after repeated bouts of carb-avoidance and falling off the wagon. Research and years of client testimonials prove that low carb eating is extremely difficult to sustain life-long.

Cleanses & Detoxifying Diets
Typically these diets consist of mainly liquids and promise to bring about quick weight loss and flush toxins out of the body. Many believe it is necessary to cleanse the body and clean out the gut in order to lose weight and feel better. Cleanse and detox diets provide inadequate protein, fat and carbs, which means followers of these diets are typically miserable during the process (see above about feeding the brain). Like the low carb diets, these types of regimens are also not sustainable and any weight lost is typically regained as soon as regular food intake is resumed. In addition, the claims of flushing toxins out of the body are unsupported by research.

Vegan
Regardless of one’s reasons for going vegan, this diet presents a number of nutrition risks. It’s vitally important to be aware of the nutrient deficiencies inherent in this diet so as to properly compensate for them. Often, vegans fall short in their protein, B-12, calcium, iron, omega-3 and vitamin D intake. Because most of these nutrients are most abundantly available in animal products, it can be incredibly difficult to meet one’s daily needs through plant-based foods and grains. It takes a lot of pre-planning and finesse to ensure that all nutrients are represented. Therefore, vegans should be seen by a physician to monitor vitamin and mineral levels in addition to seeking the assistance of a Registered Dietitian/Nutritionist.

 

By Kate Grefenstette, RD

 

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Awareness

Today ends the National Eating Disorder Awareness week and in it’s cessation I have a few thoughts to share in the spirit of bringing “Awareness”.

At a bloggers brunch today with some amazing women, it was asked “Why do people choose eating disorders?”

I almost stood up and started preaching. But I did remain seated and said politely “People do not choose to have eating disorders”.

So first, I would like to shout from the rooftop that a person chooses an eating disorder like someone chooses to have cancer.

An eating disorder is a disease that takes years to overcome. With only 50% reaching full recovery for life. 10% of people with this disorder die. This is the top killer out of all mental illnesses. (check out: http://www.nationaleatingdisorders.org/get-facts-eating-disorders)

But people choose to go on a diet – including children. Well children don’t always choose to go on diets, but their parents sure do. Many parents have their children eat what they eat. Case in point, as an eating disorder expert, I have had countless patients whose parents put the family on a Gluten Free diet, Vegan diets, all organic diet, and on and on. No child should ever be on a diet. They are growing and need a variety of foods for their best health (not including allergic or medical conditions). Teaching kids that there are good and bad foods influence children and hence there is a sense of shame in what you eat. There should be no guilt for anything we eat. Food is not a morality issue.

I have found that around the ages of 10-12 when a girls body is going through puberty, the messages they receive about their body is paramount. The average person should gain about 30 pounds during the course of puberty and everyone’s bodies grows differently. This is the time that many girls then think that they need to lose weight. Body dissatisfaction often starts around this time and is so prevalent amongst our children.

Parent Tip: Do not make negative comments about anyone’s body – especially your own.

Fact: 95% of diets fail. If diets didn’t fail, we wouldn’t have so many people in our world on diets and the diet industry wouldn’t be making an enormous amount of money.

Stay tuned for Kate Grefenstette, RD to write a post on the negatives of the different diets out there.

My hope is that we can start seeing food and our bodies not as the enemy but just a part of our humanity.

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Body + Mind + Spirit = Your Complete Self

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At Prosperity, our therapists are all trained to help a person understand and change the way they think. If our thinking is negative, distorted and unhelpful then so will our behaviors. There is a lot of evidence that confirms changing our thinking creates change in our lives. But, our minds are just part of ourselves.

Prosperity also understand the importance of a healthy body. Without being physically healthy it is hard for a person to be in good spirits or have a quality life. We aim to help you restore and improve your health through proper nutrition, education, and proper medical care. And yet, our bodies may be in good shape, but deep within your spirit there may something missing, maybe not feeling fully connected to yourself.

We believe that knowing, understanding and listening to your inner being brings a different level of change. Harmony. Joy. Peace. Wellness.

We welcome the opportunity to work in conjunction with other providers to give each person a chance to experience wellness at all levels.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]