Sometimes I get tired of all the subtle ways women are told they’re not good enough. I’ve gotten used to it happening in magazines, commercials, and in all the ads that tell us how to look younger, prettier, sexier, and skinnier. So I expect to see those messages in certain settings, which I can mostly avoid. I just never expected to see that in my OB-GYN’s office. Today when I walked in, (after a nice long Covid hiatus of which length we won’t mention) I was greeted with not one, but two full-sized standing banners advertising liposuction and laser therapy. Literally flanking the front of the check-in counter, with a whole table of anti-aging skin products laid out in between. With “You deserve to feel like yourself again!” slogans next to life-size pictures of smiling, women without wrinkles or cellulite anywhere. So, as I walked up to check in for my appointment (where I planned to discuss the various fun things one might discuss when she’s 48 and has had 3 kids, etc etc) I had to reach across all of this in order to check in with the receptionist! Even in the bathroom, there were more ads up with before and after pictures advertising wrinkle removal- right up next to that cute little silver cupboard where you deposit your urine sample. These were also spread out in my patient room. Really?! I guess things had changed in the practice during those years when I was away. One might say that I’m just a cranky middle-aged woman that’s having a hard time getting older and is taking this too personally. That’s actually not the case at all. My 40’s have been a pretty incredible decade of learning to love myself with all of my imperfections, and I feel more beautiful now than I did back in my 20’s- even with all my gray hairs and wrinkles. I also have nothing against the beauty product or cosmetic surgery industries, as they can be sources of wonderful help and healing for people of all genders. I just think there’s a time and a place for this kind of advertising, and it’s not the kind of thing I’d expect or want to see at my OB’s or any other of my doctors at any age. – not when I went in expecting to hear my first baby’s heartbeat and heard… nothing – not when I went in for a post-D&C appointment after my miscarriage – not when I was pregnant with my firstborn. – not when I had my first breast exam after a lumpectomy Not for a whole host of other reasons that so many women have to navigate and work through when they come in for their OB appointments for less than happy reasons. For those of you still reading, thanks for staying with me through this rant. And if you just so happen to have the name of a great OB practice in NOVA, go ahead and pass that my way.
When I read my friend Shannon’s post, I knew I needed to address this with the community. There’s just so much to unpack here.
In my years of seeing and treating hundreds of teens and adults struggling with eating disorders, poor body image, and shame, after a while, I begin to see a few trends along the way.
In no particular order, below are the triggers that are typically expressed by clients that have led to their eating disorders 1. Bullying 2. Severe dieting 3. Caregivers that diet, hyper-focus on eating overly healthy, and being thin. 4. Comments made by pediatricians and other physicians 5. Advertising and Social Media 6. Depression and Anxiety
Yes, you read that right, comments made by doctors. For a field that’s supposed to “first do no harm”, why is it that we’re seeing them on this list? Physicians ONLY need to take 1-1.5 credits focused on eating disorders during their studies. While it’s great that they can identify and diagnose an eating disorder, shouldn’t prevention and treatment be some of the focus? So often doctors suggest weight loss programs, tell patients they are overweight, that the cause of their illness is weight related, and praise them when they come back in a smaller body. This praise and the need to lose weight to be taken seriously can ultimately lead to one of the deadliest mental health disorders facing people. So when and how do we start expecting more from our providers? When do we start to hold them accountable and open their eyes to the microaggressions found in their offices? When will fat phobia and bias be left at the door and physicians start treating the person as a whole? Because right now, just telling people to lose weight isn’t helpful, it’s harmful.
About a year ago, one of my employees went to a gastroenterologist due to ongoing stomach pain, cramping, and heartburn. After coming out of anesthesia due to getting an endoscopy, the doctor’s only suggestion was……………you guessed it weight loss. This normally happy woman left the office that day and relayed the story to us in tears and looking defeated. She felt ashamed, embarrassed, and self-conscious, and still had no answers as to how to fix this problem.
Now I have lost count of how many of my clients have described when they first started to have eating disordered thoughts, that one of the causes of them was the way their pediatrician commented on their body size, and each time these clients quoted their doctors told them “you’re overweight”. If a patient continues to hear that from someone who they believe to be an expert in health, it’s not too hard to expect the patient will begin to think of themselves in a negative light. “I’m not good enough”, “Something’s wrong with me”, “I’m clearly doing something bad and wrong”. This narrative needs to change, help not hinder.
So lo and behold – I went to my OBGYN for my yearly appointments last week and opening the entrance to the waiting room my stomach dropped to my ankles. I was flooded by the images that Shannon described. Ads to look better by getting liposuction and more.
As I teach my clients how to advocate for their needs and rights, how to see themselves with neutrality and with loving kindness, and to reject the need to conform to the – I must do so myself and I hope you do too. The doctor at my practice helped deliver my baby 16 years ago. She is a wonderful doctor. But I can NEVER refer to this practice to any of my clients or any person for that matter.
Have you had similar experiences? Did this affect your body image?
I know I am going to hear from my colleagues that I shouldn’t post these pictures, as they are triggering. Yes. I know. Exactly.
None of us are spared from this reality and it is everywhere we go.
Will you join me in allowing yourself to take up space in this world and use your voice?
Heather Baker, LCSW, CEDS Founder of Prosperity Eating Disorders and Wellness www.prosperityedwell.com
Why is it important for parents to model healthy eating?
Social psychologists have long explored how social experiences shape our cognitions and behavior. This type of learning, known as observational learning, provides children with the opportunity to watch a “model” (aka parent, sibling or authority figure) as they react to events in their environment. Observational learning is one of the most natural types of learning that we have available to us. The idea is we watch what the model does in a given scenario and then process that scenario or schema as desirable or undesirable; ultimately our behaviors are shaped by watching how others interact with their environment. We mimic and mirror what we see and have learned is valuable to our family system.
Food is a fundamental aspect of the human experience, we all need nutrients to survive and thrive. Unfortunately in today’s society, we have become hyper aware of image and perfection as a symbol for worthiness, resulting fad diets, preoccupation with weight / image, and a generalized sense of dissatisfaction with ourselves in comparison to a perceived ideal. Despite the negative impacts societal pressures can have on an individual’s image or self-esteem, there are many ways parents can buffer the effects of these pressures, not the least of which is healthy modeling. What does this mean? In short it’s teaching your kids to develop a healthy relationship with food by setting a positive example.
Our kids are watching us all the time (we aren’t as sneaky as we think we are), they see us reading labels and being conscious which is great! It’s a great opportunity for us to teach our children about food, nutrition, and healthy eating. Conversely, they see us cringing at calories, judging ourselves and our bodies in the mirror, and they sense the importance of image. We can be a gateway to a healthy lifestyle or we can inadvertently tell our kids that food is the enemy and image is everything. It’s easy to think this learning would have to be overt, that a dance teacher who pinches her students back would obviously result in an unhealthy relationship with food. But it can, and often does, happen far more subtlety, watching mom choose a salad time and again instead of getting what she really wants because she has attached a value to the food as bad. As with most things, moderation is key, it’s not so much what you are eating or feeding your family as it is the relationship with the food and experiences.
What language should parents use/not use, around kids, to prevent unhealthy eating beliefs and behaviors?
Try to avoid making comparisons or comments, especially image oriented ones. For example don’t say,”Oh, Molly is so small, and I am just fat” or “Your friend Jen is so small and cute” “Comparisons like this aren’t helpful in promoting a positive self-image.
Kids going through growth spurts often grow out before they grow up. When your kids are in these spurts, don’t poke at them or their chubby cheeks. In general, try not to use all or nothing statements. That ice cream will make you fat, or those cookies are going to go straight to my hips. No one has ever died from a scoop of ice cream, just like if you eat a cookie or a few cookies, it doesn’t mean you are no longer loveable because your skinny jeans got a little snug. Kids don’t always have the gift of discernment, that’s another reason healthy modeling is so important. We get to teach them that food can be a wonderful and connecting experience. If you wouldn’t want someone saying it to you, then you probably shouldn’t say it to your child, they’re people too, just younger and more impressionable.
How do our kids (unknowingly) teach us how to eat healthy?
Our bodies have natural triggers that tell us when we are hungry and when we are full. People don’t have to be taught when to eat or not, it’s a natural process that occurs and that we can become mindful of as we develop. Children haven’t yet learned to ignore their inner cues and will often adhere to appropriate portions when they are allowed to choose. Kids listen to their bodies, if they have cravings they typically fulfill them and move on with what they are doing. They don’t assign value or judgement to foods which means they are naturally more healthy in regard to portion control and enjoying the eating experience.
How can we achieve health while feeling care free in the process?
Barring an allergy, one scoop, or cup, or plate of anything is not going to leave an indelible mark on our psyche or bodies. Remaining mindful as you eat and making food preparation a process and an act of love for yourselves and others can be a great way to bring joy and peace to a moment. If you struggle with your relationship with food, affirmations can be a great way to break the negative thought pattern. It may feel artificial at first, but keep saying the words, internalize that sense of peace with the food and the process of being healthy. Exercise can be a great way to mitigate depressive symptoms, as the endorphins released during and after a workout boost mood. Additionally, this can be a great way to channel your energy by doing something positive and active with your body, see what you are capable of, know that you are a blessing and that your body is a gift.
We live in a media driven culture with an endless supply of TV shows, internet sites, and phone apps to keep us busy every minute. These platforms are used to deliver messages meant to persuade, inspire, and entertain. Many of these messages contain images of men and women airbrushed to perfection….and it is that very image of perfection that haunts us as we study our own bodies and make comparisons. To say that the internet has influenced body image is an understatement. In recent years, the rise of pro-anorexia and pro-bulimia websites has glorified eating disorders and praised the behaviors that keep sufferers locked in the illness. The Social Issues Research Centre (www.sirc.org) reports that these “pro-ana” websites target individuals who consider their eating disorders to be lifestyles, something to maintain and celebrate. Users share tips on how to engage behaviors and provide support for each other’s illnesses. For individuals who are in recovery, websites like this can be seriously detrimental. Some people in recovery refuse to engage in social media at all, citing the prevalence of hashtags like #thighgap and #thinspogram as just a few of many reasons to shelter themselves from the social media revolution. USA Today (www.usatoday.com) shares the story of Donna, who is in recovery from bulimia. Afraid to expose herself to the kinds of comparisons that fueled her illness, Donna has decided to stay away from popular social media sites like Facebook and Instagram. While it’s clear that social media and pro-eating disorder websites have played a part in our global obsession with obtaining perfection, more and more websites dedicated to positive body image and recovery are beginning to pop up. Someone searching for eating disorder tips may stumble upon a recovery website or blog and be drawn into a story of hope….leading to the inspiration to begin recovery. The National Eating Disorders Association (www.nationaleatingdisorders.org) shares the story of one woman who came across the NEDA website in her search for a pro-eating disorder community….a lucky accident that turned out to be the catalyst for her recovery. Nonprofit organizations dedicated to awareness and advocacy use the power of the internet to spread positive body image messages. Eating disorder treatment centers are also getting involved in the awareness movement, offering blogs, webinars, and professional events designed to educate and inspire. Instagram is also proving to be a powerful recovery tool. An online photo-sharing service, Instagram users can visually communicate their lives to their followers. Some individuals in recovery have turned their Instagram accounts into recovery accounts. The Atlantic (www.theatlantic.com) describes this type of account as a place where users can gain support while maintaining as much anonymity as they would like. Some people don’t use their real names, and others find that it’s easier to open up and share initially in an online environment. Recovery accounts document the progress users are making through pictures of meals, inspirational messages, and even pictures of users’ bodies as they work toward weight restoration. Support from followers during the recovery journey can be motivating and provide comfort during difficult periods. Although social media can be a positive recovery tool, users must be vigilant and pay attention to their triggers. Any concerning thoughts and behaviors should be taken seriously and addressed with a treatment team. Totally In Control: The Rise of Pro-Ana/Pro-Mia Websites. Social Issues Research Centre, www.sirc.org Rojas, M. (2014). Social Media Helps Fuel Some Eating Disorders. USA Today, www.usatoday.com Kay, J. (2014). How Social Media Led Me to Recovery. National Eating Disorders Association, www.nationaleatingdisorders.org Mirhashem, M. (2015). Overcoming an Eating Disorder with Instagram. The Atlantic, www.theatlantic.com
What is perfection? Current society would have us believe that it is the Stepford Standard, that anything less than keeping up with the Joneses makes us substandard, less relevant, not good enough, or just plain not enough. Webster’s defines perfection as “having all the required or desirable elements, qualities, or characteristics” and “completely free from faults or defects”. Maybe it’s just me but I feel like these definitions are in conflict. Why can’t I have all the required or desirable elements, qualities and characteristics, AND still have faults? Why can’t I be perfectly imperfect? Perfection can be found in the faults, in the quirks that make us who we are and the experiences that we grow from that have been less than perfect.
Is it even possible for anyone or anything to be truly perfect (i.e., without flaws)? Rationally, I think most would agree that it’s not. Rationally, we know that it is part of the human experience to be flawed, to make mistakes, to rise from the proverbial ashes. But how can we rise if we’ve never been burned? Rather, in perfectionism we are consumed by the flames, the need for this unattainable perfect. Why is accepting imperfection so hard? Brene Brown has done an amazing job of addressing this question, in fact much of her work focuses this very topic.
The point of this post is not to delve into imperfection, but rather how we know when our need to be perfect, to be “completely free from faults or defects” is getting in the way of this thing called life. Society tells us that if we aren’t the highest performers, if our parties aren’t the biggest, the best, the ultimate event that has Gatsby in envy, then we aren’t doing it right.
How does this happen? How do we miss the point of the very thing we are trying to achieve? It’s simple, we forget to think about the intent of the goal itself. And, when we forget about the intent (the desired end state or outcome) we go into the perfectionistic planning mode. If you are prone to this mentality then you know how time consuming and crazed the planning gets around a desired goal. The flaw here is that the obsessive planning, the extensive preparation and painstaking compulsion to think about everything that should happen, everything that might happen, the need to think (aka obsess) about all of the knowns and unknowns, gets in the way of the goal. Not to mention it makes the process of reaching the goal exhausting. Essentially we run ourselves into the fire of worry about the “what if’s”, all the while missing the point of the event.
Take this for example, say you want to get friends together for a game night. The idea being that you would get folks together, maybe have some food, maybe some drinks, and everyone has a night full of commercial worthy fun. The perfectionist dives immediately into the planning and organizing of the “perfect” game night. Sending out the fancy semi-formal electronic invitations with the “perfect” play on words that “perfectly” captures the theme of the night. Then to the food, drinks, and venue prep. The perfectionist struggles with letting everyone bring a dish (what if two people bring the same thing, or some other catastrophe happens?!), people can bring a side but no matter what the “perfect” host needs to have the “perfect” culinary item that could make Martha Stewart green with envy. Everything must be organized, “perfectly”… heaven forbid the drink cooler not match the centerpiece. The games, must be selected with care, to facilitate the most fun of course. And then amidst all the planning and preparation for the “perfect” party, the home must be spotless. Above all cost’s this house must not look lived in!!! In the perfectionist frenzy, you stop thinking about the intent of game night, and start obsessing on the need for “perfect”, the rave reviews; you’re looking for the 5 star yelp review for what started as a means to connect with your friends/families.
Rather than connecting, you’re disconnecting. There’s no room for fun and friends when there’s a “perfect” party on the horizon. If you think your friends can’t feel the anxiety of your perfection obsession aura puts off, let me tell you, in no uncertain terms, they can. Your “perfect” planning is imperfect. It’s driven by an unattainable need to be “perfect”. Did you ever stop to wonder what perfect was?… in this case it’s not the best party favors, or the game selection, or the food, or the drinks. What makes game night perfect is the intent. You are creating a space for people that you know and love to come together and have fun (that’s the intent, that’s the desired outcome). It doesn’t matter if people love the food, or find a speck of dust under the coffee table, or if no body plays games at all on game night. What matters is that you brought people together for an evening of levity.
Some of the common cognitive distortions associated with perfectionism are:
Black-and-white thinking – “If this is not perfect, I am a failure.” Or “Only lazy people ask for help.”
Catastrophic thinking – “Everyone is watching me, if I make a mistake they will think I am stupid.” Or “If my presentation isn’t flawless, I will lose my job”
Probability overestimation – “Even if I study a lot, I still won’t do well on my exam.”
What happens in the above statements is that there is no room for life; because perfect isn’t defined and the intent hasn’t been identified, there is no way to determine success. There are always things we can do differently or do better in the future, that’s part of the learning curve of all life’s situations. Perfectionists have a hard time thinking about what success looks like ahead of time, instead they look retrospectively and judge themselves harshly for the things they “should” have known, never accounting for the fact that these things could not have been known at that time.
Here are some questions to ask yourself to make sure you aren’t going into a perfection obsession.
What is the intent? (really think about it)
Are the thoughts and actions you are engaging contributing to or detracting from the intent?
Are you enjoying it? (If the answer is no, ask yourself 1. Why am I doing this (i.e. is it aligned with my intent or my need to be perfect)? 2. What about this am I not enjoying? 3. Could I approach this differently to feel better about this?
Am I being competitive? (With myself? With someone else?)
Am I willing to ask for help? (perfectionists tend not to ask for help and/or have trouble truly delegating, also known as micromanaging)
Be kind to yourself, be kind to others, and keep it moving.