The EALM Blog Shelf

While Laura Cipullo and the Laura Cipullo Whole Nutrition Team work on some new and exciting projects, you may notice less posts on the Eating and Living Moderately Blog. We have created a “blog shelf” below to keep you entertained and educated. Get caught up on the latest nutrition education by clicking on each year below. We will send you nutrition updates, but we will not be inundating your mailboxes on a weekly basis. If you want weekly “love” and inspiration, subscribe to our Mom Dishes It Out blog for weekly posts and recipes. Mom Dishes It Out provides expert advice from mom Registered Dietitians and mom Speech Pathologists on the “how to” of health promotion!

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The EALM Blog Shelf

Please feel free to peruse our posts organized by year below. Or take a look at the categories listed at the bottom of the page to find a post in the desired.

2015

2014

2013

2012

2011

2010

Diabulimia: Learning More about your Teen and their Type-1 Diabetes Diagnosis

Diabulimia: Learning More about your Teen and their Type-1 Diabetes Diagnosis
By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team

 

Diabulimia is an unofficial term, used by both the American Diabetes Association and the Juvenile Diabetes Research Foundation, to define a serious condition effecting, but not limited to, adolescent girls diagnosed with type 1 diabetes.

Photo Credit: via Compfight cc
Photo Credit: via Compfight cc

An adolescent diagnosed with diabulimia (known formally as ED-DMT1) is characterized by the intentional misuse and manipulation of insulin for the purposes of weight loss and control. By decreasing, or skipping the necessary dose of insulin, the individual’s body cannot absorb the carbohydrate, which affects weight and causes high blood sugar. This is very dangerous state as high blood sugar can cause Diabetic Ketoacidosis.

 

Did you know diabulimia’s prevalence is most widely recognized in adolescent girls? Studies conducted by the Academy of Nutrition and Dietetics: Pediatric Nutrition, report that an adolescent girl, with T1DM, is 2.4 times more likely to develop an eating disorder than her peers. While it is difficult to pinpoint the culprit behind diabulimia, the current assumption is the hyper focus on diet, control and weight. The strict diet associated with diabetes care and the pressures associated with women, eating, and body image could “exacerbate preexisting disordered eating tendencies.” (Childers)

 

If your tween or teen has diabetes, here are signs that may signify there is an element of disordered eating or an eating disorder:

  1. Frequent Diabetic Ketoacidosis
  2. Excessive Exercise
  3. Use of diet pills or laxatives to control weight
  4. Anxiety about or avoidance of being weighed
  5. Frequent and severe hypoglycemia
  6. Binging with alcohol
  7. Severe stress in family
  8. Frequent Insulin omission (Franz)

This is a relatively new branch to the field of nutrition, displayed by its mixture of symptoms and heath concerns.  It is important to remember the American Diabetes Association (ADA) continues to stress that there is no “one-size-fits-all” eating pattern for individuals with diabetes. When it comes to dietary recommendations, there is a strong emphasis on personal/cultural sensitivity and care. If your adolescent shows the above signs, it is highly recommended to seek a registered dietitian who specializes in both diabetes and eating disorders.

DiabulimiaPostAdditionalResources

What do you think the prevalence of Diabulimia suggests about adolescent girls perception of health? How can we help to reframe this image?

 

 

Resources

  • Nancy, Childers, and Hansen-Petrik Melissa. “Diabulimia in Adolescent Females.” Pediatric Nutrition 37.3 (2014): 13-16. Print.
  • Franz, Marion J., and Kulkarni, Karmeen. Diabetes Education and Program Management. Chicago, IL: American Association of Diabetes Educators, 2001. 159. Print.

A Reflection on BMI | Part 2 – BMI Report Cards

A Reflection on BMI: Part 2 BMI Report Cards
By Laura Cipullo Whole Nutrition Services Team

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Just to recap what we learned in Part I, BMI is a measurement based on an individual’s height and weight. It is used on a scale to reflect one’s status as underweight, normal and underweight. While using measurements is essential for statistical reasons and diagnostic tools, BMI is being utilized as a marker of health rather than focusing on behaviors and a cluster of measurements. We have said it before and will say it again; BMI is only one measurement and it’s not always reflective of a person’s state of health.

 

After collecting all of this information on BMI, does this change how we look at it for our growing children and adolescents?

 

Adolescent bodies, the time of development just after childhood, are growing at a rapid pace. Mentally and physically. Teens deal with an increased level of hormones in their bodies, which contribute to the many different growth spurts they will endure. They struggle with self-identity and the desire for independence. This combination often causes teens to be deeply self-conscious, which can inhibit decision-making. It could cause them to become defiant and often times unresponsive to parental guidance.

 

Puberty arrives at different times, stages and intervals for every child but usually happens around age 11-14. On average, teens experience a 20-25% growth increase during this time—35 pounds for girls and 45 pounds for boys. In an average one-year spurt, girls grow roughly 3.5 inches and boys about 4 inches. Using a measurement such as BMI, which is already so marginalized to determine the health status of a rapidly changing youth seems counterproductive.

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Over the past few years, you may have heard of BMI Report Cards or, as they are more harshly referred to, “Fat Letters.” They are letters sent home from schools reporting on a child’s BMI and suggesting to seek out a physician if results are above normal. Needless to say, parents did not respond well to this. It caused a national outrage. In 2004, Arkansas was the first state to send BMI report cards home to parents and/or guardians. Children and adolescents with a BMI indicating they were “overweight” were suggested to consult a health care professional. Today, the program is implemented in over a quarter of United States school districts.

 

A cover story from the New York Post last week chronicled (with pictures!) this same concern. Click here to read the article in full and see the letter that a young girl was sent home with from the NY Department of Education. Unfortunately, this is happening with more regularity in New York City schools than the article chronicled. It isn’t just front cover news; a friend of ours recently received “obese” range marks for two of her three children who are nowhere near overweight. Now it becomes clear that we cannot possible classify these kids as overweight or underweight without taking into consideration other factors such as fat distribution, family history and the child’s behavior. This leads us to a very important question—if BMI calculates the relationship between height and weight, in a time when height and weight are rapidly changing at different paces and intervals, how can we justify using this as a determinant of adolescent health?

 

Knowing everything that we know about BMI, is this really something that will be beneficial for children and adolescents? Shouldn’t we be focusing on their habits through this time to pave the way for a lifelong positive relationship with health and food?

 

Perhaps even more important, we should be considering how these letters impact the children receiving them. We know that adolescence is the time that individuals are molded into adults. So what happens when a child is told they are fat? A recent article published by the LA Times discusses a study at UCLA that researched this question. Their data reflects “10-year-old girls who are told they are too fat by people that are close to them are more likely to be obese at 19 than girls who were never told they were too fat.” (LA Times, Deborah Netburn) The research goes on to emphasize the danger of “Weight Labeling” at this age. With our understanding of adolescent development, it’s easy to see why.

 

The major flaw with BMI calculations continues to be that it cannot tell you an individual’s habits. Those high in muscle weight are considered overweight, petite individuals are underweight and normal range individuals could be harboring unhealthy eating habits. BMI is limiting. It doesn’t ask the big questions; have you started menstruating? Are you feeling pressure to experiment with drugs, alcohol, cigarettes, or sex? How often do you think about food? Are you eating a balanced diet? These are the thoughts and habits that, overtime, determine the health of an individual.

 

Has your child received a BMI report card known as a Fitness Gram? What are your feelings concerning weight stigmas and children?

 

For more information on this subject, check out the Academy of Eating Disorder’s stand on BMI reporting in schools and Examiner’s take on Fitnessgrams.

A Reflection on BMI

A Reflection on BMI
Part 1 – In The Media
By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team

Photo Credit: Barbara.K via Compfight cc
Photo Credit: Barbara.K via Compfight cc

We’ve been hearing a lot about BMI recently in news. Between The Biggest Loser controversy and a recent article recounting a Yale student’s struggle with her school’s perception of health, BMI seems to be the hottest new weight assessment. Mom Dishes it Out covered BMI in 2012 (the article can be accessed here) emphasizing the importance of good and healthy behaviors over the use of a flawed scale of measurement. Since then, we found that it continues to be used in the media as a fact determining obesity. But what does BMI really tell us about our bodies? Body Mass Index—or BMI—is a measurement of body fat based on an individual’s height and weight. To determine your own BMI, you can use this easy equation.

BMI = weight (kg)/ height (m)2 

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Determining BMI is not specific; it’s general. An individual’s BMI is just one part of the puzzle when health care professionals work towards improving an individuals habits and it should not be used as the sole determinate to suggest that an individual is either under or overweight. It is merely a clue as part of a larger nutrition and health assessment.  In recent years, the parameters for BMI have changed, causing more people to fall into certain categories.

Consider this – muscle weighs more than fat. So are Tom Brady, Michael Phelps, and many of the female Olympic gymnasts overweight? Their BMI says yes, though we know this is not the case. Bodies come in all shapes, sizes, and masses and it is important to remember this.

The fueling argument behind The Biggest Loser contestant, Rachel Frederickson’s, weight controversy was her BMI of 18, a value considered just underweight and malnourished. Without considering her BMI, it’s easy to understand how and why a driven and competitive individual involved in a nationally televised weight-loss competition (who would win $250,000) would be so intent on dramatic weight loss. However, we don’t think her weight was healthy. But not because of her BMI, rather her report of exercising 6 hours a day while only consuming 1600 kcals daily in addition to losing 266 pounds in such a short period of time. This is not realistic to continue nor healthy for a lifestyle. If an Olympic athletic were in training, they may exercise for so many hours but they would also be likely consuming 4000 kcals/day. Since the final weigh-in, and after resuming her “normal lifestyle” with the tools she learned from the show, Rachel has a BMI of about 20.

What is more important to consider, is that she reports she is finding time to exercise everyday for about 60 minutes. She loves cooking and is enthusiastic about her meals. She has a renewed sense of her athleticism. She has invested in behavior modification and it is working for her. Instead of using her BMI as a tool to ask the larger questions, we used it’s against her stating that is was a fact that she was unhealthy and now that her BMI is in normal range it is a fact that she is healthy. When, in reality, none of us truly have access to that information. Particularly since none of us know the mental and physical impact that social scrutiny had on her—that’s certainly not information we can get from her BMI. We wonder, is she menstruating, is she thinking about food all of the time or some of the time? We don’t need Rachel to answer these questions, but rather, for us to understand that a mid-range BMI and decreased exercise still does not equate health. More questions need to be answered.

Photo Credit: -Paul H- via Compfight cc
Photo Credit: -Paul H- via Compfight cc

A similar scandal arose when Yale student, Frances Chan, reported in an article later picked up by the Huffington Post, that Yale was forcing her to gain weight, at risk of mandated medical leave from school, based on her BMI. Chan, 5’2” and 90 lbs has a BMI of 16.5. Says Chan;

The University blindly uses BMI as the primary means of diagnosis, it remains oblivious to students who truly need help but do not have low enough BMIs. Instead, it subjects students who have a personal and family history of low weight to treatment that harms our mental health. 

While we are given access to Chan’s height and weight and, therefore, her BMI—she is not our patient. We do not have her medical history or understanding of her body’s development overtime. Most importantly, we are not made aware of Chan’s habits and behaviors. With all of that said, her BMI is quiet low. This is a red flag to health professionals suggesting they dig deeper into one’s medical status and mental health to determine if there is an issue, perhaps behavioral, that needs addressing. Chan suggests that Yale used her BMI as the sole determinant during her nutrition intervention. Whether or not an intervention was required remains unclear to us, but we would hope that more than one’s BMI will be used in future assessments and they would take into account her medical status, her mental health and her behavior/habits.

The above scenario is particularly true when visually assessing others. The point here is size is not the only measurement of health especially that of BMI. Some people qualify as healthy with a BMI of 20 yet their behaviors say otherwise by implementing dietary restriction, smoking, over exercising and even purging. While others, with a BMI of 26 could be healthy, exercising, not smoking, and eating normally yet be considered overweight. The same holds true for someone in the extreme margins of BMI. There are many nutrition clients that we have counseled with BMI’s greater than 29 who have made dietary and lifestyle behavioral changes yet their weight does not reflect the media’s representation of health. And so the same goes for someone who is naturally thin and healthy. For women, regular menstruation, adequate nutrition intake and lack of food thoughts/obsessions along with a normal blood pressure, EKG and more, may be a better indicator of true health. So don’t judge a book by its cover.

Stay tuned; there is more information to come about BMI and how it is being used in our culture and society.

“Shattered Image”: An Interview with Brian Cuban

“Shattered Image”: An Interview with Brian Cuban
By Laura Cipullo, RD, CDE, CEDRD and the Laura Cipullo Whole Nutrition Services Team

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Weight Stigma Awareness week just passed and Laura joined her iaedp NY team at NEDA’s walk for eating disorder awareness this past Sunday. To continue raising awareness, here at EALM we are sharing a very honest and intimate interview with Brian Cuban, lawyer, author of Shattered Image, and brave individual who is sharing his own story of body dysmorphia.


1) How old were you when you realized that you suffered from BDD (Body Dysmorphic Disorder)? And could you describe what BDD is, from a patient’s perspective?

I was in my 40’s before I knew [BDD] had a name. While the disorder has been around for 100 years, BDD has really only been studied “mainstream” in the last decade. From my personal perspective, it was exaggerating the size of my stomach, love handles and the loss of hair on my head to the point where it affected my ability to function and caused me to engage in self-destructive behaviors.

2) The documented number of men with eating disorders is increasing. Why do you think this is? Do you think our society and the field is offering more resources for men to seek support?

I think it’s because more men are coming forward and being diagnosed because of increased awareness. The increase in awareness makes it easier for a guy to not be consumed by gender stereotypes and stigma and be honest with his treatment provider or other trusted person. There are absolutely more resources. When I first started going through it in the early eighties there was virtually no awareness nor were there resources. I didn’t even know the words anorexia or bulimia existed.

3) Where does bullying fit in the “eating disorder and BDD spectrum”? Would you say bullying was a trigger for your EDO and BDD? Or is there a way to describe to readers how all of these: EDO, BDD, and Poly-substance abuse are all likely to fall in the same bucket?

Bullying is definitely one of the things that played a major role in the development of my eating disorder, especially when that bullying was related to appearance.  It was certainly that way for me. Can I say it was the only reason? No. There was also fat shaming at home. I was also a very shy and withdrawn child genetically. It is possible there was a pre-disposition to such behavior for me.

I started with a distorted image in the mirror. In my mind, if I could change that image to what, I equated, as something that would cause me to be accepted, then everything would be ok. For me, that was being thin at first. When eating behaviors did not work to change the image, I cycled into alcohol and drug abuse, and, eventually, steroid addiction.  I call it a “BDD Behavior Wheel” -constantly spinning with no end game until I addressed the core issues of the fat shaming and bullying I experienced as a child.

4) As a man who has suffered from an eating disorder, in what ways could an eating disorder impact a man’s life that may differ from a woman? (If any).

Gender specific health issues aside, I think the impact is probably the same from a social and day-to-day standpoint. Shame, isolation, health, and impaired achievement affect both men and women with eating disorders. It is society that views them differently. From a male’s “going through it’ standpoint, I suspect much is the same for both sexes.

5) Do you have any advice for moms and dads raising boys or what to look for in terms of signs that their son may be developing a negative relationship with food and body?

I try not to take the role of a treatment provider since I am not one. I can only speak for my behaviors. These are the behaviors I engaged in: trips to the bathroom with water and/or the shower turned on to hide purging, evidence of purging in the bathroom, scraped/bruised finger joints from purging, and eating tiny portions. I was eating less, staying below a specific number of calories per day. Depression, isolation and social withdrawal are big ones. Children don’t isolate themselves without a reason, something is wrong.

6) In addition to genetics and other environmental stimuli, what role do you think nutrition played in the development of your eating disorder and BDD? Was there a message of health versus thin in your house and if so how do you think this affected the ED/BDD?

Nutrition played a role in that it was something I had no context for. Healthy eating was not really something that was a huge topic of discussion in the early 1970’s. I honestly can’t remember whether it was a topic of discussion in my home. I think my parents did the best they could to provide a healthy food environment within the constraints of awareness of that era. I can say that I tended to not eat healthy because it soothed my loneliness and depression in the moment. This typically occurred during lunch and during the day.

7) In terms of eating – do you now practice intuitive eating, mindful eating and/or how would you generally describe your nutrition intake?

Currently I would say that I practice intuitive eating but, I have to admit, I go through yo-yo phases like many others. I actually consulted a nutritionist about a year or so ago and did pretty well with it, but I have gotten away from healthy/balanced eating more than I would like recently. It’s nothing that ties into my disorder in itself, its just life although when I gain weight because of it that can have an effect on how my BDD thoughts play out.

8) Do you have any words of wisdom to share with adolescents who may be struggling with similar issues?

You are not alone and you are loved.  Find a trusted person you can confide in. There is an end game of recovery and a great life if you can drop the wall of shame and self protection for one second and take one tiny step forward by confiding in those who love and care about you.  Don’t wait 27 years like I did. Do it now.

Shattered Image - BCuban

One of our lucky subscribers will receive a free copy of Brian’s book, Shattered Image!

First be sure you have subscribed to EALM and then you can submit more than one entry by doing any of the following.  Be sure to leave an additional comment letting us know you subscribed and liked us! Good luck!

  • Leave a comment here and  “Like us” on our Facebook page
  • Follow @MomDishesItOut and tweet “@MomDishesItOut is having a #Giveaway”

Giveaway ends on Sunday, October 20th, 2013 at 6:00PM EST.

Contrary to Popular Belief – Men, Also Suffer From Eating Disorders

Contrary to Popular Belief – Men, Also Suffer From Eating Disorders
By: Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team

Many people believe that the majority of individuals with eating disorders are female. However, recent studies are showing that this is not the case. Males, also, suffer from eating disorders. In fact, the amount of men facing an eating disorder may surprise you.

The National Institute of Mental Health has determined that an estimated 1 million men struggle with eating disorders or roughly 1 in 10 eating disorder patients is a male1. Researchers believe this suggests, not only that the incidence of male eating disorders is increasing, but the amount of men seeking treatment is also rising2.

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A recent report featured in the Journal of Men’s Health and Gender found that a frequent behavior among males with eating disorders is a term called “Anorexia Athleticism,” or extreme and frequent exercise3. It is typical to see male eating disorder patients use excessive exercise to make up for their eating habits or on the other hand, exercising without enough food intake, resulting in possible starvation or Anorexia. Andrew Walen, LCSW-C, a psychotherapist specializing in male eating disorders, states that eating disorders can also stem from childhood bullying (A. Walen, LCSW-C, phone communication, September 2013). For example, a young boy who is bullied because of his weight may be prone to dieting to feel accepted by his peers. This can be a slippery slope that could potentially lead to an eating disorder.

According to NEDA, boys’ and men’s body images are formed by the “attitudes and beliefs that culture attributes to the meaning of masculinity, including the traits of independence, competitiveness,
strength, and aggressiveness. Those who do not conform to the culture’s ideal image tend to have a
lower self-esteem than those who do conform. When males fail to live up to these masculine expectations,
they feel emotionally isolated, and this leads to problem behaviors. These problem behaviors may take
the form of eating disordered beliefs and behaviors”4.

John F. Morgan, the author of The Invisible Man: A Self Help Guide for Men with Eating Disorders, Compulsive Exercise, and Bigorexia, states that if left untreated, male eating disorders can affect aspects of the man’s life, such as “interference with their work, social activities, or just meeting day-to-day responsibilities”5. “While the effects of an eating disorder don’t differ dramatically between males and females,” Andrew Walen explains, “males typically experience a deeper feeling of shame.” The male psyche has an “I can handle it” mentality and admitting the need for help can be difficult for men. There is often a sense of isolation for men, even in recovery (phone communication, September 2013).The good news is that the amount of resources for males with eating disorders is beginning to change with the increasing level of awareness.

Study authors, Kearney-Cooke and Steichen-Asch, state that in our modern day culture “muscular build, overt physical aggression, competence at athletics, competitiveness, and independence” are desirable traits for males, while, “dependency passivity, inhibition of physical aggression, smallness, and neatness” are often viewed as more appropriate for females6. Here at EALM, we encourage families to be very cautious and not fall prey to furthering this type of categorizing and or stereotyping of boys and girls. We ask parents to educate yourselves on eating disorder warning signs that your sons may exhibit.

Possible Warning Signs of EDO Young Boys:

  • Experienced a negative reaction to their bodies from their peers at a young age6.
  • Tendency to share a closer relationship with their mothers, in comparison to their fathers.
  • Dieting in response to being overweight, (whereas females begin to diet because they may “feel” overweight).
  • Likely to manage their weight through exercise and calorie restriction.
  • Fixated on building a muscular “shape,” or a certain look. They are less likely to be fixated on their actual weight on the scale.
  • Participate in the following sports: gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers. Are particularly vulnerable to eating disorders because their sports necessitate weight restriction. It is important to note that weight loss in an attempt to improve athletic ability differs from an eating disorder when the central psychopathology is absent4.

 In addition to the above signs, there are psychological and biological factors that may also be associated with eating disorders including, but not limited to the following:

  • A lack of coping skills or a lack of control over one’s life
  • Experiencing anxiety, depression, anger, stress, or loneliness
  • Having a family member with an eating disorder

If you feel that you, or a family member, may be suffering from an eating disorder, we’ve provided some suggestions from Andrew Walen:

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  • Visit The National Association for Males with Eating Disorders, Inc.
  • Find a male therapist or find a program that understands the male perspective.
  • Get help wherever you can, educate yourself, and be sure to include your family.
  • Lastly, don’t let shame or your eating disorder voice tell you that you aren’t worth it, because you are.


Here are our recommended resources:

National Eating Disorder Association, NEDA

The International Association of Eating Disorder Professionals Foundation, iaedp Foundation

The International Association of Eating Disorder Professionals Foundation of NY, iaedpNY Foundation

The Eating Disorder Referral and Information Center

Diet, Detox, or Disorder – An article featuring Laura Cipullo

Screen shot 2013-09-25 at 1.19.21 PMIf you live in the NYC area, come join us on Sunday, October 6th in a walk to raise awareness of eating disorders at the NYC NEDA Walk. Click here to learn more.

 

References:

1. Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. 2012. Eating Disorders in men: Underdiagnosed, undertreated, and Misunderstood. Eating Disorders, 20(5), 346-355.
2. Striegel R.H., Rosselli F., Perrin N., DeBar L., Wilson G.T., May A., and Kraemer, H.C. Gender Difference in the Prevalence of Eating Disorder Symptoms. Intnl J of Eat Dis. 2009; 42.5: 471-474. Available at: http://works.bepress.com/ruth_striegel/24
3. Weltzin, T. 2005. Eating disorders in men: Update. Journal of Men’s Health & Gender, 2: 186–193.
4. Shiltz T. Research on Males and Eating Disorders. NEDA. undefined. Available athttp://www.nationaleatingdisorders.org/research-males-and-eating-disorders. Accessed September 20, 2013
5. Morgan, J. 2008. The invisible man: A self-help guide for men with eating disorders, compulsive exercise, and bigorexia, New York, NY: Routledge.
6. Kearney-Cooke, A., Steichen-Asch, E. 1990. Men, body image, and eating disorders. Males and Eating Disorders. 54-74.

Healthy in the Mind and the Body

You want to be healthy in the mind as well as the body, right? So do you think a gym is a place of healthy attitudes and positive role models? Unfortunately, it’s not always the best place for our mind or bodies especially when we are moving for the wrong reasons. Many times, I encourage my clients to move but fear they will get caught up in over-working their bodies, or triggered when their trainer or instructor give unsolicited diet advice or encourages more than one spin class a day. Well my colleague had the brilliant idea to create a training program to educate fitness specialists/trainers at the gym how to work with health seekers in a way that honors both the mind and body. This amazing training helps the gym employees to identify individuals with eating disorders and gives them tools to work with clients in a healthy way rather than encouraging the disorder. Read on to learn about Jodi’s Destructively Fit and perhaps think about whether or not your health club needs a little bit of Jodi’s energy.

By Guest Blogger, Jodi Rubin

Eating disorders have always been my passion. They have been my specialty since I began my LCSW private practice more than a decade ago. Over the years, I’ve directed a program for eating disorders, currently teach a curriculum I created on eating disorders at NYU’s Graduate School of Social Work, and have done a few other things. Yet, I have not found a way to connect my love of healthy fitness and honoring one’s body with my passion for helping those struggling with eating disorders.

The issue of eating disorders within fitness centers is a ubiquitous one. I’ve seen people spending hours on the treadmill, heard countless patients recounting their obsessiveness with the gym, and others seeming as though their self-esteem became immediately deflated if they couldn’t work out hard enough, fast enough or long enough. The research I have done has revealed that the presence of eating disorders within fitness centers is “sticky” and “complicated” and gets very little attention. Through no fault of anyone in particular, if people aren’t given the education and tools, then how can anyone feel knowledgable and confident enough to address this sensitive issue?

I went directly to fitness professionals to see what they thought about eating disorders within the fitness industry. As I suspected, it was clear that there was not a lack of interest in this issue. Quite the contrary. Most, if not all, of those with whom I spoke were eager and excited to finally have a forum in which they could learn about eating disorders and how to approach the issue. That’s when DESTRUCTIVELY FIT™: demystifying eating disorders for fitness professionals™ was born. I created this 3-hour training with the goal of educating those within the fitness industry about what eating disorders are and what to do if they notice that someone may be struggling. It has since been endorsed for continuing education by both the National Academy of Sports Medicine (NASM) and The American Council on Exercise (ACE) and has sparked the interest of variety of fitness clubs. Check out Destructively Fit™ in the news here!

Some stats for you…
• 25 million American women are struggling with eating disorders
• 7 million American men are struggling with eating disorders
• 81% of 10 year old girls are afraid of being fat
• 51% of 9-10 year old girls feel better about themselves when they are dieting
• 45% of boys are unhappy with their bodies
• 67% of women 15-64 withdraw from life-engaging activities, like giving an opinion and going to the doctor, because they feel badly about their looks
• An estimated 90-95% of those diagnosed with eating disorders are members of fitness centers

 

Read more about Destructively Fit™ on destructivelyfit.com. You can also follow Destructively Fit™ on Facebook and Twitter. Help spread the word and be a part of affecting change!

4 Smart Superbowl Swaps

After the holiday madness, most of us made a resolution to start the new year on a healthy note.  We are only one month in and with Super Bowl weekend quickly approaching, many of us will be thrown off track by the endless buffets of fried foods, chips and dips.  You don’t have to deprive yourself during the big game, just make sure to practice intuitive eating and consume foods in moderation. Pay attention to portions, and always stock up on proteins and fresh fruits and veggies since they will help keep you satisfied longer!  If you are hosting the party or looking for something to bring, why not try a few of these healthy alternatives to traditional Super Bowl Sunday favorites that everyone will love and will not have you missing the extra fat and calories!

Broiled Buffalo Wings

INGREDIENTS
Serves 10

2 pounds chicken wings, split at the joint 
(~20 wings)

1/4 cup of your favorite hot sauce

Dash of cayenne pepper

1 clove garlic

METHOD

Place wings into a large pot and fill the pot with cold water to cover the wings by 2 inches. Bring to a boil, and boil for 10 minutes. While chicken is boiling heat your broiler to HIGH. When done, drain and place chicken wings on rimmed cookie sheet. Broil 6 inches from element or flame for 5 to 6 minutes per side. The skin should blister and brown. You will notice that the skin appears to be crispy. While chicken is in the oven, combine hot sauce, cayenne pepper, and garlic in small bowl.  Set aside. Put chicken wings into bowl or dish and toss with hot sauce to evenly coat.

Serving Size: 5 wings, 240 calories, 12 g fat, 4 g carbohydrates, 27 g protein, 1 g fiber

Broccoli and Cheese Twice Baked Potatoes

INGREDIENTS
Serves 8 

8 large baking potatoes

2 tablespoons olive oil

3/4 pound broccoli florets (approx 5 cups)

1 large onion, finely chopped

4 cloves garlic, minced

2 cups grated low-fat Cheddar

1/2 cup nonfat Greek yogurt

1/4 cup skim milk

Salt and pepper

 Preheat oven to 375°F. Rub potatoes with 1 Tbsp. oil; pierce with a knife. Bake until tender, 1 hour and 30 minutes. Steam broccoli until tender, 5 minutes. Drain; rinse. Pat dry and roughly chop. In a skillet over low heat, warm 1 Tbsp. oil. Sauté onion until soft, 10 minutes. Add garlic; cook 2 minutes. Remove from heat. Let potatoes rest until cool enough to handle. Set oven to 350°F. Cut top 1/4 inch off potato. Scoop out flesh. Mash potato flesh. Mix with remaining ingredients. Fill potato shells with mixture; bake 30 minutes.

368 calories, 6.0g fat, 10.4g fiber, 64.4g carbohydrates, 16.4g protein

Chili Lime Tortilla Chips

Serves 6

INGREDIENTS

12 6-inch corn tortillas

Canola oil cooking spray

2 tablespoons lime juice

1/2 teaspoon chili powder

1/4 teaspoon salt

METHOD 

Position oven racks in the middle and lower third of oven; preheat to 375°F. Coat both sides of each tortilla with cooking spray and cut into quarters.
3. Place tortilla wedges in an even layer on 2 large baking sheets. Combine lime juice and chili powder in a small bowl. Brush the mixture on each tortilla wedge and sprinkle with salt. Bake the tortillas, switching the baking sheets halfway through, until golden and crisp, 15 to 20 minutes.

90 calories, 1.0g fat, 17.0 g carbohydrates, 3.0g fiber, 2.0 g protein

Cucumber Salsa

Serves 8

 INGREDIENTS

2 cups finely chopped seeded peeled cucumber

1/2 cup finely chopped seeded tomato

1/4 cup chopped red onion

2 Tablespoon minced fresh parsley

1 jalepeno pepper, seeded and chopped

4-1/2 teaspoon minced fresh cilantro

1 garlic clove, minced or pressed

1/4 cup 0% nonfat Greek yogurt

1-1/2 teaspoon lemon juice

1-1/2 teaspoon lime juice

1/4 teaspoon ground cumin

1/4 teaspoon seasoned salt

METHOD

In a large bowl, combine all ingredients and serve with toasted pita wedges or tortilla chips.

12 calories, 0.1g fat, 1.8g carbohydrates, 1.0g protein

 

Is food always on your mind?

 

 

5 Signs You May Be Eating When You Don’t Need To

  1. You sneak food.
  2. You eat every time you come home regardless of your hunger level.
  3. You eat in bed.
  4. You always eat when you are sad or angry.
  5. You eat food just because it is there.
If you answer yes to any of the questions above, read the article below. 

ENDING THE INTERNAL FOOD FIGHT

By Laura Cipullo, RD, CDE, CEDS

You’ve finished eating dinner. You’re satisfied and feel good. But coming from the other room is a voice. It whispers, “Eat me. You’re tired, and I will make you feel better. You gorged last night. . . and every night the week before—why not tonight?” So you get off the couch and sink, bite by blissful bite, to the bottom of a pint of your favorite ice cream.

Moments later, your feeling of bliss is gone. Guilt, remorse, shame and loss set in. You just ate an entire pint of ice cream when you weren’t even hungry. You feel that food is controlling you and that you just can’t win.

Well, you can win. Food needs to be balanced with your physical needs and sometimes your emotional needs. You can break the cycle of behavioral eating by giving yourself time and working in phases. This article outlines six phases to end the internal food fight and gain a neutral relationship with eating. Each step focuses on a small behavioral change designed to prevent the feeling of deprivation. The continuation and accumulation of the new habits can lead to big health and lifestyle changes for your future. Give yourself a week or two to move through each phase.

This article addresses night eating of previously restricted foods and builds off the ice cream example above, but these phases can be applied to many other eating habits. Other non-hunger reasons for eating include eating to comfort yourself, eating something after a meal because you grew up eating dessert, and eating socially because your friends are eating. Using the steps below as a guide can help you break these too. Before you begin, however, you have to first identify and accept your counterproductive habit. Only then can you begin the journey toward freedom from your internal struggle.

Phase 1 (Weeks 1 & 2): Once you’ve identified your behavior, embrace your habit or forbidden food. Give yourself permission to eat ice cream past your point of fullness. Allowing yourself the food or behavior removes the guilt and releases you from the internal struggle. Enjoy the food/habit, recognizing how your body feels as you are indulging. In our example here, remember how good that first bite of ice cream tastes (it’s often what your body remembers most, because as you continue to eat, your senses are dulled).

Phase 2 (Weeks 2 & 3): It’s time for another small change. Start by reducing your portion to three quarters of its original size. While you’re modifying your behavior in a healthy way, you’ll still be allowing yourself to enjoy the food. You aren’t depriving yourself, and you’re beginning to be mindful of your physical needs.

Phase 3 (Weeks 4 & 5): Decrease your portion to half the original size over the next two weeks. While slowly reducing the portion, you shouldn’t feel restricted or deprived. Savor your food; notice the color, the texture, the taste, and how it makes you feel during and after eating it.

Phase 4 (Weeks 5 & 6): You have experienced your food fully and have probably realized that a smaller portion satisfies you. Now change the food you are eating. Using our example, try a creamy sorbet. If nuts are your night food of choice, try switching to another salty finger food, like popcorn.

Think about why you are eating. Do you want to keep this habit? While you’re continuing to eat at night, you’re now doing so with a neutral food (one that was not formerly restricted), which is less numbing. Your relationship with food should feel more balanced.

Phase 5 (Weeks 6 & 7): Get ready to reintroduce your original food. Alternate eating the halved portion of regular ice cream with one of sorbet. When you crave the ice cream, eat it. And when you want the sorbet, dig right in. Try to alternate your snack every other night and eat your food at the kitchen table with no other stimuli (watching TV, talking on the phone). This creates an environment that allows you to be mindful, and intuitive. Hopefully you feel freer and are better able to enjoy both foods.

Phase 6 (Weeks 7 & 8): Incorporate your night foods in moderation. Enjoy the food while paying close attention to your body’s needs. Remember that your night eating should be stimulus-free and at the kitchen table. Alternate your foods, follow your cravings and, most important, if you aren’t hungry, find something else to do.

Follow this proactive plan, and after 12 weeks of gradual changes, you will be eating less and feeling more empowered and less controlled by food. Don’t be tempted to race through phases. There’s no reward for finishing first, so remember to take your time. Doing so will help make your new habit a permanent one, and you’ll be more in tune with your body’s needs.

Moving forward, you can repeat the phases if you feel the need to further reduce your portions or if your old habit recurs. Finally, remember that you can always receive additional support from trusted friends, family, self-help books or a registered dietitian.

Phases 1 through 6, in Brief

Phase 1: Allow yourself your chosen food or behavior for the first one to two weeks.

Phase 2: Reduce your portion size to ¾ its original size.

Phase 3: Decrease your portion further to ½ its original size.

Phase 4: Choose a different food. Change the food you are eating.

Phase 5: Alternate eating the halved portion of original food with its healthier counterpart. Remember to eat in a stimulus-free environment at the kitchen table.

Phase 6: Incorporate all foods, in moderation. Choose ice cream one night, sorbet one night and perhaps nothing another night (if you are not hungry), maintaining your new healthy habit.

 

The above is not intended for those suffering from eating disorders.