Navigating diet talks at holiday events

Blog post written by Therese Kenny, MSc

As we near the transition from 2021 to 2022, many of us will be spending more time with friends and families. After what has undoubtably been a challenging 21 months, this may be the first time that some of us are seeing certain people in person. Of course, for many, this may bring up concerns about changes in appearance; we are all familiar with the unsolicited weight, body, and food comments that come up this time of year, and the increased time apart may seemingly invite more of these.

              Although it would be fan-freaking-tastic if everyone were knowledgeable about the negative impacts of comments about weight, bodies, and food, this is not the reality. We may then need to set boundaries with family members or friends in order to keep ourselves feeling safe. One way to do this is to set guidelines ahead of time. You may want to reach out to people who are closest to you and express the desire to avoid diet talk this year. It is up to you how much you share about why this is important to you, but letting people know ahead of time can help them understand that (and why) you may change the subject or leave a conversation.

              Unfortunately, asking to avoid these topics often does not prevent all diet talk and so we need to be prepared to respond to unsolicited comments or advice in or after the moment. There are many approaches to doing this and it will ultimately, depend on your level of comfort addressing this topic with people around you. Before attending a function, take a moment to consider who will (or may) be there and your level of comfort with these individuals. Then, you can plan ahead to have some of these strategies in your back pocket.

1.       Ignore: If I am at an event with people that I do not know super well and someone makes an offhand comment, I often choose to ignore it. For me, I do not feel that a public setting is the time or place to have a conversation with someone I do not really know and may not see frequently. If however, the comments persist, I may take a different course of action. An example of when you may want to ignore could be an extended family member commenting on your appearance when you first see them.

2.       Change the subject: If the comments continue and you are feeling uncomfortable (or even if the single comment was enough to send you spinning), you may want to change the subject. You can do this by subtly redirecting the conversation or by making an obvious statement to indicate that the conversation is over. I was once at a training where we were practicing derailing diet talk, and a colleague used the example of, ‘So what about the political climate in America?’ Depending on who you are with, you may choose a less inciting statement, but you get the idea! If you are uncomfortable with shifting the topic, you may want to confide in a trusted friend or family member who can redirect the conversation for you when it gets into unhelpful areas.

3.       Ask for something to change: You may also choose to have a conversation with someone about how their comments are affecting you and what they can change to support you. Depending on the situation, you may want to have this before, during, or after the event. A good acronym to help you structure this conversation is DEAR:

Describe: First, you want to describe the facts of the situation (not your feelings or interpretation). For example, you might say, ‘Last night at the dinner table, you made a comment about needing to go to the gym after having eaten.’ This statement describes what happened in a non-judgmental way.

Express: You will then express how the situation made you feel. While our inclination may be to tell the other person how they made us feel, it is often more effective to express our own feelings without blame or judgment. In the example above, I might say, ‘When I hear statements like these, it triggers thoughts of needing to lose weight, which makes it harder to engage in my recovery journey’ as opposed to ‘Your comments make me feel crappy.’

Assert: A is the most important step. It is what we are going to ask for in our conversation. Before you enter into the conversation, it is helpful to know what you are asking for. Would you like everybody at the party to avoid all diet talk? Do you want your friend to be more mindful of what they say? Being clear about our ask is important in that it helps us get our needs met or to determine that our needs cannot be met in a particular situation. For example, a friend who is deeply invested in diet culture may have difficulty shifting conversation and thus, you may need to think of other strategies for interacting with this person. In the current situation, an example of an assertion could be, ‘I would appreciate if you could not talk about diets, weight, food, or exercise around me.’

Reinforce: Finally, we want to reinforce what we are asking for. We are asking for something from someone else and want to demonstrate or highlight how this will also benefit them. Sometimes this could be a tangible benefit (e.g., a worker asking for a raise who will do better work if they are appropriately compensated). Sometimes this could be appreciation or gratitude (e.g., appreciating someone’s attempts to be more mindful of triggers). Here I might give examples of both, ‘I would really appreciate if you could do this as it will make me feel safer. I also think that you may notice some benefits from not always talking about these subjects!’

4.       Have a conversation: With certain relatives and friends, you may feel open to having a conversation about the ways in which these comments affect you. Engaging in this dialogue in an open and honest way can be helpful in supporting others to understand you. It however, also carries risks in that another person may not be able to see your perspective or may not understand why this is so upsetting to you. You are the best judge of your own tolerance of this risk, as well as of your friends’ and family’s openness to difficult conversations. Depending on your stress levels, the middle of a party may not be the best time to have this conversation; however, the next day over coffee may feel manageable. Your level of comfort dictates how much or little you want to share about your personal experience. If you are not feeling comfortable disclosing, you may choose to share a resource, such as this article (https://www.self.com/story/body-talk-consent) about the impact of these statements.

5.       Leave: Sometimes, despite our best efforts, openness, and willingness to engage in dialogue, people are not ready to change how they talk. Other times, we may just feel exhausted by all the diet and body talk and not have the energy to redirect, ignore, or comment on it. This is your annual reminder that it is okay to leave! You can leave the conversation, the room, or the event. Having a supportive friend who can help you with this can be beneficial.

This time of year can be challenging for many reasons. Planning ahead for possibly triggering, harmful, or uncomfortable statements can be helpful in managing your mental health this holiday season.

The Forgotten Origins of the Body Positivity Movement

Blog written by Tamanna Nijjar, Arts and Science Student at the University of Guelph

#beautifulasis #bodypositivity #loveyourbody #effbeautystandards #bodyacceptance #allbodiesarebeautiful 

I’m sure you have read these hashtags at some point while scrolling through social media. What a great way to empower individuals to embrace their true selves. Isn’t it? But it’s common to see these hashtags thrown around by brands and social media influencers to gain followers and a positive image on social media rather than promote the true message behind the movement. 

So, what are the origins of body positivity?

 It began with Fat Activism in the 1960s when the women’s liberation movement and Black Civil Rights were gaining momentum. It was common to see Black women labeled as fat, ugly, and sluggish in the media which allowed the movement to focus on fatphobia as the product of misogyny and racism. Those with marginalized bodies were given a voice to advocate for body acceptance in colored individuals and those who identified as LGBTQ+. These individuals strived to create a safe and accepting environment for those who did not fit the strict beauty standards of that period.

The issue in modern society is that the movement has caused those with marginalized bodies to become more marginalized. Mainstream media is constantly overlooking the fact that there are women that don’t classify as white, hourglass-figured, and a US size 12 and are learning to love their bodies as well. It is common to see white fitness influencers and celebrities promote hashtags by showcasing their flaws on social media. But these bodies have always been accepted by the media, and now they are used to erase the roots of a movement that promoted appreciation towards colorism and gender identity regardless of body size and shape.  As we see more white women embracing their bodies while promoting the hashtag, we don’t see many colored women in the media embracing their beautiful organic bodies. This is due to the fear of being compared to their white counterparts and facing backlash. 

Hence, society has whitewashed the body positivity movement. 

This raises the question of what Black women are doing to take back the movement. Many Black women are using social media platforms to redefine and expand the body-positivity movement. It is encouraged to support these Black influencers and amplify their voices to create a movement that is more focused on diversity. Many of these influencers can be found Instagram, a popular social media platform.

«  @StephanieYeboah posts great content on fatphobia and moving towards fat acceptance.

«  @TiffanyIman, her content focuses on separating body weight and confidence to empower individuals to believe that they are more than the number on the scale.

«  @laurenleavellfitness posts fitness content for all bodies and discusses ways to dismantle diet culture while still embracing the body positivity movement.

«  @itsmekellieb created the #FatatFashionWeek series to emphasize that fashion can be enjoyed by anyone, especially those living in bigger bodies.  

Overall, body positivity cannot be recognized without its fat activist ancestors that paved the way for body acceptance regardless of gender identity and color in a society that strongly favored those with unmarginalized bodies. A body-positive movement without fat people, Black people, and those with marginalized bodies isn’t truly a body-positivity movement. 

Cheers to #BodyPositivityInColor – BIPOC individuals are encouraged to use this hashtag to restore the roots of the body positive movement.

References

BBC. (2021, October 26). The history of the Body Positivity Movement. BBC Bitesize. Retrieved from  https://www.bbc.co.uk/bitesize/articles/z2w7dp3.

Johnson, M. (2019, March 5). If you ever felt like body positivity wasn't for you, here's why. Healthline. Retrieved from https://www.healthline.com/health/beauty-skin-care/body-positivity-origins#9.

Johnson, R. (2021, May 3). Has the body positivity movement forgotten its roots? THE UNTITLED MAGAZINE. Retrieved from http://untitled-magazine.com/has-the-body-positivity-movement-forgotten-its-roots/.

Miller, K. (2020, June 22). How whiteness killed the Body Positive Movement. Medium. Retrieved from https://elemental.medium.com/how-whiteness-killed-the-body-positive-movement-4c185773101e.

Socially driven inequities and disordered eating experiences

Written by Natalie Doan, MSc, PhD candidate, School of Public Health Sciences

Eating disorders are increasingly understood to affect people of any weight and size, as well as a diverse range of people with different racial and cultural backgrounds, gender identity, sexual orientation, and socioeconomic status. Given the diversity in which eating disorders can present, it is important to highlight the heterogeneity in disordered eating experiences and identify the links to systems of power and oppression. When discussing the social determinants related to eating disorders, it is important to highlight the systems of power that undergird inequities. For example, when discussing disparities related to socioeconomic status, we can shift our language to explicitly identify income inequality as the driver of inequities, rather than socioeconomic status.

Racism

In many ways, the bodies we have been taught to value have been coloured by white supremacy. To understand the origins of fat phobia and its consequences on our prevailing attitudes towards body size, it is necessary to understand its roots in anti-Black racism. During the period of the transatlantic slave trade, body size was violently used as a marker to characterize people who were deemed to not deserve freedom. Although this period of time has passed, our attitudes towards body size continue to ascribe to the notion that it is okay to objectify certain bodies, in particular fat bodies.

Weight stigma

In recent years, research has highlighted the pervasive impact of weight stigma, discrimination, and bias. It is important to note, although individuals of any BMI and weight may experience weight-based discrimination, weight bias affects individuals classified as “overweight” or “obese” by Body Mass Index (BMI) standards differently than individuals whose bodies are not classified using these labels. Weight-based stigma is associated with multiple psychosocial experiences that are often seen alongside disordered eating, including depression, body dissatisfaction, and low-self esteem. Although weight-based stigma is associated with disordered eating behaviours, such as binge eating and purging, it can also serve as a barrier to seeking help for an eating disorder due to the stereotyping of eating disorders as only affecting people who are thin.

Gender identity and passing

Research has found that individuals whose gender identity falls outside the gender binary (e.g., transgender individuals) report more disordered eating behaviours (e.g., use of diet pills or laxatives) than compared to cisgender individuals. To conform more closely with their gender identity, non-binary individuals may engage in behaviours in an effort to influence the shape of their bodies. For example, transgender individuals may attempt to delay or suppress the development of secondary sex characteristics, such as breast and genital growth, to mitigate body dissatisfaction.

Food insecurity

It is important to consider the influence of experiencing food insecurity on one’s relationship with food. Emerging research has demonstrated the importance of considering the experience of the ‘feast or famine cycle’ in which food intake oscillates as food availability fluctuates between periods of food scarcity and relative food abundance. For example, individuals may experience fluctuations in food availability that can align with an influx of funds for food at the beginning of a pay period and limited food availability when funds are exhausted. This cycle can result in a cycle of restriction and relatively high intake that may be inadvertently amplified by some approaches to alleviate food insecurity, such as the U.S. Supplemental Nutrition Assistance Program.

In summary, disordered eating experiences can sometimes reflect responses to disordered social conditions. It is crucial that we intentionally discuss socially-driven inequities in eating disorder spaces. Creating space for these conversations is vital to support social justice for all.

References

Becker, C. B., Middlemass, K., Taylor, B., Johnson, C., & Gomez, F. (2017). Food insecurity and eating disorder pathology. International Journal of Eating Disorders, 50(9), 1031-1040.

Diemer, E. W., White Hughto, J. M., Gordon, A. R., Guss, C., Austin, S. B., & Reisner, S. L. (2018). Beyond the binary: differences in eating disorder prevalence by gender identity in a transgender sample. Transgender Health, 3(1), 17-23.

Dinour, L. M., Bergen, D., & Yeh, M. C. (2007). The Food Insecurity–Obesity Paradox: A Review of the Literature and the Role Food Stamps May Play. Journal of the American Dietetic Association, 107(11), 1952–1961.

Friedman K. E., Reichmann, S. K., Costanzo, P. R., Zelli, A., Ashmore, J. A., & Musante, G. J. (2005). Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults. Obesity research, 13(5), 907-916.

Hazzard, V. M., Loth, K. A., Hooper, L., & Becker, C. B. (2020). Food Insecurity and Eating Disorders: a Review of Emerging Evidence. Current Psychiatry Reports, 22(12).

O'Brien, K. S., Latner, J. D., Puhl, R. M., Vartanian, L. R., Giles, C., Griva, K., & Carter, A. (2016). The relationship between weight stigma and eating behavior is explained by weight bias internalization and psychological distress. Appetite, 102, 70-76.

Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: a review and update. Obesity, 17(5), 941.

Puhl, R. M., Moss‐Racusin, C. A., & Schwartz, M. B. (2007). Internalization of weight bias: implications for binge eating and emotional well‐being. Obesity, 15(1), 19-23.

Puhl, R., & Suh, Y. (2015). Stigma and eating and weight disorders. Current psychiatry reports, 17(3), 1-10.

Strings, S. (2019). Fearing the Black Body. New York University Press.

Taylor, S. R. (2021). The body is not an apology: The power of radical self-love. Berrett-Koehler Publishers.

Natalie’s research focuses on applying an intersectional approach to address socially-driven dietary and health inequities.

Making the Transition to College or University

Written by Carla Giddings OT Reg. (Ont.), Canadian Mental Health Association, Eating Disorders Program

It’s that time of year! Within the context of the COVID-19 pandemic disruptions, we find ourselves at the beginning of another school year. As an occupational therapist, I’ve worked alongside students to transition to College and University for the first time, re-adjust plans along the way, and return after taking a leave of absence for eating disorder (ED) treatment. Over the years, College and University students have taught me much about the many paths to and through school.

1. Assess your school readiness:

Is this the right time for school? If you’re already in school, does it make sense to return this year or take a break?  Is your recovery at a place where you can take on new experiences and stressors? How do you want to engage with school? Lauren Muhlheim and Katie Grubiak (2015) recommend being symptom-free from an ED for six months before attending post-secondary. They offer a checklist to think through when deciding if school is the best option for your recovery and education/career goals. For many people, this might mean deferring (i.e., delaying the start of school) or taking a break to focus on recovery. Most Universities/Colleges have options for deferring from one semester to one year, and supports for a leave of absence.  

Be mindful of “all or nothing” or perfectionist thoughts about school like “I need to attend University full-time living in residence or not at all”. You have options! You might want to test out College or University by taking 1 or 2 courses through distance education. Maybe you keep your living situation consistent for the added structure and support. If this is where you’re at, that’s completely ok.

If after careful consideration, you think it’s the right time for post-secondary, read on for more ideas.

2. Match your school schedule to your recovery needs:

I know as a student, I was completely unaware of options for taking part-time or a partial course load. I thought I needed to be enrolled in a full-time program taking 5 courses each semester. This is not true! There are lots of options for taking fewer courses. Going to school at your own pace that supports your wellbeing will mean you have space to engage in the process more fully like making new friends, getting to know a new city, and exploring new interests. It also means you reduce your likeliness of relapse.

So how do you know the right balance of school and recovery? When planning out your weekly schedule, start with recovery-related activities: your “non-negotiables”.  For many people, these are your meals, snacks, meal planning/preparation, sleep, therapy and medical appointments, and support groups. After you fill in your “non-negotiables” for treatment/recovery work, consider self-care, leisure/recreation and other responsibilities (childcare, family support, community obligations, etc.). Many students also have financial considerations to take care of and may have work schedules to navigate. For these reasons, some students find it helpful to have a full day off school each week for catching up on rest, time with friends or family, meeting new people, exploring new interests, and doing things they enjoy outside of school.

Now take a look at your schedule. How many courses can you reasonably take while prioritizing your wellbeing?  For many people, a part-time or a reduced course load makes sense. Students with eating disorders can register with the school’s Accessible Learning and a reduced course load is a common accommodation. A reduced course load is when you take fewer courses and are still considered a full-time student. That means your OSAP (Ontario Student Assistance Program) funding can remain at the full-time amount for ongoing financial support. This accommodation recognizes that recovery is work – it takes time, energy, and resources!

3. Access accommodations: Academic accommodations are arrangements put in place to create equitable access and opportunities for all students to succeed at school. It is your right to have the accommodations you need: you are not asking for a favour – you are deserving of the same opportunities as any other student to learn.

Academic accommodations are based on your specific needs and can include reduced course load, preferential seating, more frequent breaks (e.g., for meals and snacks), extensions on assignments, a separate location for exams, and others. All Universities and Colleges across Ontario have Accessible Learning Services (although they may have a different name) and Counselling Services. Register as soon as possible so your academic accommodations are in place if/when you need them – there will be information on their website, or you can call them directly.

To register with Accessible Learning, your school may ask for documentation. In Ontario, it is your choice if you want to disclose information related to mental health. Your information will be kept confidential, and your Instructors will not know your diagnosis. The only thing your Instructor will receive is a letter from Accessible Learning saying what accommodations you need. This is your private information and it’s your choice if, what, when and how you share. Typically, it’s up to you to follow-up with your Instructors to put your accommodations in motion. For example, Accessible Learning works with you to determine an accommodation like having an extension on assignments then sends a letter to your Instructor. You will then tell your Instructor if you need the use that extension. Your Accessible Learning Advisor will have more information about the process.

4. Build your support networks:

With times of transition, it’s important to consider the formal and informal supports available to you while at school. Formal supports might be your Nurse Practitioner / Family Doctor, Therapist, Dietitian, or Academic Advisor. This might also include your Accessible Learning Advisor or Counsellor through your University/College. Make sure to have your local crisis line and ED helpline/instant chat on your phone and another place you can easily access it.

Good2Talk: Free and confidential 24/7 Helpline for Post-Secondary Students across Ontario

·       Phone: 1-866-925-5454

·       Text: GOOD2TALKON to 686868

·       Website: https://good2talk.ca/

HERE24/7: Addictions, mental health and crisis services in Guelph-Wellington.

·       Phone (Toll Free): 1-844-437-3247 (HERE247)

·       Phone (Local): 519-821-3582 TTY: 1-877-688-5501

·       Website: https://here247.ca/

National Eating Disorder Information Centre (NEDIC): Information about EDs, finding providers and support groups, or speaking to someone directly through their instant chat/Helpline.

·       Phone (Toll Free): 1-866-633-4220

·       Phone (Toronto): 416-633-4220

·       Website: https://nedic.ca/

·       Instant chat: Monday – Thursday 9:00am – 9:00pm and Friday 9:00am – 5:00pm

Informal supports are family, friends, peer support groups, housemates, classmates, and others. These are people and services that are supportive of your wellness that you can contact when you need help. Each support will have a different function and it makes sense to build a robust network. Your informal supports might also include podcasts, blogs, online groups, and recovery websites.

Throughout your school journey, it is common to encounter oppressive messaging or behaviours about bodies, food, and diet culture (ACHA-NCHA-II, 2019). Many students find it essential to build their skills in identifying unsafe situations / triggers, setting clear boundaries, thinking critically about intersecting forms of bodily oppressions (Crenshaw, 1989) and diet culture, connecting to positive role models and/or peers, and strengthening (self-)advocacy strategies such as challenging stigmatizing language/beliefs (Venturo-Conerly et al., 2020; Rice et al., 2020). There may be spaces and supports on your campus such as advocacy groups for International No Diet Day and organizations for gender empowerment + diversity. Online communities can also be an important space that pushes back against toxic diet culture such as Recovery Warriors or The Eating Disorder Recovery Podcast. You might also find it helpful to check out an intersectional social justice approach such as the work of Sonya Renee Taylor’s online community The Body is Not An Apology: Radical Self-Love for Everybody and Every Body and/or the Body Justice Podcast – BIPOC & Eating Disorder Recovery with Julissa Minaya. Students who identify as LGBTQ2IA+ may want to connect with student organizations on campus or find online supports such as Fighting Eating Disorders in Underrepresented Populations (FEDUP)’s website and blog or thirdwheelED: Two Queer Perspectives on ED Recovery. Be sure to see WWEDC’s Supports and Services and NEDIC’s Resources to find supports that represent your multi-faceted lived experiences and treatment/recovery process.

5. Reinforce your skills

Reflect on what is working well in your treatment and/or recovery. It can be helpful to write out a list of skills and strategies as a reminder. Keep it somewhere where you will see it often while still maintaining your privacy (e.g., journal, on your locked phone, etc.). As a quick reminder, some students find the acronym PLEASE helpful. It’s grounded in Dialectical Behavior Therapy (DBT) (Linehan, 1993, 2015), and I’ve modified this Emotion Regulation skill so it is specific to ED recovery:

·       P – Plan your meals, sleep, and daily activities

·       L – Look out for triggers / high stress situations

·       E – Eat regular meals and snacks according to your meal plan to give your body and mind nourishment

·       A – Assert boundaries and advocate to prioritize your wellbeing

·       S – Seek support from informal supports (e.g., friends, family) and formal services (e.g., therapists, dietitian, Doctor or Nurse Practitioner, group therapy, counselling services, Accessible Learning, etc.)

·       E – Express your feelings / emotions (rather than act them out through ED behaviour)

Additionally, there are Apps that can help remind and reinforce your recovery work. You may want to try Recovery Record or Rise Up & Recover.Treatment and recovery will not always go as planned as you get ready for school and work to find a balance.  There will be days when something might not happen in the way you want or expect. Start again. Return to what works. Access your supports.

References:

American College Health Association – National College Health Assessment (ACHA-NCHA-II) (2019) Canadian Reference Group Data Report: Spring 2019. Available from: https://www.cacuss.ca/files/Research/NCHA-II%20SPRING%202019%20CANADIAN%20REFERENCE%20GROUP%20DATA%20REPORT.pdf

Centre for Innovation in Campus Mental Health (CICMH). (June 11 ,2020). CICMH webinar: Increasing capacity to support students with an eating disorder. Available from: https://www.youtube.com/watch?v=sqdZ_6Htm_k

Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics. University of Chicago Legal Forum, 1989: 139-167.

Muhlheim, L. and Grubiak, K. (2015). If your young adult with an eating disorder ready for college? Available from: https://www.eatingdisordertherapyla.com/wp-content/uploads/2015/10/Is-your-ya-ready-for-college_-_11_23.pdf

Rice, C., Pendleton Jiménez, K., Harrison, E., Robinson, M., Rinaldi, J., Lamarra, A., and Andrew, J. (2020). Bodies at the intersections: refiguring intersectionality through queer women’s complex embodiments. Signs: Journal of Women in Culture and Society, 46(1): 177-200.

Venturo-Conerly, K., Wasil, A., Shuingleton, R., and Weisz, J. (2020). Recovery as an “Act of Rebellion”: a qualitative study examining feminism as a motivating factor in eating disorder recovery. Eating Disorders, 38 (3): 265-271.

Image source ©Roman Drits via Canva.com

Reflection on HAES from a Dietetic Intern Perspective

Blog written by Elyse Hodgins, Master of Applied Nutrition Candidate

As a dietetic intern and future registered dietitian, I recognize the importance of nutrition professionals having an understanding of body image and a skill set in this area, as these two topics can be often linked. My knowledge of body image frameworks was expanded much more in the past 2 months throughout my public health placement with Student Wellness Services at the University of Guelph and specifically working with Lindzie O’Reilly, RD, who practices dietetics with a weight-inclusive approach, specifically through the HAES framework. If you are unaware, HAES stands for Health At Every Size and it is a movement specifically in healthcare settings which shifts the focus away from weight management and more towards health promotion. This is important as weight is sometimes assumed to be an indicator of an individual’s health, when this is not reality. Weight is actually a poor indicator of overall health status, and those with an average BMI are not necessarily “healthy”, just as those with an above average BMI are not necessarily “unhealthy”. Furthermore, HAES recognizes that weight cycling and dieting can be linked to compromised psychological well-being and can have an overall negative impact on health, therefore healthcare professionals are encouraged to take the focus off of weight outcomes and emphasize actual health indicators instead.

The HAES movement also encourages body acceptance rather than a focus on weight loss or other weight-related outcomes. This is similar to another recent topic and movement in the body image field that has become popular, and that I have learned more about throughout my placement, which is body neutrality. Body neutrality encourages individuals to accept their body in its current state, and focus on all the functions our body does for us rather than how it looks. For some people the idea of body positivity and loving the way they look can feel like a big stretch, therefore body neutrality is a more attainable way of viewing ourselves, as it falls somewhere between self-love and self-criticism. If you are having a difficult time fully loving the way you look, try a body neutral approach, where you don’t need to see your body in a positive or negative way, but rather you accept and appreciate all the incredible functions your body does for you.

 Working under a preceptor who practices dietetics using the HAES framework has allowed me to reframe the way I communicate nutrition information to the public to ensure I am portraying the correct message. For example, labelling certain foods as “good” and “bad”, or even “healthy” and “unhealthy”, could perpetuate certain issues such as disordered eating by inadvertently sending the message that some foods should make you feel guilty if you eat them. Instead, I learned to refer to foods in other ways such as “nutrient dense” which shifts the focus more towards health promotion and encouraging the public to consume foods that make them feel their best. HAES encourages individuals to recognize how the foods they consume make them feel, and to use these feelings to make decisions on the foods they eat. For example, encouraging the public to select food that makes them feel energized, satisfied and in a good mood, as opposed to restricting or binging on certain food categories for fear of negative weight outcomes. Therefore, the main lesson that I have learned throughout my placement is how meaningful the words we use can be, and nutrition professionals should be aware of the way they communicate with their clients and the public because of this.

 Learning how to practice dietetics using HAES terminology and understanding the topic of body neutrality throughout this past placement has inspired me to continue advocating for these movements and topics in my future career as an RD. I plan to practice dietetics in a non-judgmental and inclusive way, which also means weight-inclusivity, whereby all my clients feel equally supported and their individualized needs are met through nutrition care. I will be aware of the language that I use as a nutrition professional to ensure that I am not perpetuating diet terms and that the goals I have for my clients are based on overall health promotion, rather than weight outcomes. In conclusion, I am grateful for my public health placement which has allowed me to fully embrace the HAES movement and I am excited to bring this knowledge into my future career and share it with my future clients, colleagues, and workplace.

References

1. Bacon, J., & Aphramor, L. (2011). Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutrition Journal, 10(9), 1-13.

2. Muenter, O. (2020, Aug 19). 7 Wellness Experts Explain “Body Neutrality” and Why it’s Worth Exploring. Byrdie. https://www.byrdie.com/what-is-body-neutrality-5075038

3. Resnick, A., & Goldman, C. (2021, May 20). How to Practice Body Neutrality. Very Well Mind. https://www.verywellmind.com/how-to-practice-body-neutrality-512091 

An eating disorder disguised in fitness & health

Blog post written by Emily Sanderson

“You’re so fit.”

“I wish I was thin like you.”

“How do you do it?”

“You’re so lucky.”

These are just a handful of the comments I used to receive, when in fact I was actually sicker than ever before. For the most part, these comments came from strangers; people who didn’t see beyond the superficial appearance I hid behind in public.

Those who really knew me, knew better. They saw past the thin, “athletic” disguise I wore.

They saw my personality change; how I never really laughed anymore. How I never had the energy for spontaneous get togethers, or fun nights staying out late.

They noticed how I retracted into myself. How I turned down invites and isolated myself.

And I’m sure they noticed how I carefully picked away at food when I was in front of people… Only to binge later on, because my body and mind were in a constant, animalistic state of starvation.

Those closest to me also witnessed me letting go of some of my most precious relationships… For how could I possibly maintain a relationship, when I was in a full-blown affair with my eating disorder?

And these were just the things people noticed.

Most people didn’t notice the depression, or the extreme anxiety I felt around anything regarding food, exercise or routines. They didn’t recognize the hair loss, the insomnia, or that I hadn’t had a menstrual cycle in over 5 years.

Yet despite my state of illness, people continued to praise me on my appearance and the level of well-being they assumed I was in. Even though they didn’t recognize it, their praise was validating my eating disorder. Validating my sickness.

And so naturally, the loud (obnoxious) eating disorder voice in my head told me to keep going. That I wasn’t thin enough, fit enough, sick enough.

And I don’t want that to sound as though I blame other people for the comments they made. Although my eating disorder thrived off of their approval, many people’s comments were simply a by-product of the diet culture ridden society we live in, and quite possibly, an expression of their own desire to feel accepted.

Ironically, some of the comments people would make were actually true. I am lucky. I’m lucky that I have thin privilege; I have the privilege that my body is accepted in our society (even in a recovered, weight restored state), whether or not my eating disorder tells me so.

And I’m lucky that my thinness didn’t go unnoticed… that I had people close enough to me that could identify that I was, in fact, TOO thin. And those people helped me to get help, when I wasn’t strong enough to ask for it myself.

I was so very fortunate to have some incredible supports and services available to me, when I needed them the most. And I was lucky to have the luxury of financial and job security, which allowed me the ability to access said services.

Realizing how lucky I am has highlighted to me that there are way too many people living in this world who are not nearly as fortunate as I have been… People living in larger bodies, who are suffering with eating disorders that may never be noticed or validated.  People who live in bodies that our society rejects. People who don’t have access to the amazing supports and services that I did, and still do. And even further, many people who don’t even have access to the possibility of “health”.

 So, what is it exactly that I want people to take away from this post…?

I guess it’s for everyone to be more critical.

To question our society’s ridiculous standards of health and wellness.

To stop praising thinness and the “ideal body”, and open our minds to different ways of “healthy living”.

To start recognizing disordered eating and exercise obsession for what it is.

And maybe, most importantly, to lend more compassion to ourselves and others who may never be so lucky.

We as humans are all different. Our bodies are different, our minds are different, and our hearts and souls are different. With that, “health” can and should look different on everyone – physically, mentally and emotionally.

Join us in celebrating International No Diet Day 2021!

Blog post written by Lindzie O’Reilly, Registered Dietitian, MAN, University of Guelph

Every year on May 6th, individuals and organizations around the world recognize International No Diet Day (INDD). The objectives of INDD are to challenge the idea that there is one ‘right’ or ‘ideal’ body, to push back against the industries that sustain diet culture, to raise awareness about the prevalence of weight discrimination and fatphobia, and to reinforce the harms of dieting among people across age, gender, culture, and body size.

Dieting can be defined as any intentional change to our lifestyle (modifying food habits, exercise routine, supplements) for the sole purpose of changing our weight or shape. The common belief in our society is that decreasing our weight is beneficial for our health when that is often not true. In fact, weight is an outcome that we have a lot less control over than we think. According to Set Point Theory, our bodies have a genetically programmed weight range that they like to hang out in, where each individual will feel their best physically and mentally, and where their risk of disease is lowest. When we engage in behaviours that support our wellbeing, our weight tends to naturally settle in the range it likes to be in. The range of natural human set points is much broader than society leads us to believe. Unfortunately, many individuals and health professionals still refer to the Body Mass Index (BMI) as a marker of health. BMI was developed by a statistician with the intention of being applied to a population as a whole, not to individuals. If you’ve ever taken a stats class, you might remember learning about a Normal Distribution. It means that, naturally, within a population, 68% of individuals will fall within the ‘normal’ range on the curve. This means that the remaining 32% of the population will naturally have a BMI that labels them as ‘underweight’ or ‘overweight’. It would be statistically impossible for everyone in society to achieve a ‘normal’ BMI.

INDD in particular and the Health At Every Size (HAES) movement in general are not arguing that every individual is currently at their natural set point. INDD is not encouraging us to use May 6th as a once a year “cheat day” (I hate that phrase, but that’s a topic for a whole other post…) and eat more than what feels good for their body. Instead, it’s encouraging folks to develop a relationship with food that they can feel good about every day. It’s saying that targeting our weight as the measure we would like to change is not helpful and often leads us to engage in very extreme habits that can have risks and side effects for both physical and mental wellbeing. Instead, it’s encouraging folks to experiment with different habits to discover what make you feel best. Everyone is an expert in their own body, and everybody is different – there’s no one ‘ideal’ size and there’s no one size fits all approach to food. In a weight-obsessed society, it can be really hard to tell the difference between what truly makes us feel good as individuals and what makes us feel good because we’re following the ‘rules’ and doing what we feel we ‘should’ be doing. Here are some suggestions to help you spot the difference.

Some things that may be helpful:

• Experimenting to find a way to move your body that you enjoy

• Experimenting with new foods to discover what you like the taste of

• Eating when your body tells you it needs fuel. This doesn’t mean only eating when your stomach grumbles. There are all sorts of other ways our body can tell us it needs fuel, such as feeling sleepy, feeling irritable, having trouble concentrating or focusing, having a headache. Sometimes we need to eat even if our body isn’t giving us cues as it may be our only break in the day, or it may be important prevention for feeling really hungry later.

• Experimenting to discover what portion size feels good for your body. Did you know that portion size and serving size are two different things?? Serving size is listed on a package or box in order to give us information about macro and micronutrients. Portion size is the amount that YOU choose to eat of a food because it’s what satisfies your hunger, energizes you, or tastes good to you. In most cases, that portion size is larger than the serving size.

• Eating for a wide range of reasons including to meet your energy and nutrient needs, for social reasons, for pleasure or for comfort (that’s right, it’s okay to eat for comfort!).

Some warning signs that a behaviour may be risky:

• Exercising to change your body, because you think you ‘should’, or as a way to punish your body

• Labelling foods as “good”, “bad”, “healthy” or “unhealthy”

• Restricting yourself to only eating foods you define as “good” or “healthy” and feeling guilty if you eat a food you define as “bad” or “unhealthy”

• Only allowing yourself to eat at certain times of the day, even if your body gives you cues that it would like fuel at other times

• Limiting yourself to certain portion sizes, even if your body gives you cues that it would like more

• While it is very much okay to eat for comfort, we can get ourselves into trouble if eating more than your body would like or less than your body would like is one of your only coping strategies when emotions are high. It’s helpful to get support and build additional tools in your toolbox.

As we enter the fourteenth month of a global pandemic, so much unhelpful emphasis has been placed on appearance and weight. Weight is so much more than calories in and calories out. It’s a reflection of where we are at, and the past fourteen months have been truly challenging for most folks. INDD encourages us to pause and reflect on habits that we can engage in that support our physical and mental wellbeing and that help us care for ourselves, rather than engaging in restrictive or weight-focused behaviours that only make it more challenging to care for ourselves and feel well.

If you’re used to seeing positive affirmations in the windows of Waterloo-Wellington businesses during the first week of May, fear not, the Waterloo Wellington Eating Disorders Coalition is adapting the campaign to go virtual again this year. Check us out on Facebook and Instagram to see positive INDD messages on May 6th. Follow and support your local businesses that will be sharing our virtual window signs on May 6th. Spread the word in your own networks and make a difference today!

Take a self-compassion break

Blog written by Lindsay Rafuse, MSW RSW, Counsellor at University of Waterloo Counselling Services and private practice at The Space Within

We’ve been living in a pandemic for over a year now. For myself, it has felt like the longest and shortest year, all at the same time. For a year, we have been adjusting and adapting to the ever changing reality of our world – with so much uncertainty, never really knowing what the next day, week, or month will hold. For many folks, the past year has brought on homeschooling, working from home, continuing to go to work as an essential worker – facing risk of exposure every day, caring for loved ones young and old, financial insecurity and uncertainty, job loss, further social isolation, and mental health struggles. Of course, we cannot forget other world events occurring around us while in this pandemic state – most noteworthy being the anti-racism movement and protests following the murder of George Floyd in May 2020.

With all of this uncertainty and change, I believe that self-compassion can act as a powerful force in helping us to show ourselves the kindness we deserve and help us navigate these difficult times. For myself, it has been useful in helping me shift my inner narrative when I fall into self-criticism – whether that be with my ability to strike a work-life balance while adjusting to working from home or the fears I face as a mother parenting a toddler through the current state of the world.

We can think of self-compassion as having three main components – mindfulness, common humanity, and self-kindness:

• mindful awareness that we are in a moment of suffering without labeling it as good or bad

• recognizing that pain and suffering is part of what makes us human and connects us with others

• giving ourselves the kindness we would offer a dear friend during a time of need.

A brief practice that I have been using is called the “Self-Compassion Break”, developed by self-compassion researcher Dr. Kristin Neff. This practice helps remind us to apply the three components of self-compassion in a moment of pain or struggle. Written instructions for the practice can be found here:

Self compassion break

Guided version can be found here:

Self compassion break - audio version

INTERESTED IN LEARNING MORE ABOUT Compassion and eating disorders?

Our coalition will be hosting a virtual, one-day workshop on the use of self-compassion in eating disorders featuring Dr. Allison Kelly and Sydney Waring in May 2021. Find more information on our CFT Conference page.

CFT Conference

Managing eating disorders during the COVID-19 pandemic

Blog post written by Peer Health Education volunteers at the University of Waterloo

The COVID-19 pandemic has created psychosocial stressors specific to those managing disorders around eating and/or body image. The disruption of daily routines and the uncertainty of the ongoing public health crisis can heighten stress and anxiety, leading to unhealthy food behaviours. The sharply increasing rates of infection nationwide, concentrated in the most populous provinces, can intensify these feelings. In particular, the social isolation inherent to physical distancing can cause difficulty in maintaining support networks. For those dealing with eating disorders, this can spell out an increase in symptoms.

A few tips for you and your social circle to support your emotional well-being are outlined below.

Tip 1: Remain connected to your providers

To continue providing treatment to their patients, many healthcare providers have switched to operating via phone or video conference.

• Continue to work with your healthcare providers (e.g., psychiatrists, dietitians, therapists) to recover from an eating disorder, if this applies to you.

• Check if there are online options, such as online peer support groups and virtual check-ins.

• Create or revise a relapse prevention plan to share with your healthcare providers. Ask for their advice on the most effective options for supporting your recovery during these difficult times.

Tip 2: Practise strategies to manage anxiety

The uncertainty of the ongoing pandemic and the changes it has brought about across all domains of life can elevate feelings of helplessness, stress, and loss of control. It is okay to acknowledge that. Here are practical, straightforward techniques to abate those feelings:

• Adopt some breathing techniques, such as counting your breaths or nostril switches. Learn more here.

• Practice the 5-4-3-2-1 grounding exercise. Learn more about this exercise here.

  • Name 5 things you can see.

  • Name 4 things you can feel.

  • Name 3 things you hear.

  • Name 2 things you can smell.

  • Name 1 good thing about yourself.

• Use the STOP method for dealing with stress. Learn more about this method here.

  • S = Stop

  • T = Take

  • O = Observe

  • P = Proceed

• Switch off media and social media.

Tip 3: Connect with a support system virtually

As a result of the feeling of social isolation with physical distancing efforts, consider strengthening existing support systems through family and friends.

• Invite friends and family to join you during meals and snacks through video-conferencing platforms (Zoom, Skype, MS Teams, FaceTime, to name but a few).

• Create a system to connect with friends and family after eating, in those especially vulnerable moments.

• Be open with friends and family whom you trust about the difficulties that you are grappling with, and your emotional state.

• Connect with virtual communities, including support groups, peer communities, recovery mentors, and meal support.

  • WWEDC (Waterloo-Wellington Eating Disorder Coalition) has a directory of local supports and services, ranging from support groups, to books and websites, to therapists, dietitians and coaches and trainers.

  • NEDIC (National Eating Disorder Information Centre) offers a live chat on their website (nedic.ca) and a toll-free helpline (1-866-633-4220). NEDIC also has a FAQs (frequently asked questions) webpage discussing the complications and risk about COVID-19 and EDs.

COVID-19 is a stressful time, even more so if managing concerns around eating and/or body image. Please be kind to yourself, and practise self-care and self-compassion. It can be surprising how the littlest of things—petting a cat, smiling at a baby—can be the most uplifting.

References

1. https://medicine.umich.edu/dept/psychiatry/michigan-psychiatry-resources-covid-19/specific-mental-health-conditions/managing-eating-disorders-during-covid-19

2. https://www.emilyprogram.com/blog/advice-for-those-struggling-with-an-eating-disorder-during-covid-19/

3. https://butterfly.org.au/covid-19-tips-advice-for-people-with-an-eating-disorder/

The value of lived experiences

Blog post written by Therese Kenny, MSc, PhD Student Clinical Child and Adolescent Psychology 

Eating Disorder Awareness Week (EDAW) invites us to deepen our understanding and awareness of eating disorders. It is important in doing so however, that we are mindful of where the information comes from. Statistics, research, and treatment protocols all have value, but they tend to miss the human experience of eating disorders. To get this, we must turn to the people who know eating disorders best: the people who have lived them and their loved ones. In looking to folx with lived experience, we can learn from their expertise, gain a more holistic perspective, and diversify our understanding of what eating disorders are and whom they affect.

Expertise

Individuals with lived experience bring enormous expertise in the experience of having an eating disorder. Expertise is defined as ‘expert skill or knowledge in a particular field.’ While we often think of mental health experts as helping professionals or researchers, this overlooks the incredible contributions to be made by folx with lived experience. These individuals can offer valuable and unique insights into what having an eating disorder entails. Equally important, folx with lived experience are able to share what helps and what does not help when treating eating disorders and associated mental health challenges, something that is too often identified by professionals who do not have the experience of being service users. In this way, highlighting lived experience perspectives increases our understanding of eating disorders and how we can best support individuals navigating the challenges posed by these disorders.

The Whole Picture

One thing that is unique about lived experience expertise (versus clinical or research expertise) is that individuals with lived experience understand the experience of being a person with an eating disorder. While clinicians and researchers have an abundance of knowledge about eating disorders, they tend to focus on just that: the eating disorder. The reality, however, is that people who struggle with eating disorders have hopes, dreams, and lives outside of the eating disorder. When we focus on just the eating disorder, we can forget these other aspects and target just symptoms and behaviours. This has resulted in definitions of recovery and treatment approaches that focus on what people should abstain from with little focus on what can be grown and cultivated (Kenny & Lewis, 2021). When we look at people’s lived experiences, however, we find that recovery is about so much more than symptom abatement. Instead, these individuals highlight, resilience, transformation and growth, and alternative coping strategies (Bohrer et al., 2020; de Vos et al., 2017; Kenny et al., 2020).

Diverse Experiences

Perhaps most importantly, lived experience perspectives provide diversity. The overwhelming majority of what we know about eating disorders comes from white, able-bodied, cis women. While this knowledge has propelled our understanding of eating disorders in this population, it is essential that we expand our understanding of eating disorders to individuals inhabiting other social locations. This is particularly important because we know that individuals who experience one or more marginalized identities face additional stressors, some of which are directly related to body and food. For example, policing of Black bodies sends an overt message that these bodies are wrong. Living in a body that does not match one’s gender identity can lead to body dissonance. Having a disability means that one’s body may not be functional in the way that one wants. Understanding the intersection of these experiences with other experiences that contribute to eating disorders (e.g., temperament, life stressors/trauma, diet culture) is essential in being able to offer fair, equitable, and effective care. The only way that we can start to expand our understanding of these diverse experiences is to listen to the people who have lived them.

Though by no means exhaustive, these reasons highlight the importance of centering lived experiences in conversations about eating disorders. Ultimately, if we want to learn about and make change in eating disorders, we need to go to the people who are experts in this experience. This EDAW, we encourage you to seek out, listen to, and/or share diverse lived experiences, so that we can all better understand what it means to have experienced or supported someone with an eating disorder.   

References 

Bohrer, B. K., Foye, U., & Jewell, T. (2020). Recovery as a process: Exploring definitions of recovery in the context of eating‐disorder‐related social media forums. International Journal of Eating Disorders, 8, 1219-1223.

de Vos, J. A., Lamarre, A., Radstaak, M., Bijkerk, C. A., Bohlmeijer, E. T., & Westerhof, G. J. (2017). Identifying fundamental criteria for eating disorder recovery: A systematic review and qualitative meta-analysis. Journal of Eating Disorders, 5, 34.

Kenny, T. E., Boyle, S. L., & Lewis, S. P. (2020). #recovery: Understanding recovery from the lens of recovery‐focused blogs posted by individuals with lived experience. International Journal of Eating Disorders, 8, 1234-1243.

Kenny, T. E., & Lewis, S.P. (2021). Reconceptualizing recovery: Integrating lived experience perspectives into traditional recovery frameworks. Psychiatric Services. Advanced online copy.

Recovery: So what now?

Blog post written by Shannon

So what now?

Over 2 years out where do I go from here?

Am I recovered? Am I sick? Am I over all of this?

I think a bit of all three

My body is healed

My brain is getting there

I think there is being sick, living in treatment and living outside of treatment

I think there is recovery from recovery as well

Learning to not necessarily forget those long 8 years

But to put them in a bag under your bed, know they are there but also understand that its okay to not need them anymore

Recovery is a hard word for me to understand.

What constitutes it?

Will I always be so mean to myself?

Is that just a norm that society has dictated?

I don’t believe in one definition of recovery

So I created my own.

Days without staring contests with my food or the clock

Ice cream for dinner

Long lazy days in bed

Good night sleeps

Pizza with extra cheese

Facemasks

Lots of water

Bubble baths

Then I am recovered

Maybe not all in one day, maybe only a few times a week,

But I created my own new normal life

Where I applaud myself for things that are so mundane but are WINS for me.

So what now?

I take it day by day, sometimes minute by minute

And will continue to practice the amazing power of Self love and positive thoughts.

Utilizing self-compassion in therapy for eating disorders

Blog written by Natalie Doan, MSc, PhD Student in Public Health and Health Systems, University of Waterloo

Self-compassion

Self-compassion, as defined by Gilbert (2005), is an attitude of kindness and acceptance towards personal distress and disappointment. Neff (2003) identified three components of self-compassion: self-kindness, feelings of common humanity, and mindfulness. Self-kindness refers to treating ourselves with care and understanding, rather than being harshly critical and judgemental, and recognizing the common humanity of making mistakes and feelings of inadequacies. The practice of mindfulness involves the intention of being in the present moment. By attempting to live in the present moment in a manner that neither suppresses or exaggerates painful feelings, mindfulness can help abate the tendency to over-identify with painful thoughts and feelings.

Although self-compassion and self-esteem may appear at face value to be similar concepts, self-compassion and self-esteem differ in many ways. For example, self-compassion and self-esteem diverge greatly in their reliance on evaluation and judgement. Contrasting the construct of self-esteem, which is predicated on individuals making self-evaluations and judgements of worthiness based on comparisons to other people, self-compassion does not necessitate appraising or making judgments. Hence, fostering self-compassion instead involves recognizing and accepting the universality of personal inadequacies and mistakes.

Interested in learning more about CFT?

Our coalition will be hosting a virtual, one-day workshop on the use of self-compassion in eating disorders featuring Dr. Allison Kelly and Sydney Waring in May 2021. Find more information on our CFT Conference page.

CFT Conference

Compassion Focused Therapy

Compassion Focused Therapy (CFT) is a treatment modality that is aimed at helping individuals prone to self-criticism and shame to cultivate inner kindness, especially when confronted with personal shortcomings and distress. CFT operates under the theory that criticism and hostility have evolved to stimulate a response from threat systems, leading to anxiety, anger, shame, and sometimes maladaptive self-protective behaviours, whereas warmth, affiliation, and compassion stimulate the system that fosters a sense of calmness and behaviours oriented towards trust and connection. Given the favourable effects that occur when compassion is experienced, CFT focuses on enhancing individual’s capacity for self-compassion.

Self-compassion and Eating Disorders

In the context of eating disorders, researchers have suggested that eating disorder symptoms (e.g., restricting, excessive exercising, bingeing, purging) can sometimes represent attempts to regulate underlying feelings of shame. Eating disorder symptoms may be useful to suppress shame in the short-term, but prolong and intensify shame in the long-term. Specifically, bingeing and purging may serve as a brief distraction from feelings of shame; however, engaging in these secretive behaviours can further contribute to the belief that one is “defective” and/or “disgusting” in the long-term. Restriction may also temporarily lower shame by yielding a sense of pride. Similar to bingeing-purging symptoms, the relief of shame is often short-lived and returns as eating disorder thoughts and urges progress. Empirical evidence in the literature provide support for this framework. Researchers have identified an association between shame and eating disorder symptoms in both clinical and community samples. Additionally, research suggests that self-compassion may be protective against shame and eating disorder pathology.

Compassion Focused Therapy for Eating Disorders

Compassion Focused therapy for Eating Disorders (CFT-E) was developed by Goss and Allan (2010). Briefly, the goal of CFT-E is to address the regulation difficulties, shame, self-criticism, and self-directed hostility experienced by individuals with an eating disorder through the development and practice of compassion. CFT-E puts an emphasis is put on an evolutionary and neuroscience model that highlights the ways in which the human brain and body have evolved to regulate different affects. Special attention is also given to help improve the ability to manage feelings of anxiety, anger, grief, and disgust. Beyond the standard CFT, CFT-E has been uniquely developed to help individuals use compassion to meet the challenges associated with eating disorder recovery.

References

Carter, C. S. (1998). Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinology, 23(8), 779-818.

Gilbert, P. (Ed.). (2005). Compassion: Conceptualisations, research and use in psychotherapy. Routledge.

Gilbert, P., & Miles, J. (Eds.). (2002). Body shame: Conceptualisation, research, and treatment. Psychology Press.

Goss, K., & Allan, S. (2009). Shame, pride and eating disorders. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 16(4), 303-316.

Goss, K., & Allan, S. (2010). Compassion focused therapy for eating disorders. International Journal of Cognitive Therapy, 3(2), 141-158.

Kelly, A. C., Carter, J. C., & Borairi, S. (2014). Are improvements in shame and self‐compassion early in eating disorders treatment associated with better patient outcomes?. International journal of eating disorders, 47(1), 54-64.

Kelly, A. C., Vimalakanthan, K., & Carter, J. C. (2014). Understanding the roles of self-esteem, self-compassion, and fear of self-compassion in eating disorder pathology: An examination of female students and eating disorder patients. Eating behaviors, 15(3), 388-391.

Kirsch, P., Esslinger, C., Chen, Q., Mier, D., Lis, S., Siddhanti, S., ... & Meyer-Lindenberg, A. (2005). Oxytocin modulates neural circuitry for social cognition and fear in humans. Journal of neuroscience, 25(49), 11489-11493.

LeDoux, J. (1998). The emotional brain: The mysterious underpinnings of emotional life. Simon and Schuster.

Neff, K. (2011). Self‐compassion, self‐esteem, and well‐being. Social and personality psychology compass, 5(1), 1-12.

Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and identity, 2(2), 85-101.

Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and identity, 2(3), 223-250.

Panksepp, J. (2004). Affective neuroscience: The foundations of human and animal emotions. Oxford university press.

Navigating recovery during the holidays

Blog written by Lindzie O’Reilly, MAN, Registered Dietitian and Samantha Durfy, MA, MSW, RSW

The holidays are a time to relax – a time to visit with family and friends and enjoy home cooked meals. The holidays can also be a stressful time. Many holiday events revolve around food, and often the types and amounts of food are different than our usual routine. It’s helpful if you’re willing to practice some flexibility over the holidays, while also still prioritizing your own needs around food.

1. Eat often during the day. Many of us have a tendency to eat less during the day to compensate for a larger holiday dinner. This actually puts even more focus on the holiday meal and tends to give it more power than it deserves. It makes it nearly impossible to participate in pre-dinner conversation when all you can think about is when and what will be served for dinner. It makes it a lot more likely that you will feel out of control during the meal, making different food choices than you would if you were well nourished all day. Eating often means having at least a bit of a plan in place that helps you determine where and what you will eat leading up to the holiday meal. It might even mean packing some of your own snacks to have on hand, acknowledging that you may need to eat at times when others around you might not be eating.

2. Can you say ‘yes’ sometimes? The holidays often bring many food options that aren’t a part of our usual food routine. The holidays also often mean meals based around food cooked by others. If you feel able, it can be helpful to reflect on holiday foods that you enjoyed prior to having an eating disorder. Are there one or two things you can give yourself permission to enjoy – truly taste without compensation or guilt – this holiday season?  Consider joining in on meal planning with your family members, whether that be menu planning, grocery shopping, or the meal prep itself. Balance the goal of following a plan by taking some calculated risks.

3. Sometimes it’s important to say ‘no’. While important to practice flexibility, it’s equally important to reflect on choices that will help you achieve your personal recovery goals. Holiday meals often mean we are surrounded by family and friends that we haven’t seen for a while. Many folks feel pressure to ‘prove’ to their loved ones that they are ‘well’; leading to food choices that may push us too far outside our comfort zones. Sometimes it can be helpful to survey all of your food options before you begin to fill your plate. From there, decide on foods and amounts that you feel comfortable with, not what you think someone else would like you to have. Boundary setting with others can be a key skill in protecting your recovery.  If those around you are asking you to push yourself too far past your comfort zone, it’s important to say no.

4. Have a support plan. It’s normal for urges and emotions to arise before, during, and after a holiday meal. It’s helpful to create a plan in advance, which could mean identifying a family member or friend that you can pull aside for a chat or identifying a space you can go to take a break and be alone in an empty room or outside.  Asking for support and accountability with your eating goals can help you to survive the additional stressors which often come with the holiday season.

5. Take time to acknowledge your feelings.  The holidays are not always filled with cheer and joy.   For many people the holidays can be challenging, which can impact your recovery goals with food.  If there are tensions within a family or if there has been a recent loss, the holidays can sometimes highlight what we don’t have or who is not at the dinner table this year.  Take time to journal, cry, or talk with someone about your feelings. Bottling up your emotions can put you at risk to engage in eating disorder behaviours.

6. Engage in self-care.  Because the holidays can be a busy time, it’s important to take time for yourself, whether that be journaling, mindful walking, or creative expressions, such as music, painting, or crafts.  Carve out some time during your busy holiday schedule for you and your self-care routine.  Also make a priority of sleeping well and avoiding excessive alcohol or substance use to limit vulnerabilities to your eating disorder.

Navigating holiday meals with an eating disorder is tricky. Going in with a plan in place, checking in with yourself often, asking for support, and keeping your personal recovery goals in mind can help.  Best wishes to you in your recovery this holiday season!

Coping with loneliness, isolation, and an eating disorder

Blog written by Natalie Doan, MSc, PhD Student in Public Health and Health Systems, University of Waterloo

The holiday season can be a very challenging time for individuals living with or recovering from an eating disorder. Holiday treats, family dinners, and social get-togethers centred around food can make the holiday season a time of heightened anxiety for individuals with a history of an eating disorder. For others, the holiday season can exacerbate feelings of loneliness. This year, with COVID-19 being a global public health crisis, it is understandable that physical distancing, lockdown, quarantine, and social restriction measures will impact people’s psychological well-being in various degrees, including by eliciting feelings of loneliness and isolation.

Research has long demonstrated that social support and a sense of connectedness is strongly associated with multiple indicators of health. Feelings of social isolation and loneliness have detrimental effects on physical and mental health, including being risk factors for depression, anxiety, chronic stress, and insomnia. Furthermore, seeing the role that social support plays in coping with symptoms of mental distress following crises, such as natural disasters and pandemics, means that it is essential to consider how individuals struggling with an eating disorders and other mental health concerns cope during COVID-19.

In the context of eating disorders, researchers have long recognized that loneliness can play a pivotal role in contributing, maintaining, and perpetuating eating disorders. For example, feelings of loneliness can trigger bingeing, and bingeing and purging can be used to cope with feelings of loneliness. This introduces implications for eating disorders, especially during a pandemic where maintaining socially connections is a lot more challenging than it would be for many people in other years. Knowing how to cope with feelings of loneliness and isolation is arguably more critical this year than ever before.

Below is a list of some strategies to cope with feelings of loneliness and isolation with social distancing measures in place.

Connect with others

Although it may be increasingly challenging to discover ways to keep connected with members outside your household, technological advances provide many options to explore ways of maintaining connected to others, especially through various virtual platforms.

Build a support system

Whether it is by sharing your thoughts and feelings with your friends or family, joining an online support group, or seeing a therapist, building a support network is helpful in keeping socially connected and coping with loneliness. Sharing your feelings of loneliness with the right people, who might also understand experiencing similar feelings, may be helpful in coping with feelings of loneliness during these isolating times.

Engage in distraction

Distraction can be very useful to cope with emotions, especially in the short-term. There are many ways to stay distracted during the pandemic. Consider doing more of the things you already enjoy spending time doing or learning a new hobby or skill. Some starting points include reading books or audiobooks, listening to music or podcasts, engaging in creative arts (e.g., drawing, painting, crocheting), learning a new language, writing, and watching a new series or movie.

Participate in meaningful activities

Volunteering your time can be a great way to contribute to the community and foster a sense of collective well-being. Depending on your interests, consider taking on activities that might provide you a sense of meaning and purpose, such as volunteering with a local community, student, social, academic, research, or professional organization.

Practice self-compassion

It’s especially important to be gentle with yourself during this time. It might be useful to follow the news, but if exposure to the media leads to increasing fear and anxiety or exacerbate feelings of loneliness, try balancing time spent on the news and social media with other unrelated activities, such as reading, listening to music, or learning a new skill.

References

American Psychological Association. Keeping your distance to stay safe. Accessed from: https://www.apa.org/practice/programs/dmhi/research-information/social-distancing

Banerjee D, Rai M. Social isolation in Covid-19: The impact of loneliness.

Canadian Mental Health Association. Coping with loneliness. Accessed from: https://cmha.bc.ca/documents/coping-with-loneliness/

Levine MP. Loneliness and eating disorders. The Journal of psychology. 2012 Jan 1;146(1-2):243-57.

National Health Service. What you can do if you feel lonely during the coronavirus outbreak. Accessed from: https://www.nhs.uk/oneyou/every-mind-matters/coping-loneliness-during-coronavirus-outbreak/

Pietrabissa G, Simpson SG. Psychological consequences of social isolation during COVID-19 outbreak. Frontiers in Psychology. 2020 Sep 9;11:2201.

Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psychological Trauma: Theory, Research, Practice, and Policy. 2020 Jun 18.

Recovery reflections

Blog post written by Shannon

I’m not truly passionate about anything unless I’m talking about this. It’s the only thing I really care about whole-heartedly. I love my family, my friends, my boyfriend, but I see the world so differently than them, because of my past.

I never mean to preach around my friends, but sometimes I can’t help it

Self-hatred around me

Picking up their shirt in a mirror

Talking about calories

I can’t hear or see these things and not put in my two cents

Do my friends have eating disorders? No, not necessarily

But you don’t have to be sick to make self-love a new priority in your life

But damn it’s hard

It’s easier to tell others then to practice it on your self

But

What if me saying something makes someone think differently, or second-guess their mentality even for a moment

I wish someone had done that for me

When I would check my body

When I would skip dinner

My ED has changed me forever, for better and worse

I don’t think the specifics or details of my eating disorder are important or helpful

My lowest and highest weight aren’t either

Because my insecurities started way before there was the eating disorder title placed on it

I was never made fun of, called names or put down as a little girl.

It was the demon in my head that just made existing seem too hard.

It needed something to attack and blame for EVERYTHING and that was my body.

My parents fight? It’s because I’m too big

I fail a test? It’s because I ate dinner

I get in trouble? It’s because my leg jiggles

Kinda funny and totally ridiculous when you think about it.

But I promise you these thoughts ended, it took therapy, and hospitals, and incredible lows, and fighting and screaming, and laughter, and smiles and hugs and cuddles and so much more...

To get to a place where my weight and my body are no longer to BLAME but are THANKED and CELEBRATED for keeping me alive and fighting so hard to put me in a place where I can maybe help someone else.

It gets so much better I PROMISE you.

YOU ARE WORTH so much more then this.

Why we need to #EndWeightHate: Weight Stigma Awareness Week 2020

Blog post written by Amanda Raffoul, PhD, Postdoctoral fellow at STRIPED

Today is the first day of Weight Stigma Awareness Week, an annual week of advocacy hosted by the National Eating Disorders Association (NEDA). Weight stigma is often called and confused with many other terms, including fatphobia, weight bias, and weight-based discrimination. Briefly, weight stigma captures the stereotyping and discrimination that people with higher weights in our society experience. Considering the role of weight stigma in eating disorders (more on that later!), we’ve decided to highlight why it’s important to #EndWeightHate.

Weight stigma is a social justice issue

Although negative comments, “jokes”, or bullying about someone’s weight are symptoms of a weight-focused culture, weight stigma goes beyond one-off interactions and is a structural, social justice issue. This means that the stereotypes many of us have about higher weights or the treatment of people with higher weights are embedded into every facet of our daily lives. People who live in larger bodies face discrimination on social media, in relationships with family and friends, and at doctors’ offices, school, work, and so on. Again, weight-based discrimination goes beyond rude comments — children in larger bodies are graded lower and evaluated as “less smart” than their peers, adults with higher weights are less likely to receive a promotion, and higher-weight people are often neglected in medical care settings, worsening their health outcomes overall.

Weight stigma is a public health issue

Weight stigma is associated with harmful health consequences, both mental and physical. Since weight stigma is a structural issue that worsens health outcomes for some people more than others, it is also a public health issue. One major problem with this is that public health researchers, practitioners, and policymakers themselves can be the perpetrators of weight stigma. (Side note: As a public health researcher myself, I can unfortunately attest to this…) There are tools out there, such as the STRIPED Roadmap, to help minimize weight stigma in public health work, but much still needs to be done to take the focus of public health interventions off of weight and towards health more holistically.

Weight stigma is important to consider in eating disorders work

So why does our coalition care so much about weight stigma? Weight stigma is directly linked to disordered eating and the risk of eating disorders among people across the weight spectrum. Internalized weight stigma, or the ways in which a person applies negative weight stereotypes to themselves, is associated with harmful food and weight behaviours. The Academy for Eating Disorders recently published this infographic outlining common myths about weight stigma and how it may relate to eating disorder risk.

If you live in the Waterloo-Wellington region and would like to find an eating disorders clinician who is weight-inclusive and/or has training around the harmful impacts of weight stigma, please visit our supports & services page.

How to get involved in Weight Stigma Awareness Week 2020

We won’t be able to eliminate weight stigma in one week, but getting involved in Weight Stigma Awareness Week is a great way to raise awareness of the harmful impact of weight stigma within your circles. You might even be able to teach someone about something for the first time! NEDA has a list of social media graphics and resources for you to share on social media, as well as a series of hashtags so you can connect with other advocates online (#EndWeightHate, #WSAW2020). If you’re interested in learning more, our supports & services page also lists dozens of books and articles on weight stigma.

Groceries during a pandemic

Grocery - Delivery/ Pick up

• You can now get groceries delivered from zehrs.ca; walmart.ca; instacart.ca; pcexpress.ca; Market Fresh Guelph

• You can pick up groceries from the comfort of your car, in the store parking lot: nofrills.ca; grocerygateway.com; www.homefieldorganics.com;

• Most restaurants are offering delivery and pick up options. Some are even now providing grocery options.

Grocery - Senior's/Medically compromised Options

• Shopper's Drug Mart has quiet / assisted hours at 8am-9am

• Some Zehrs locations also have early quiet hours for seniors and those who are medically compromised.

Local Food Bank / Food Programs

• Guelph Food Bank  - 100 Crimea St unit c12 Guelph

• HopeHouse Food Bank - 10 Cork St East Guelph

• The Food Bank of Waterloo Region - 50 Alpine Court Kitchener

• St. John's Kitchen - 97 Victoria St., North, Kitchener

• Ray of Hope Community Centre - 659 King Street East, Kitchener

• Cambridge Self-Help Food Bank - 54 Ainslie St S, Cambridge

• Cambridge Shelter - 26 Simcoe Street, Cambridge

• Trinity Community Table - 12 Blair Road, Cambridge

It’s more important than ever to celebrate International No Diet Day in 2020

Blog post written by Lindzie O’Reilly, Registered Dietitian, MAN, University of Guelph

Every year on May 6, individuals and organizations around the world recognize International No Diet Day (INDD). The objectives of INDD are to challenge misconceptions about dieting, push back against the industries that sustain diet culture, and reinforce the harms of dieting among people across age, gender, culture, and body size. Dieting can be defined as any intentional change to our lifestyle (modifying food habits, exercise routine, supplements) for the sole purpose of changing our weight or shape. The diet industry often touts products aimed at improving our health and wellbeing while in truth, these products net the Canadian diet industry hundreds of millions of dollars in profit each year at the expense of our health and wellbeing. For more information about INDD and the harms of dieting, check out Break Free From Diet Culture.

This year, in the midst of a global pandemic, even those savvy at spotting and fighting against diet culture have faced new challenges. Like a sneaky virus, diet culture has mutated and introduced a whole new breed of myths and misconceptions that lead us to doubt our bodies and promote body shame. Posts abound suggesting that if we don’t ‘watch our bodies’ while spending more time at home in isolation, they will lead us astray. The diet industry taps into our human desire to find something to control when so much around us is out of our control.

In the midst of a global health crisis, staying healthy, physically and mentally, is very important. Since diet culture equates our weight with our health, it’s no surprise that the internet has exploded with strategies to ‘keep tabs’ on our weight – through monitoring, body checking, tracking our intake, and fixating on a need to move our bodies. At best, these behaviours promote body shaming and negative body image. At worst, they can progress to symptoms of an eating disorder that feel all too familiar to anyone who has ever struggled with one. Many individuals with a history of an eating disorder wisely put a lot of effort into screening their social media to ensure they are following accounts that promote recovery and body acceptance and avoiding accounts that promote dieting, body checking, and body shaming. Right now, information about COVID-19 exists in some form on essentially every social media account and news outlet. Individuals looking for accurate and up to date information on the pandemic can very easily be blindsided with information that serves up a side of diet culture.

In this time when physical and mental wellbeing truly is so important, and diet culture is sneakier than ever, let’s talk about some real things that we can do to support our health.

• In addition to practicing physical distancing and washing your hands, eating an amount of food that is right for your body is the best way to keep your immune system strong. While access to food might be different than usual for you right now, it’s important to continue to do your best to follow the same meal plan or food goals that you were following pre-COVID. There is no ‘diet’ to improve your immunity and most diets lack nutrients and energy, compromising your immunity.

• Our lives have changed a lot in the past two months. It’s likely that everyone has experienced some degree of stress related to these changes. Rather than letting diet culture infiltrate your thoughts and contribute to further stress and body vigilance, it’s helpful to find outlets to manage stress. This can include things like reading, painting, connecting with a loved one, meditation, or even cooking and baking. Contrary to what diet culture tells us, baking and enjoying what you bake does not automatically classify you as a stress eater. It’s perfectly okay to bake, even if you’re baking a little more than you usually would right now. It is helpful to have a wide range of coping strategies so that you are not relying on any one single strategy to help you manage.

• While most of us have a little bit more time at home than usual, now is a great time to try a couple new recipes. They don’t need to be complicated and don’t need to include challenge foods (unless that is a goal of yours). Taking time to learn new go-to staples will give you more meal options to draw from when you return to your regular routine. Variety in your diet can go a long way towards helping you meet your nutrient needs. Trying new recipes when your schedule is packed can feel impossible. If you do have more time right now, getting comfortable with a new recipe or two can help further your recovery in the future.

• Getting some fresh air and moving your body in a way you enjoy can be helpful in managing stress and boosting mood. For someone with an eating disorder, that’s not a simple ask. For many folks, exercise was already a complicated thing and may now be an even more complicated thing in our current situation. It’s helpful to ask yourself what is motivating a given decision about exercise – am I doing it because it truly feels good in my body, or because I think I should? For support in trying to tease this question apart, an upcoming discussion facilitated by Dr. Andrea Lamarre will be helpful - https://www.eventbrite.ca/e/working-it-out-exercise-and-recovery-tickets-103030910226?aff=erelexpmlt

Now more than ever, moving away from diet culture and engaging in behaviours that truly support our mental and physical wellbeing is so important. If you’re used to seeing positive affirmations in the windows of Waterloo-Wellington businesses during the first week of May, fear not, the Waterloo Wellington Eating Disorders Coalition is adapting the campaign to go virtual this year. Check us out on Facebook and Instagram to see positive INDD messages on May 6th. Follow and support your local businesses that will be sharing our virtual window signs on May 6th. Spread the word in your own networks and make a difference today!

Recovery blog: Living alone with an eating disorder during a pandemic

Blog post written by Sarah Braun

I’ve always loved my alone time. I grew up an only child, so I’ve become quite accustomed to it and being alone has always felt somewhat normal to me - I never knew anything else. As an adult I have learned to value, appreciate and prioritize my alone time amidst a busy and chaotic schedule. At times I’ve found myself becoming anxious and irritable when I am in social situations or surrounded by others for an extended period of time. I would look forward to going home to rest, relax and recharge by myself. I needed and enjoyed that solitude, because without it my mental health would suffer. However, time spent alone can be a double-edged sword.

When you live with an eating disorder, you are never truly alone. There is always that voice lingering in the background, sometimes very faint and other times overwhelmingly loud. Over the past couple of years, I’ve learned how to quiet that voice through various means; most of which take place outside of the house or in the company of others. Therefore as this pandemic strengthens, and more measures and restrictions are placed upon us, I find myself isolated and confined alone to my
apartment. As mentioned, I am quite familiar with living and being alone, yet this feels different, daunting almost and at times, quite hopeless. Not only is it just myself trapped inside these four walls, I also have the company of my mental illnesses, only now they are being amplified. My eating disorder is latching on to the isolation and begging to thrive in it. Secrets keep you sick, and it is easy to keep those secrets when you have no physical contact with loved ones and the outside world. Connection is only found through a screen these days; fluctuations in weight can go unnoticed and
behaviours can go unknown.

From my experience, most eating disorders stem from or involve some desire for control; so with the COVD-19 pandemic bringing with it so many unknowns and so much uncertainty, the draw to return to eating disorder behaviours seems more desirable than normal. With countless hours spent scrolling through various social media apps, I’ve noticed a theme among posts in what is meant to be a sort of uplifting perspective. Society and governments have been placing emphasis on focusing on
what we can control; our thoughts, our behaviours and our actions throughout this unprecedented time in our lives. For those with an eating disorder or even those in stable recovery, focusing on what we can control usually involves food; what we do eat and what we don’t eat and that can quite quickly become a very risky scenario. Right now more than ever, the world feels unsafe. We are bombarded with stark numbers and statistics. We are told not to leave the house and if necessary, then to wear a mask, gloves and to maintain a safe distance from others. Personally, my eating disorder has always provided me with a sense of protection and safety, therefore now more than ever, the thought of returning to my illness weighs heavier on my mind than normal. With the isolation, lack of control and feelings of being unsafe these days, my eating disorder has been in the corner smiling warmly and waiting to welcome me back with open arms.

Motivation to continue along my recovery journey throughout this pandemic has come in waves, sometimes few and far between. I would be lying if I said keeping my head above water right now is easy, because it certainly is not. In times like these I think back to advice I’ve received over the past of couple years; when it seems impossible to keep climbing, just pause and enjoy the view - nothing more, nothing less. I’m doing my best to take this new normal day by day and sometimes even hour
by hour. I have been working on putting a daily schedule together to provide some sense of structure and routine. My recommendations would include incorporating designated and specific times for creativity, such as writing, colouring and crafting. Next would be an intellectual activity such as reading or an online course. After that, using caution when engaging physical activity, nothing to intense that an eating disorder will cling to and push to the extreme. Perhaps something a simple as stretching, yoga or a leisurely walk around the neighbourhood. The most important part of my schedule involves safe socialization through online platforms such as FaceTime or Zoom. Staying connected in such isolating times, especially for those who live alone, is crucial to maintaining mental health. I make sure to check in with at least one or two people a day and I find that helps to really keep my mood up and feel a sense of love and belonging. However, some days all of that can feel extremely difficult to accomplish. On those days, I’m trying to be compassionate towards myself and do what I can, rather than beating myself up for what I can’t (even if that means just moving from the bed to the couch to watch Netflix - that is okay too.) There is no handbook, no guideline and no rules on how to live through a pandemic, we are all just out here trying to do the best we can to survive.

Create structure to manage social isolation and maintain recovery

Blog post written by Lindzie O’Reilly, MAN, RD. Student Wellness Services, University of Guelph

We are all adjusting to a new reality amidst COVID-19. While our situation continues to change and many things remain unknown, creating a routine can help you manage physical and mental wellbeing and support your current stage of eating disorder recovery.

1. Create and maintain a consistent sleep schedule – With fewer options to occupy our time, many of us have fallen into a habit of sleeping for much longer than usual. For others, motivation to enforce a bedtime might be low, meaning you are staying up late into the night (or morning) and experiencing a decrease in sleep quality. With fewer obligations, there’s no need to stick to the same sleep schedule you had pre-COVID-19, but it is important to have a schedule. Give thought to what your natural sleep rhythm looks like, the sleep routine that would help you fit in the number of meals and snacks you need, and the amount of sleep that helps you feel your best. Choose a rough time to get to bed by each night. This will also likely mean choosing a time by which you need to start to wind down and get ready for bed, move away from screens, and transition to activities that help you relax. Choose a rough time to wake up each day. This may mean setting an alarm to wake you up, ensure you don’t oversleep, and ensure you get your first meal of the day in at a reasonable time.

2. Decide on times for meals and snacks – Based on your sleep schedule and on the number of meals and snacks you need to include each day to support your recovery, choose eating times throughout the day. For many working on eating disorder recovery, pushing off meals and snacks is a common behavior, and justifying meals and snacks when you haven’t left the house or engaged in many activities can feel really challenging. Based on our current reality, we will all be going fewer places and doing fewer things for the next while. Decide on meal and snack times that are non-negotiable regardless of what you’ve accomplished in a day.

3. Create a list of meaningful activities – social activities and hobbies are going to look different than they did pre-COVID-19, but that doesn’t mean you can’t include meaningful and enjoyable things every day. Create a list of things you enjoy – like listening to music, drawing, practicing a language, reading a book, getting some fresh air or chatting with a friend. Schedule times for activities each day as a way to break up the day. Just as an example, this could mean creative time from 10-11am, self-care time from 3-4pm, and connection time from 7-8pm On this list, also include supports you can reach out to, be they professional supports or friends and loved ones.

4. Stock up on staples – As we all try to limit how often we grocery shop, it’s helpful to purchase a few things with a longer shelf life each time you go to the store. Some folks may be used to writing out a weekly meal plan as a step in their recovery. For those who don’t or who haven’t for a while, it might be good to restart the practice during this time to ensure you get everything you need, can make a grocery list, and can arrive at the store with a purpose. Give thought to items you are comfortable with that have a longer shelf life – perhaps things like rice, quinoa, potato or sweet potato, canned legumes, or meat that you can freeze. Great meal options could be things like chili and toast, a stirfry with meat/tofu, frozen veggies and rice, a tuna melt, or an omelet with toast or potatoes. Give thought to substitutions you can make, such as buying fruits and veggies like carrots, apples, oranges and pears with a longer shelf life, or canned or frozen fruits and veggies. In line with the SPREAD acronym, now is likely not the time to add new food challenges, but it is a really important time to maintain current recovery goals. If part of your recovery includes having a baked good once a day, for example, this means ensuring that you buy enough options each grocery trip to last you through until your next trip.

While we are all adjusting to a new day-to-day, it’s really common for it to feel even harder to create structure and routine. The goal of a routine is not to have a strict schedule that you must follow and that feels rule bound or rigid, but it is really helpful to outline a consistent bedtime, wake up time, and eating times. Creating a list of supports and activities you enjoy and can look forward to can help combat worry, loneliness, and sadness. Planning ahead and creating a meal plan can help you make the most of grocery trips and ensure you have what you need to maintain recovery.