AUGUST 2013 NATIONAL EATING DISORDERS ASSOCIATION MAKING CONNECTIONS

“Aha” Moments Readers share insights on the road to recovery

PLUS How Common Are Eating Disorders in Pregnancy? Abigail Easter, PhD Calling All Dads: “There’s a Ball At the Castle” Don Blackwell and Mike Polan Raising Awareness on a Navel Base Theresa Larson, DPT

A Publication of NEDA’s Parent, Family & Friends Network (PFN) 2

Letter from the PFN Chair By Deborah Kreiger, Florida

Hello Everyone! Day, is a unique opportunity to take In 2003, NEDA opened their arms wide strides in your journey, too. Lobbying to include parents and friends during As I pull together on Capitol Hill will forever change how their annual conference. Feeling a bit my thoughts for you view our legislative process. You nervous and very alone, my daughter this issue, I have may be only one voice, but you are one. and I gathered our courage and flew to taken the time And on this day your voice will be heard Chicago to take part in what was to be to reflect upon in tandem with others who share your life-changing for us. I encourage you to my family’s very passion to affect change for good. You will thoughtfully consider being a part of both personal journey feel empowered and hopeful as your day Lobby Day and the NEDA Conference…you with NEDA. What wraps up and these feelings will catapult will look back and be so thankful you did. began as a starting point for information you into a conference that will continue and resources when our daughter was to expand your knowledge; you will be I look forward to welcoming you in struggling has evolved into a lifetime supported, understood and nurtured, Washington D.C.! commitment of learning, sharing, and I believe you will establish a network advocating for positive change and giving that you will continue to reach out to Deborah n back to an organization and a community long after the conference has ended. How to whom we are most grateful. good you will feel cannot be overstated…. the people, the resources, the friendships The annual NEDA Conference, preceded and the ongoing lifeline of hope you will by a most important opportunity to experience is invaluable. participate in the NEDA Federal Lobby

PFN Steering Committee: Lorri Antosz-Benson, California Nancy Hemendinger, New York Mike Polan, New York Deborah Kreiger, Florida (Chair) Don Blackwell, JD, Florida Phoebe Megna, Connecticut

NEDA President & CEO Bob Kovarik, Chair Evelyn Attia, MD Kimberli McCallum, MD Lynn Grefe, MA Oakton, Virginia New York, New York St. Louis, Missouri Deborah Q. Belfatto, Vice Chair Ric Clark Tamara Pryor, PhD NEDA Board of Directors Summit, New Jersey Larchmont, New York Denver, Colorado The Board of Directors is composed of Lisa Ryan Burke, Treasurer Mary Curran Elizabeth Sarquis members from the corporate, medical Summit, New Jersey West Simsbury, Connecticut Minneapolis, Minnesota and philanthropic arenas, with some Phoebe Megna, Secretary Julie Finkelstein Allison Kreiger Walsh, JD also representing the constituents we Darien, Connecticut Purchase, New York Orlando, Florida serve. Karen Andonian Mary Lipton Steve Wonderlich, PhD Clyde Hill, Washington New York, New York Fargo, North Dakota

NEDA Board Senior Advisors: Ovidio Bermudez, MD, Media Advisor Amy Baker Dennis, PhD, Conference Advisor Margo Maine, PhD, Advocacy Advisor Doug Bunnell, PhD, Navigators Advisor Walter Kaye, MD, Research Advisor

NEDA Junior Board: Laura Serico, Chair Christopher Skarinka, Treasurer Elizabeth Sexton Lindsay Belfatto, Vice Chair Brooks Brodrick Lauren Steiner Troy Roness, Secretary Erin Hall

For more information on NEDA’s Leadership Councils, please visit www.nationaleatingdisorders.org/leadership-councils 3

Editor’s Note By Susie Roman, Director of Programs

Dear Readers, Making Connections provides an This issue of Making Connections, opportunity to share the challenges focusing on Aha Moments, was the We are getting more you have faced, and what you have result of a conversation among members excited by the day for learned, with other families and loved of the PFN about the many different the first ever NEDA ones of those struggling or pursuing important moments that marked Federal Lobby Day on recovery. In upcoming issues we will their families’ journey to recovery. We October 10th, which feature perspectives on the challenges hope that you find inspiration, insight will kick off the 2013 and lessons learned in dating and long- and encouragement as you read the NEDA Conference, term relationships, sources of hope and perspectives of parents, a boyfriend, October 10-12th in Washington, D.C. It is maintaining hope when it is difficult, those in recovery, a nutritionist and those such a wonderful opportunity for all of us strategies to use when fighting insurance raising awareness in the military. to build a stronger community of support denials, and of course book reviews, and learning, and we hope to meet you research summaries and more. Your Sincerely, there. We offer a NEDA Buddy program, submissions are what make this magazine Susie Roman Support and Recovery Roundtable Series, the resource that it is for families Director of Programs n and plenty of networking opportunities affected by eating disorders. Please email to enhance a great educational us at [email protected] if you are experience with connection to others interested in contributing! who share aspects of your journey.

IN THIS ISSUE

2 Letter from the PFN Chair 16 Real Mannequins for Real People 3 Editor’s Note 17 STAR Program Victory in Missouri! 4 Research Summary | Recognizing the Symptoms: 18 Transforming My Struggle into a Tool for How Common Are Eating Disorders in Pregnancy? Successful Advocacy 5 A Moment of Courage 19 Fighting for Recovery in the Face of Health Insurance Denials of Care 6 Learning On the Path to Recovery 20 NEDA Conference 2013 7 What Readers Are Saying 21 Calling All Dads – “There’s A Ball At The Castle” 8 A Friday Phone Call 22 BlackStar Film Festival: Baby Steps 9 Nutrition and Eating Disorders: A Shared Journey 24 NEDA Walk Volunteer Spotlight 10 The View From the Top of the Mountain 24 NEDA Walks 2013/2014 12 Raising Eating Disorders Awareness on a Naval Base 25 Upcoming PFN Series Webinars 13 Advances in Eating Disorders Awareness in the 26 Network Spotlight Military 26 Meet the NEDA Staff! 14 This Side of the Table 27 Chat with the Helpline 15 Don’t Settle For Barely Recovered 4 Research Summary | Recognizing the Symptoms: How Common Are Eating RESEARCH Disorders in Pregnancy? By Abigail Easter, PhD, Research Associate, University College London, United Kingdom

regnancy can be a crucial transitional In this study, we highlight the need for phase in a woman’s life, characterised increased recognition and awareness of Pby significant psychological and eating disorders during pregnancy and social adaptations. Physically, pregnancy the crucial need for further support for is associated with substantial and rapid women experiencing an eating disorder changes to a woman’s body shape and during this critical phase of their life. size. For women with eating disorders, the Community projects aimed at supporting bodily changes associated with pregnancy individuals with eating disorders during can give rise to unique challenges. periods of significant life changes have Many women with eating disorders find been initiated. An example of one such it difficult to discuss their illness with initiative is theTransitions Project re- healthcare professionals in antenatal cently launched by B-eat (a UK based eat- settings, and therefore remain unknown during early pregnancy, and a large pro- ing disorder charity). This project offers and unsupported during pregnancy. A portion of women experienced associated mentoring support to young people with recent in-depth study of the experiences symptoms, such as extreme weight and eating disorders, helping them to adapt of six women who had anorexia shape concerns and frequent episodes of during time of great change (i.e., leaving nervosa during pregnancy revealed binge eating. We found that 7.5% of the school and starting university or work). that pregnancy can be an unfamiliar women asked had an eating disorder (e.g. Similarily, NEDA Navigators are volunteer experience, associated with feelings of Anorexia Nervosa, Bulimia Nervosa or mentors that have experience navigating social and emotional isolation and a lack Eating Disorder Not Otherwise Specified) the complex and overwhelming systems of psychological support (Mason, Cooper during their first trimester of pregnancy, and emotions involved with the diagnosis and Turner, 2012). and almost a quarter of women (23.4%) and process of seeking help for an eating experienced weight and shape concerns at disorder. They provide informal, personal Few studies have investigated the fre- a clinically significant level. support through a difficult journey, and quency with which eating disorders are direct individuals and families to the present amongst women during pregnan- While the overall number of women professional help they need. Community cy. In general, eating disorder symptoms who had an eating disorder in the first support projects and programs like these are thought to decrease during preg- trimester of their pregnancy was lower may be beneficial to women transition- nancy (Micali, Treasure, and Simonoff, than prior to pregnancy, the proportion ing through pregnancy and into early 2007), but the risk of reoccurrence in the of women with binge eating disorder motherhood. n postnatal period is high. (BED) increased. Little is known about the association between pregnancy and BED, References: In the March edition of the European however, previous research by Cynthia Mason, Z., Cooper, M., & Turner, H. (2012). The Eating Disorder Review, we reported on a Bulik and her team in North Carolina sug- experience of pregnancy in women with a history of anorexia nervosa: An interpretive study of the prevalence of eating disorder gests that pregnancy may be associated phenomenological analysis. Journal of Behav- symptoms amongst pregnant women in with a worsening of symptoms. More ioral Addictions, 1(2), 59–67. the UK. In this study, we aimed to investi- research on the topic of binge eating in Micali, N., Treasure, J., & Simonoff, E. (2007). gate the proportion of women experienc- pregnancy is clearly needed. Eating disorders symptoms in pregnancy: A longitudinal study of women with recent and ing an eating disorder or related symp- past eating disorders and obesity. Journal of toms amongst those attending antenatal Pregnancy can pose several challenges Psychosomatic Research, 63(3), 297–303. appointments in early pregnancy. to the accurate detection of eating Easter, A., Bye, A., Taborelli, E., Corfield, F., disorders. Features of pregnancy such as Schmidt, U., Treasure, J., & Micali, N. (2013). Women in their first trimester of pregnan- weight gain, changes in appetite, nausea Recognising the Symptoms: How Common cy were asked to anonymously complete and vomiting can mask the presence of Are Eating Disorders in Pregnancy? Euro- pean Eating Disorders Review. doi: 10.1002/ an eating disorder screening question- an eating disorder. Given the typical, but erv.2229. [Epub ahead of print] naire, whilst waiting for their pregnancy often temporary reduction in symptoms Bulik, C. M., Von Holle, A., Hamer, R., Knoph ultrasound scan at Kings College Hospital, during pregnancy, eating disorders can Berg, C., Torgersen, L., Magnus, P., & in central London. Over 700 women com- remain hidden and go unsupported. Reichborn-Kjennerud, T. (2007). Patterns pleted the questionnaire. These factors can make it particularly dif- of remission, continuation and incidence of broadly defined eating disorders during early ficult for healthcare providers in antena- pregnancy in the Norwegian Mother and The results from this study indicated that tal settings to identify and offer support Child Cohort Study (MoBa). Psychological eating disorders are relatively common to women with eating disorders. Medicine, 37(8). 5

My “Aha” Moment

A Moment of Courage By Kirsten Haglund, NEDA Ambassador, Miss America 2008, New York City television didn’t see it that way. One of the camera crews was taping our down time, and caught a contestant, who was eing a former At 15 years old, I did not want to die. That about to get her long, blond hair cut to a Miss America passion I had funneled into ballet wasn’t bob, refuse a plate of snacks. “I don’t eat Bcomes with its just a passion for the art form, it was a when I’m nervous!” she said. The director fair share of benefits passion for life. I wanted to go, to do, to of the camera crew made a note of the and shortcomings. dream, to accomplish, to LIVE my life. I comment saying, “That was a great sound One of the greatest didn’t want to die, a slave to perfection. bite.” I knew it was exactly the kind of blessings of being That day, I turned around on the road. I stereotypical comment likely to make it a public person, in started taking small, small steps toward on air, likely to be sensationalized — likely my view, has been to advocate and raise recovery and fullness of life – toward to ring in the ears of impressionable, awareness for a devastating and often freedom. young people watching the show. “silent” disease that affects 30 million Americans — eating disorders. I chose Almost ten years later, I am recovered I don’t know what courage possessed this issue as my platform during my and free from the eating disorder, and I me, but later, I pulled the director aside. I year as Miss America in 2008 and have fully credit my incredible treatment team asked him not to let that comment make been traveling, speaking, and writing in southeast Michigan, my family who it into the final edit. I explained what my for greater awareness and action on believed in me, my friends who held me platform was, and briefly the reasons disordered eating ever since. up, my God, who showed me grace. As why their attitude toward painting us as an advocate now, I’ve also had an Aha superficial women made me so mad. He The reason I am committed to helping moment. Honestly, small Aha moments didn’t give me a “yes” or “no,” regarding others find hope and healing is due to my come almost every time I speak to an my complaint, but approached me at the own struggle and recovery from an eat- audience of college students, or share end of the month of taping. He explained ing disorder. Long before I ever entered with a friend who comes to me, divulging that what I had said made an impression a pageant (something I never dreamed their own struggles whether with food, on him — his wife had been a dancer, had I would do!), I was a ballet dancer and anxiety, depression or relationships. battled an eating disorder, and he had a all-A student, whose goal was to be a However, I’ll relay the moment of most five year old daughter. He realized that professional ballerina. Making a long and significant impact. he didn’t want his own little girl grow- complicated story very short, in pursuit ing up hearing negative messages about of my dream, I started a diet that turned On the road to the Miss America women’s bodies, and their eating behav- into a serious battle with anorexia at age competition, when I was Miss Michigan, iors. He promised the line wouldn’t end 12. My parents, reluctant but deter- all the contestants participated in the up on the show — and it didn’t. mined, pushed me into an outpatient taping of a reality TV series that would air treatment program at age 15. Although in before the pageant. We were flown out One small victory, perhaps, in a media denial then, I am incredibly thankful now, to Los Angeles, lived in a house together saturated with less than positive mes- for their action in the face of my belliger- for four weeks, sharing curling irons and sages. That day, however, I learned the ence. I fought my doctors, nutritionist bathrooms, participating in ridiculous power of one, small voice. That Aha and therapist for six months, until my competitions each week, suffering the moment showed me the power of con- Aha moment arrived with blunt force. humiliation of “eliminations.” It was not necting with other human beings, sharing fun, to put it nicely, but certainly helped stories, stepping out in courage to say I was sneaking in exercise one day, when us to bond as contestants against the “this will not be tolerated,” even when I almost fainted on the treadmill. It was expectations of the production crew, there is the risk of being misunderstood. the most out of control of my body, mind inspiring each other to maintain our class That moment is what drives me today. and heart I had ever experienced. Stop- in the face of Hollywood. The little daughter of the TV director, and ping immediately, I made my way to the every other young person who will grow floor, the physical expression of my mind The “moment” came the day we were up learning that they are worth more seeing the depths to which I had sank. all being given makeovers. I person- than what they look like. Instead, they I realized that my treatment team was ally believe a makeover begins with a are worthy because of their heart, their right – the eating disorder could kill me. transformation of heart, but of course, voice, and their passion to live. n 6

My “Aha” Moment (continued)

Learning On the Path to Recovery new therapist to the team who worked By Lara and Howard Baker, NEDA Navigators, Florida with Dani on exposure therapy. When we interviewed the therapist, and she  Lara facets of eating disorders. This meant was explaining to us how we can change HA MOMENTS. It is amazing how looking closely at our relationship. Dani Dani’s pattern of thinking to include many meanings one three letter and I have always been close, perhaps, at healthy reactions to anxiety driven A word can have. The Aha can times, even too close. Recognizing that situations, we went “Aha, that makes change simply based upon which letter our relationship needed to shift led to the total sense.” This exposure therapy piece you emphasize, the moment it occurs or Aha moment of detachment. There were came at just the right time; when Dani where you are in recovery. so many things to detach from. First, and was well into recovery and ready to say foremost, I needed to detach from the good-bye to her eating disorder. Our journey has been filled with so many eating disorder. I needed to understand Aha moments. The first, and one of the that the person living in my house was an Which leads me to the most recent, most significant was thatAha moment illness and not my amazing kid. I needed and by far, my personal favorite Aha of discovery. I was sitting with our moment — the one of delight. The daughter, Dani, in the nutritionist’s one said with a sigh of relief (and office, and he was asking her to gain some trepidation); the moment that a pound a week for the next nine is preparing us for Dani leaving for weeks. It was in this moment when college. she looked at him like he had asked her to swallow knives, that I knew Our journey with Dani’s eating we had a problem on our hands. It disorder, while difficult, scary, sad, was this Aha moment that moved us challenging and tiring, has also been into action. From that day on and for one of learning, growth, change and the next seven months, our actions hope. I am not saying the journey is included a multi-dimensional treat- over yet (that is up to Dani to do). I ment team for Dani. It also included am saying that right now, we are in therapy for all of the members of our a place that shows us a future. We family. are so very proud of our daughter and her fight for life. We are proud After those initial seven months into of ourselves as well for latching on Dani’s journey toward recovery, to those Aha moments and making came another Aha moment; this one something useful of them. Not that a moment of departure. The moment long ago, I would have never believed that signaled something needed to Dani would go to college. Today, with change. While our treatment team support, hard work and her treatment was great, Dani needed something team beside her I am confident and more. We made the very difficult deci- to understand that when Dani engaged hopeful that like the mascot of her new sion to send her to a treatment center in in eating disorder behaviors or was just school, the phoenix, she will continue her California (we live in Florida) for residen- plain mean, that was the eating disorder path to recovery and rise again. tial treatment. And, while it was one of and not her trying to hurt me. Detach- the worst days of our lives, we knew she ment meant breaking the co-dependence  Howard was going someplace safe and getting the and allowing Dani to start problem solv- Although we are two people watching help she needed. I would love to say that ing on her own. It meant letting go and the same child struggle with an eating when she came home it was the end of learning to let Dani become the person disorder (ED), some of our Aha moments our Aha moments and that things would she was meant to be. are very different. As a man and a be better, but there was still much work father, it was very difficult to watch my and healing to be done. And then came the Aha moment of daughter, Dani, struggling with an eating diversity. The one when we realized disorder. One of my first Aha moments As Dani continued to work on her recov- the treatment team we were working was understanding and accepting that I ery, I continued to work on my role as with needed something more, a tweak could not fix the problem by being the her mom and to learn about the many if you will. That was when we added a ➥ continues on next page 7

 Learning On the Path to Recovery continued food police. I mistakenly believed if I just Once Dani was discharged from residen- path to recovery can feel like a rollercoast- told her what to eat and when, I could tial treatment and was back home in er filled with ups and downs. Often when make the eating disorder go away. outpatient care, I was shocked to learn things were going well, I would be on pins that her eating disorder was not a simple and needles, hoping this would last, and After Dani had been in outpatient ther- light switch that could just be turned off; forever worried it would not. apy for seven months and all of us had this was just the beginning of the real participated in family therapy and made work for her and our family. The residen- But the greatest Aha moment came constant efforts to make changes, we tial facility was simply teaching her to with accepting that Dani had to take were doing everything we could to keep cope and deal with the anxiety that she responsibility and own her own behavior. Dani from going into residential treat- experienced in a way that was different I’m a dad, and the way I see it, it is my ment. It was another Aha moment for me than what her eating disorder taught her job to protect and care for my family. when I realized that residential treatment to do. This Aha moment was exhausting There will never be a day that I don’t was the best chance she had to get bet- and frustrating to learn. worry about Dani and her battle with ED. ter. I felt a sense of shame in knowing she I know now I can’t fix it, but I will always would go, almost like I had failed her. It Our journey with Dani’s eating disorder be there as her greatest supporter and was not easy to watch her go, but I knew has been a long, bumpy road. When cheerleader. I am proud of her fight, and I this was a necessary step. While Dani was someone first told me to “put the seatbelt would not give up these Aha moments for working on recovery, I too began to look on because this will be a bumpy ride,” I did anything. n at myself. I had to be open and willing not believe them. Now I understand the to see how I could change in an effort to support her recovery. My Aha moment was understanding Dani’s perception of Parent Toolkit our family unit, of learning how to “deliv- er a message” better, learn to hear what The NEDA Parent Toolkit is for anyone who wants to understand more about was being said to me and to validate the how to support a family member or friend affected by an eating disorder. You person saying it. My behavior was only will find answers to your insurance questions; signs, symptoms and medical one of many pieces of the puzzle and consequences; information about treatment and levels of care; and questions an extremely eye-opening experience. I to ask when choosing a treatment provider. To view NEDA’s Parent Toolkit visit: believe this particularAha moment has www.nationaleatingdisorders.org/toolkits made me a better father, husband and person in general.

What Readers Are Saying

I read several of the articles in the June Connections already. The article “Communicating Through Art” was moving and truly shed light on how powerful art therapy can be in recovery. I have a picture my daughter painted during her early treatment days. It is a single small boat in the vastness of the ocean. It is simple, but it clearly depicts about how she felt… Please know that NEDA has helped continue our family’s journey in healing. I also appreciated the article about evidenced based treatment. Dr. Marx has a great ability to communicate in a clear way for the lay person. — A Mom

Each issue we highlight additional opportunities to learn from other PFN members and eating disorder professionals through the PFN Webinar Series. Webinar attendees have found them to be helpful in many ways. Here are just a couple of comments from your fellow readers/listeners:

 Eating Disorders in the DSM-5: Implications of Changes in the Diagnostics Categories and Criteria It was a great webinar. Dr. Walsh presented a lot of good information as an introduction to the DSM-5. Thanks for your work. — A Treatment Professional

 An Eating Disorder By Any Other Name: How EDNOS, OSFED, and other Eating Syndromes Can Be Just as Severe as Anorexia, Bulimia and Binge Eating Disorder Thank you for having multiple perspectives on this subject! — A Webinar Attendee 8

My “Aha” Moment (continued)

A Friday Phone Call By Andy Hunter, 2012 Williamsburg, South Carolina NEDA Walk Coordinator, North Carolina

“Andy, you ready? Let’s make a stop at the prevent this from happening to just one store before practice.” person, it would all be worth it.

“Yeah, let me grab my bag, and we’ll go.” The first year of the Williamsburg NEDA Walk went on to raise over $20,000 and left the apartment, picked up one brought in 270 participants. Recently, I of my freshman teammates, Matt, called Matt, now a senior, and told him I and detoured to the store. We were no one had taken the reins for year three. running late — something that never I asked him if he was up for it and with- happened —but as it turned out, I needed out hesitation, he gave a profound, “Yes.” to be late this day. It was the start of Matt continued Emily’s bold vision and a Friday afternoon that I would never promise that it would not just be the 3rd forget. Williamsburg NEDA Walk; it would be the 3rd Annual Williamsburg NEDA Walk. The As I sat in my car in the store parking amount of support we have seen in just lot with Matt, my phone began to our tiny Williamsburg is a testament to chime. I grabbed it and looked down at the character found in people across this texts from my girlfriend. The messages country. It shows a desire felt by many were nothing out of the ordinary, but a to protect loved ones and to learn about strange, eerie feeling came across me. It and suddenly in this moment, it was at my this important cause. put a chill down my spine and told me doorstep again. Only this time, it was an something was not right. I responded opportunity to spread the very knowledge NEDA Walks are about making our and told her if she wanted to call, I was that had nearly cost me the life of a loved communities safer. MyAha Moment free at the moment. Instantly, my phone one to learn. includes recognizing that I was reactive began ringing. I turned to Matt and said, to my situation instead of proactive. “This might not be good.” I picked up to I responded and asked if this was just a Knowing the warning signs and under­ hysteria on the other end. My girlfriend promotion or a call for volunteers. The standing the seriousness of eating had tried to purge and in the process reply I received was nothing short of an disorders is the key to being able to overdosed on various medicines. essay. It was a gigantic email filled with take action before it is too late. Being passion and excitement. It was from our proactive saves lives. Arm yourself with When she first told me she was struggling first walk coordinator, Emily. Devoted to that knowledge, so you never have to with bulimia, I had no idea a life was the walk’s success, she assembled a team, take a phone call like the one I did. n in danger. I had no clue how to help and I happily joined. We set lofty fund- someone with an ED. I could not imagine raising and attendance goals and were that I would one day be calling 9-1-1 and constantly scheming up ways to make the hoping someone I cared for would live. event bigger and better.

Six months later, I found myself browsing As I became more entrenched in the ED through a campus email looking at the community, it did not take long for me Student Happenings, when I had my to discover how widespread the lack of Aha moment. I saw a post for the 1st eating disorders awareness truly is. There Annual Williamsburg NEDA Walk and were people I knew — friends, family, did a double take. In disbelief, I scrolled teachers, administrators, even medical back up and read the listing. Everything professionals — who could not separate I knew or thought I knew about eating myth from fact. It was a startling truth; disorders had recently been turned upside however, I found myself surrounded down. I was now mentally engaged and by peers with stories of their own and emotionally attached to the entire subject, volunteers who thought if we could 9

Nutrition and Eating Disorders: A Shared Journey By Sondra Kronberg, MS, RD, CDN, CEDRD, New York

y perception – cross all socioeconomic boundaries. In I see my role and the role of nutritional of nutritional their search for how to fill their internal therapy differently now. I have learned, Mwellness, void and find answers on their relationship and now teach, that there is so much nutritionists and the with food, these patients seek external more to the process of food choice and role of nutrition in expertise. Most have long ago lost con- food behaviors than information, science recovering from an nection to their own inner knowledge, and plans. eating disorder has wisdom and life force. been a progression, I now approach nutrition and disordered a shared journey, and there have been This exhausting struggle with food, eating as an aggregate of physiological, many Aha moments along the way. Early weight and body image often stems from emotional and behavioral factors. The in my practice, armed with scientific a sense of worthlessness. It is an all- physiological component is determined training and medical model concepts, I consuming attempt to feel better about by biochemical factors, such as nutrient was geared up for providing patients with themselves, numb their pain, cope with deficiencies, blood sugar fluctuations, what I have come to call the “quick fix.” feelings or gain a sense of control. This metabolism and genetics. The emotional Having acquired the scientific answers eating disordered symptomatology which component includes the ways in which about food, nutrition, health, weight and I was initially so eager to fix and change is one turns to or away from food to cope how the body works, I was now qualified not only a clever adaptation for survival, with intolerable thoughts or feelings, to help others improve their nutritional but is a crucial means, often the only such as depression and anxiety. The status. Patients came to me seeking ad- means, of communication. As destructive behavioral components such as bingeing, vice. I was naïve enough, and they were as it may seem to the outside world, the purging, starving and over exercising are desperate enough to believe that merely eating disorder can be a mechanism of patterns which evolve over time and have knowing what their body needed would self-care and a measure of security for become routine ways of managing situa- catalyze their transformation toward the person who is struggling. A profound tions. All three of these areas need to be health. My job would be to 1. Assess their Aha moment came when I realized work- addressed to facilitate changes in eating physiological status, 2. Determine their ing to create positive and longstanding behaviors and nutritional status. nutritional needs, 3. Calculate the correct change was no “quick fix.” percentage of macro-and micro nutrients Another huge Aha transformation is to be included in the daily allotted calorie I have had many other Aha moments that that I no longer bear the sole burden intake, 4. Produce a food plan that meets have impacted my work. I have discov- of responsi­bility. I view the treatment their nutrient and energy needs and 5. ered that working with people, their food as a shared journey, a collaborative Provide a brief assist in getting started. I choices, eating behaviors, preferences, effort. Eating disorders are serious, bore the burden of responsibility and, in weight or aspirations is complex and life threatening illnesses that are often line with my training, thought that was multidimensional. It involves so much accompanied by anxiety disorders, what I had to do. I had to take care of more than choosing an apple over a pear depression, substance abuse issues them. or setting up a theoretical eating plan. and other co-occurring conditions. The I have learned that food has meaning. treatment requires a team of specialists, The majority of people who show up at my There are foods that have sentimental who have an awareness of the depth office do so because they don’t feel good value, those that are rewards, and others and magnitude of eating disorders about themselves. Many of my clients that are used or taken away as punish- including the biological, psycho­logical, have been deeply affected by our culture’s ment. There are foods that are exciting environmental and genetic factors intense focus on unrealistic standards of and others that are comforting. I found that may cause the illness. Patients beauty. In an effort to cope, they often that there are food-related behaviors and are the experts on themselves, their hold onto the belief that losing weight, rituals that bring pleasure and some that behaviors and thoughts. The nutritionist wearing a smaller size or restricting their bring pain. I have become aware of foods is the expert on physiology, nutrition food intake will either make them feel bet- as part of customs and family traditions. information, eating thoughts and beha­ ter about themselves, give them a sense of Many food choices emanate from our viors. The therapist is the expert on control or make them eligible for a better ethnic, religious, philosophical and per- the emotions and underlying dynamics life. They are people of all shapes, sizes, sonal beliefs. There are food choices that that support the eating disorder. Other ages and gender seeking help for a variety have both sensual and sexual links. There professionals, including physicians and of eating disorders including anorexia, are also food aversions and phobias. Of- pharmacologists are involved, usually bulimia and binge eating under the guise ten a person’s identity, worth or purpose with less frequency. Responsibility and of nutritional counseling perhaps because is attached to his or her food choices. My answers lie within the patient, and the this feels safer and more acceptable. The early training did not prepare me for the team is a guide. It is a partnership. That is eating-disordered patients I see – a mix of psychodynamics I would encounter. My a huge Aha! housewives, ballerinas, athletes, grand- “quick fix” mentality was ineffective and, ➥ continues on next page fathers, wrestlers, teenagers and models in many cases, detrimental. 10

 Nutrition and Eating Disorders continued Crucial to one’s ability to change and self-acceptance, where food choices are Nutrition, the physical nurturance of successfully meet these challenges is the based on caring about oneself. Nutrition- the body, mind and spirit, is a reflection development of positive self-talk and al wellness is a lifelong process of listen- of personal growth. How one nourishes affirming dialogues. Replacing the dys- ing to one’s needs. In my practice this is a one’s self with food mirrors how functional inner food dialogues and the shared journey of self-care, self-discovery one feels and cares about one’s self. unspoken message of the eating disorder and self-fulfillment – both mine and my Nutrition therapy helps our patients with a strong and healthy new voice is an patients’. I have furthered my training, observe and understand how variations important goal of the treatment. sought support, took some risks and in their carbohydrates, protein, fat and made many discoveries. My patients have caloric intake impacts their physical and Years of working with eating disorders learned to challenge their fears and take emotional well-being. Patients learn and many Aha moments have changed back their lives. Our work still requires a to recognize and meet their physical the face of my work, the relationships large amount of education, information needs. Nutritional therapy includes the I share and the roles that I embrace. At and knowledge, but I know now that it is development of skills for identifying, this point in my journey, my awareness the delivery of this knowledge, and the satisfying and distinguishing emotional of the connection between the mind and relationship which develops around this and physical hunger. It also provides tools body is ever present when I listen to the delivery, that fosters the healing, not the for prioritizing time, money and energy language of food. I listen more carefully “quick fix.” n so patients are able to meet their own to what patients are truly saying through needs as opposed to the needs of others. their food choices. The idea that people References: could change their eating behaviors with Prochaska, J, Norcross, C & Declemente, C. (1994). “Changing for the Good” New York: Nutritional therapy is a medium for chal­ only nutritional knowledge and a brief as- William Morrow. lenging distorted beliefs about food and sist seems unrealistic now. The evolution later recognizing where similar beliefs of my nutritional beliefs and practice has have been operating in other areas of the deepened over time. I have transformed Sondra Kronberg, MS, RD, CDN, CEDRD patient’s life. It is a forum to challenge as a nutritionist the way I am hopeful my is the Founder and Nutritional Director of old thoughts, behaviors and patterns in patients will transform through obser- Eating Disorder Treatment Collaborative a safe and supportive place. Calculated vation, awareness, support, risk and and F.E.E.D. Intensive Outpatient challenges are agreed upon to broaden discovery. Programs. Author of ED Learning the comfort zone. Gradual risks to Teaching Handout Series Manual, Sondra change the variety, content, calories, The goal of treatment is to move the speaks nationally on the prevention and social settings and timing are negotiated patient from a place of worthlessness, treatment of eating disorders and is a and the consequences explored. Taking where food choices are aimed at fix- consultant to the Monte Nido Treatment risks with food paves the way for taking ing oneself, to a place of self-loving and Centers of NY. parallel risks in life.

The View From the Top of the Mountain By Emily Hemendinger, University of Pittsburgh MSW/MPH candidate, Pennsylvania

here I was, eating disorder, but because I was free Egypt, I continued to have less dramatic, watching the from it. All the years I had spent believing but equally meaningful moments where Tsunrise on that my anorexia would make me happy I realized that there was a whole world top of Mt. Sinai in melted away. Anorexia could never make outside of the eating disorder that I Egypt, when I had me happy. My eyes seemed to be opened could now explore. My life after Mt. my revelation. My for the first time, and I could see all the Sinai began to be filled with instances of classmates and I had opportunities available to me because body satisfaction. These brief episodes just climbed from I was healthy. The years of therapy and lengthened into days where I was happy St. Catherine’s Monastery up to the treatment that I once thought were with my body and myself. I was amazed famed Mt. Sinai summit. As we huddled pointless and unhelpful, finally made by the things I could now do; things I together for warmth, I began to think sense. It was as if I needed to be at that never could have done when I was active about a year before, January 2008, altitude to finally grasp the concept that in my disease. I rediscovered my passion when I was in the hospital being treated my eating disorder need not control me. for travelling and went on to study for anorexia nervosa. My thought then abroad in Madagascar, South Africa, and brought me to the realization that only a Recovery from an eating disorder is most recently Cuba. I was able to shop year stood between me being controlled not just about one big revelation or for bathing suits and jeans for the first by my eating disorder and being able to Aha moment. My experience on Mt. time in years. Free from feeling self- climb a mountain, much less travel to Sinai was a culmination from years of conscious, I stopped wearing sweatpants Egypt. As the sun began to rise, it dawned pain, treatment, therapy and small and loose clothing and began to wear on me that I was here not because of my accomplishments. Even after my trip to form-fitting clothes. I consider these to ➥ continues on next page 11

 The View From the Top of the Mountain reminders of my vulnerability to relapse would accomplish everything I have over continued along the way. It was during these times the past five years, I would have never be progressive accomplishments which when I discovered that I could rescue believed them. To this day I am still in have brought me to where I am today: myself with another, simple Aha moment. awe of my journey, from the depths of complete body satisfaction. It was not I asked myself this question: “Was it despair to the height of my progress. I easy, but it was a battle worth fighting. worth it to go backwards?” I realized that owe a tremendous amount of gratitude I had come so far and accomplished too to my parents, sister and therapist for While I was in the midst of my their love, support and guidance. eating disorder, I wasn’t able to They have helped me push through help myself, much less assist oth- to believe in myself, visualize my ers who were struggling with their strengths and realize my passion own issues. Recovery has enabled for wanting to live an extraordi- me to see that I must first work nary life. on my own progress before I can reach out to others. Since then, My hike up Mt. Sinai and my road supporting others suffering from to recovery are very comparable. eating disorders has become a Both proved to be extremely passion of mine. On a professional challenging, and I struggled many and personal level, I am now able times along both paths. Both to positively impact individuals journeys were painful, mentally living with eating disorders and and physically. There were times other mental illnesses. Currently, on both roads where I felt hope- I am attending the University of less and worn out, and that I might Pittsburgh earning a dual Master’s not make it. In both cases, I had degree in Social Work and Public encouragement from those closest Health. I hope and plan for a future in much to let my eating disorder back into to me: family, therapist, friends and class- aiding others through counseling and my life. I decided I would not allow my mates. Both climbs required me to reach prevention and awareness efforts. eating disorder to assume control and deep down inside myself to find my inner take everything I had achieved away from strength. Through all of the struggle Those Aha moments are the gifts of many me. I was able to draw upon my years of and pain, I made it to the top. I can see ordinary days in treatment. The therapy intense treatment, therapy and support where I am going, and where I have been. and support I received helped me reach to gain strength in resisting the urge to And, standing at the top of both of these a solid place in my recovery. The years revert back to my disease. mountains, I am able to see how wonder- I spent regaining my health were far ful life can truly be. n from easy and there have been constant If someone told me eight years ago that I

Need personalized guidance for yourself, or in support of a loved one affected by an eating disorder? The NEDA Navigators are here to support you!

EDA Navigators* are individuals who have experience, responsible way. You can request to speak with someone either personally or in support of a loved one, navigating who’s dealt with co-occurring conditions such as depression, Nthe overwhelming systems and emotions involved with substance abuse or self-harm; shares an aspect of your identity seeking treatment for an eating disorder. Volunteers, trained such as ethnicity, gender, religion or sexual orientation; or has by NEDA staff and program Clinical Advisors, Douglas Bunnell, the same relationship to the person struggling, such as a fellow PhD and Ilene Fishman, LCSW, ACSW, are available to: Help dad, mom, partner/spouse, sibling or friend. you find treatment referrals, local support groups, and resources tailored to your needs; be a listening ear through Email us at [email protected] and we’ll get you con- your or your loved ones’ journey; provide encouragement nected. For more information about the NEDA Navigators, visit through a difficult time; and share their own story responsibly the Navigators homepage at www.myneda.org. n to offer hope for recovery. * Navigators are not mental health professionals or treatment The range of experience among the Navigators is diverse, and providers. They are PFN volunteers who have been through an eating when you request to be connected with a Navigator, we can disorder themselves or with a loved one and are now in strong match you with someone who has been through a similar set recovery. Navigators are trained to help you identify resources, of challenges and can share their experiences in a helpful, treatment options and be a source of support in your journey. 12

eating disorders, separate from sending those struggling to a PTSD specialist My “Aha” Moment or an Alcoholics Anonymous group (continued) when appropriate. It is also extremely important that service members feel safe to let their command know they are suffering, as they do with any of the Raising Eating Disorders Awareness on a Naval above disorders, without fear of being kicked out of the service. If alcoholism, Base By Theresa Larson, DPT, US Marine Corps Veteran, California PTSD, and depression can be accepted in the service, then eating disorders must be accepted and treated as well. n February 7, 2013, I had the op- from a single parent home, raised by Early intervention and treatments are portunity to speak with a number my father, and having two amazing and key in giving the person struggling the Oof amazing panelists at the Norfolk very protective older brothers, I was in best chance of a full recovery. Service Virginia Naval Station on the serious topic the mindset to set the standards as high members need to have access to support of eating disorders in the military. The as possible for women in the service. I groups and one-on-one counseling turnout was tremendous, the participa- performed at the top of my game, so ev- sessions that employ evidence-based tion was excellent, and the question and eryone thought, almost all the time. This methodology, specific to handling the answer session at the end was meaningful peak performance was stifled while I was illness. for all who attended. Not really knowing in Fallujah, Iraq serving as an escort for what to expect or what kind of response female insurgents and convoy command- The Aha moment and success of the we would get from a room full of primarily er for missions such as land mine clearing eating disorders awareness seminar was enlisted Naval seamen/women and a few and the formation of forward operating that all in attendance took this issue officers, I could not have felt more sup- bases. I was quietly suffering with bulimia seriously, acknowledging a need for ported and blessed to be in Norfolk that nervosa, and I had to call for help ASAP. action. With service members, officers, day. This was the first time I would share enlisted flight surgeons and civilians my story with military members, and I was recognizing my story and thanking me thankful for the opportunity. for sharing it, I was delighted to see they now better understood the severity of Being honored to speak after Dr. Kim eating disorders and the need for support Dennis of Timberline Knolls, I knew the for those affected in the service. It was audience was well-educated about bulimia a compelling day for me personally, nervosa and other eating disor­ders as well. and sharing my experience with fellow Initially, a raise of hands on how many service members ignited a desire in me people in the audience knew someone to continue reaching out and making with an eating disorder, who were also in a difference — thanks to Lieutenant the military, showed that roughly one-third Gregory and Chief Stiles and the support of our audience members had a colleague of those who made the seminar possible. affected. I think this was an Aha moment not only for myself, but for the military and I am honored and thankful for my service everyone in the room, as it became very as a Marine Corps officer. I met some of clear just how serious a problem eating the most amazing people and personally disorders in the military are. pushed myself to make a difference as a I am just one of many in the military strong, humble leader of Marines. Suffer- I spoke about my invisible battle with who has needed access to professional ing from bulimia nervosa for 90 percent bulimia nervosa while serving as an help for an eating disorder. The picture of my military career caused trauma to engineer officer in the United States Ma- was beautifully painted by all the my mind and spirit. However, my intense rine Corps. While I was the only Marine speakers highlighting how someone love for the Marines and dedication to my Corp personnel in the room that day, I who is potentially very driven to high country fueled a fear of being dismissed believe my story profoundly resonated achievement and performance may be from something I had worked years for with some audience members, who were vulnerable to developing this illness. and made me second guess speaking up clearly relating to some degree. Mission Panelists discussed how the military and getting the adequate help I needed. accomplished in my book! The mission of will support someone suffering with my talk was not to explain in detail what alcoholism, post-traumatic stress and I am hopeful that the military is now my job entailed as a Marine, but rather depression, and how an eating disorder having its own Aha moment as it moves to paint a picture of a young woman (my- is often accompanied by one or more of forward, addressing the needs of those self) who joined the officer corps in the the above conditions. However, because who do suffer with eating disorders in Marines to make a difference. eating disorders require treatment by the service because it could be anyone, a trained clinician, it is critical that the from a high-performing officer to a quiet I simply wanted to be the best! Coming military provide access to care specific to young new private. n 13

Advances in Eating Disorders Awareness in the Military By Molly Greendeer, Mass Communication Specialist 3rd Class, Naval Station Norfolk Public Affairs, Virginia

aval Station Norfolk (NSN) hosted Larson explained she did not initially get are deterring factors for members to an eating disorders awareness the help she sought. After pressing the come forward for help with what could Nseminar February 7 at the base issue, she was medically evacuated from be a life threatening situation. auditorium. February is National Eating Iraq to get the help she needed back in Disorder Awareness Month, and Naval the states. She participated in a 12-week “This is not an end all,” said Dennis. Station leaders took the opportunity to outpatient program where she learned “Those diagnosed and treated go back to focus on the subject, bring awareness to about her disorder and how to treat it. living full productive lives.” sailors and discuss resources for treat- ment. According to the United States “Although I miss the Marine Corps, I know It is up to the leadership to educate Army Research Institute of Environmental I made the right decision to seek treat- themselves on signs and symptoms,” said Medicine, 10% of the military popula- ment and take care of myself,” she said. U.S. Navy Lieutenant Pamela Gregory, a tion is suffering from eating disorders guest speaker and dietician with Navy as opposed to the nationwide general Dennis said that the stigma associated Medical Center Portsmouth (NMCP), population where the prevalence is only with all mental disorders, not just eating “Knowing what to look for may save between 3-4%. Awareness among lead- disorders, along with fear of medical someone’s life.” n ers and resources for treatment must be boards and separation from the military a priority.

With the growing prevalence, Command Master Chief David Carter, command master chief of NSN, said there is no better time to train our Sailors and leadership on the dangers of eating disorders.

“It is important for all levels of leadership to know about eating disorders and be able to recognize some of the symptoms,” said Carter. “Only through proper training, can we get our shipmates the help they need to deal with the disorder and get them on track to a healthy life and Navy career.”

Boatswain’s Mate 1st Class David Pendly who attended the seminar, said that he is all too aware of the pressure meeting physical fitness standards put on his Sailors and himself.

“The pressure is on for those of us who have struggled with weight problems our whole lives,” said Pendly. “We have to do what we have to do to meet the Navy’s standards or we’re out (of the Navy).”

Guest speakers included Dr. Kim Dennis, a board-certified psychiatrist who spe- cializes in eating disorder treatment at Timberline Knolls Residential Treatment Center and Dr. Theresa Larson, a doctor of physical therapy and a former Marine Corps Engineer Officer who shared her own story about her struggle with an eating disorder and her recovery path. 14

This Side of the Table By Sarah Bentley, Brooklyn, NY

n February of 2013, I had the oppor­ and physical illness. Sadly, eating Turns out, I was really in trouble. tunity to speak to a group of college disorders, and in particular anorexia, Istudents as part of a four person thrive on this line of extreme thinking I finally sought out a nutritionist to try panel during National Eating Disorders and comparing. It might be the only to fix the problems I was having with my Awareness Week. The three other mental illness where those who have it body. After meeting with the dietician, panelists participating were professionals, often partially don’t feel good enough or the diagnosis was clear, “You have a all with experience treating individuals qualified to have it. severe case of anorexia nervosa, and you with eating disorders. I was the panelist need to go to treatment.” She seemed offering my personal insight and story In my case when I was struggling, I so professional and so with it, how could of recovering from an eating disorder. couldn’t actually see or acknowledge that she also be nuts? Yet everything she said If someone would have told me two I was indeed ill. So many of us, including turned out to be true: I had osteoporosis. years ago that I would be sitting on this myself, have been encouraged by our My EKG levels were “like an Olympic panel, representing anorexics with strong culture and dieting industry to take all marathon runner,” according to my very recovery, I would not have believed necessary measures to be thin, under the surprised doctor. I couldn’t eat. Well, I them. To say the least, I was very grateful guise that thinner automatically equals could eat, but I couldn’t eat meal after to be there that night. healthier or more attractive. And, often meal after meal … like she wanted me to. I was receiving praise for the very eating The first question asked to the panel behaviors that were contributing to Two years later, after taking a leave was, “What was the worst case you ever keeping me ill. Sure, I couldn’t stop losing from my job for six months of intensive treated, or how bad did you get?” weight, even though I wanted to stop treatment, where I had to be assured losing weight and was just trying to get a over and over again that I did in fact There was a long pause, as we all started little more insurance for when I was going have anorexia nervosa, here I sat on this looking at each other to see who would to start eating normally (which didn’t panel. The question that night, I realized, lean into their microphone and take the seem to ever happen). Yes, I had to stand was the reason I was there. I finally got first stab at an answer. It seemed that at the same place at the kitchen sink to a chance to say to that voice, I am a none of us had anticipated this as the quickly eat my weighed-and-measured recovering anorexic. And, if any of you first question of the evening, asking for breakfast. Ok, I’d stopped being able to hear anything at all that sounds like your examples of extreme behavior. Each pro- sleep through the night for fear that I’d story, no matter if you feel you do not fessional took turns answering, and each miss morning exercise, and my digestive “qualify” to have an eating disorder, do used the moment to educate the audi- system seemed to have stopped working. not compare yourself to anyone else. If ence that any experience with an eating BUT, I wasn’t growing those downy-like you know deep down inside that your disorder should be considered serious, as hairs all over me that I read about in high relationship with food is affecting your eating disorders are potentially life-threat- school, and I was still holding down a life in a negative way, you deserve to ening illnesses that can seriously affect a corporate management job, quite well get help. Or if you are concerned about person’s physical and emotional health. in fact, and I was almost 40 … I couldn’t a loved one and think they may be in possibly have an eating disorder because trouble, say something. You or your loved I felt sad in this moment. Here I was, on I wasn’t a teenager. I didn’t restrict all one deserve recovery. Help is available. This Side Of The Table, feeling derailed the time! And no one was really saying Recovery is possible. n by this question. As if suddenly, people anything to me. Surely they would say would not take my experience seriously if something if I was really in trouble…. I couldn’t show I had been “that bad.” Fi- nally, I answered, with hope that I would not alienate the person who asked the question, and with a sense that this was an important moment for me in my own recovery, as well as an illustration as to the importance of having these conversa- tions about eating disorders.

It was that very question, I said, or the spirit behind it, that kept me sick for so long. In our culture and in our media, we are so used to hearing and seeing the extremes of everything that we have made an art form of one-upmanship. Even with subjects as tragic as mental 15

Don’t Settle For Barely Recovered By Jennifer J. Thomas, PhD, Massachusetts and Jenni Schaefer, NEDA Ambassador Chair, Texas

hen Jenni Schaefer was in disorders — anorexia nervosa, bulimia you struggle with anorexia nervosa or recovery from her eating nervosa, and binge eating disorder. Sadly, a subclinical variation. As we say in the Wdisorder and restoring her most never address the issue because book we co-authored together, Almost weight, she cringed when well-meaning they don’t fully meet the relatively narrow Anorexic: Is My or My Loved One’s friends and relatives said, “We’re so glad diagnostic criteria. These individuals, suf- Relationship with Food a Problem? “Don’t you’re feeling better!” Although she was fering immensely, often feel their struggle settle for barely recovered.” n incredibly grateful for their support, she is invalidated when they are diagnosed wished they wouldn’t use her body weight with a subclinical illness described with as a barometer for how she was doing. a perplexing acronym like EDNOS (which Jennifer J. Thomas, Ph.D., is an stands for Eating Disorder Not Otherwise assistant professor When you are supporting a loved one Specified, in DSM-IV) or OSFED (which of psychology in with an eating disorder, it’s easy to forget stands for Other Specified Feeding and the Department that, while the number on the scale Eating Disorder, in the recently published of Psychiatry at yields information about possible medical DSM-5). Others who struggle are dis- Harvard Medical complications, it provides little indication missed completely—they don’t even get School and co- of how the individual is feeling inside. an acronym, but suffer silently in the ill- director of the Eating defined limbo of “disordered eating.” Disorders Clinical and In fact, in psychologist Jennifer Thomas’s Research Program clinical experience, patients who narrow­ly It’s essential to provide hope, help, and at Massachusetts General Hospital. She miss the weight criterion for anorexia ner- validation to those who restrict, binge, is coauthor of Almost Anorexic. Visit vosa (i.e., those whose body mass indices purge, or battle poor body image, at JenniferJThomasPhD.com. Connect with fall in the “normal” range), sometimes feel whatever number on the scale. Because her at Twitter.com/DrJennyThomas. even worse about themselves than those recent research suggests that anorexic who are officially underweight. Indeed, behaviors exist on a continuum with nor- Jenni Schaefer is a singer/songwriter, Sarah hits the nail on the head when she mal, we agree with Sarah when she says: speaker, and author describes in This Side of the Table those “do not compare yourself with anyone of Life Without Ed with anorexia often not feeling “qualified else. If you know deep down inside that and Goodbye Ed, to have it.” your relationship with food is affecting Hello Me. Chair of the your life in a negative way, you deserve Ambassadors Council It implies that, unlike other mental health to get help.” of the National Eating problems such as alcohol abuse or de- Disorders Association, pression, anorexia nervosa carries with it Some questions used to help you deter- she is also coauthor a certain cachet. We believe this pseudo- mine if you (or your loved one) might be of Almost Anorexic. prestige stems in part from the exclusiv- experiencing symptoms consistent with Visit JenniSchaefer.com. Connect with ity of the diagnostic criteria listed in the an eating disorder and could benefit her at Twitter.com/JenniSchaefer and Diagnostic Statistical Manual of Mental from an assessment by an eating disorder Facebook.com/LifeWithoutEd. Disorders (DSM), which healthcare specialist may include: professionals use to diagnose psychiatric • Are you underweight or does your illnesses. Although the hallmark symptom weight frequently shift due to of anorexia nervosa is low body weight, repeated attempts to drop pounds? the majority of individuals who struggle • Do you regularly restrict your food with eating disorders—just like people intake by amount or variety? in the general population—are normal • Do you eat large amounts of food weight or overweight. And according to while feeling out of control? Dr. Thomas’s research, individuals with • Do you try to “make up for” calories subthreshold eating disorders typically consumed (e.g., vomiting, laxatives, have problems with eating pathology, diuretics, exercise, fasting)? comorbid conditions, and physical health • Does negative body image interfere that are just as severe as those with with living your life to the fullest? anorexia nervosa. The more “yes” responses someone While only 1 in 200 adults will struggle provides, the more likely it is that his or with full-blown anorexia nervosa, at least her relationship with food is problematic. 1 in 20 (including 1 in 10 teen girls) will But please know that freedom is possible. exhibit key symptoms of one or more You (or your loved one) can take steps of the officially recognizedDSM eating to make peace with food—whether 16

Real Mannequins for Real People By Rebecka Silvekroon, Founder of SwedishMannequins.com, Sweden

wo and a half The first week after the photo went years ago, I was viral was an unusual week for me, Tout shopping on with interviews on TV, for radio and in my own one Saturday. I papers. And, I thought I’d seize those entered one of the big- fifteen seconds of media attention to ger department stores do something useful. So, I created the in the middle of the city, website www.swedishmannequins.com, and headed for the underwear section. where I hope to keep the discussion Suddenly, I stopped. It wasn’t the clothes about this important topic going. If you on the mannequin in front of me that have a story of your own addressing made me stop. This mannequin didn’t positive body image and self-acceptance, look like most mannequins do. She had I encourage you to share it! reported that at age thirteen, 53% of a stomach that reminded me of my own, American girls are “unhappy with their and thighs that looked real and strong. I And, why is this important? Unfortunately,­ bodies.” And, that it grows to 78% by the was so happy to see that! I grabbed my the fashion industry often portrays an time girls reach seventeen. mobile phone, took a photo and posted it unrealistic body and beauty ideal – on to my personal blog. catwalks, in magazines and billboards. I hope that my photo of the Swedish Every day and almost everywhere, we are mannequin–that has been liked and subject to the ideal that you must look discussed by so many people – will catch a certain way to be beautiful. When you the attention of retailers and other walk into a mall, what do you see when companies in the fashion industry. If you look at the store windows? Most enough people ask for a change perhaps likely, you will see mannequins showing they might consider using a wider range off the newest trend. They are supposed of mannequins in their stores. Perhaps to show you how that piece of clothing they will celebrate diversity in body actually looks on you. But, if there are only size rather than a “standard” type of very thin mannequins with specific beauty mannequin that promotes an extreme in ideals, how will that make you feel? body size and beauty. Let’s change that! Many companies use these mannequins A childhood friend of mine struggled with because they believe that consumers will anorexia and bulimia for many years. be more likely to buy their clothes. My There is no way of explaining why, as eat- experience shows that consumers want ing disorders have complex contributing diverse, realistic displays. factors that include biological, social, and At that point, I only received two posi- psychological elements. But, I do believe Beauty and body acceptance should not tive comments on my blog about the that we are affected by this unrealistic be defined by a limited set of criteria. mannequin. But, in mid-March of this image we encounter in the media and in Real people come in all sizes and shapes, year, something happened. Somehow my our public spaces, more than we want so why shouldn’t mannequins? n photo ended up spreading throughout to admit. I recently read a study that social media. The Facebook page “Wom- en’s Rights News” first shared the photo, and after just a couple of days, it had received more than fifty thousand likes. Others followed, and the image started Become a Media Watchdog! to appear rapidly across the globe. In a he Media Watchdog program empowers consumers to advocate for positive matter of days, it had been liked more media messages. This means recognizing and celebrating advertisements that than one million times! Tsend healthy body image messages, as well as taking the time to express our concerns about advertisements that send negative body image messages or promote Today, the photo has been shared in unrealistic ideals. news articles and magazines around the world. But, most importantly, it has been When we act together, we have a stronger voice to hold advertisers and entertainment discussed and liked by so many people. I media accountable for the impacts of their media messages. Visit the Media Watchdog have read comment after comment from homepage to alert NEDA about a praise-worthy or protest-worthy advertisement/ women and men who applaud the size media message, download how-to instructions on deconstructing an advertisement, of the mannequin and wish that more check for current Media Watchdog Action Alerts and more information on becoming a retailers would use a more diverse range media activist! n of dolls. 17

STAR Program Victory in Missouri!

he Missouri state legislature has authorized an actuarial study on the costs of eating disorder insurance reform. TSenate Bill 161, sponsored by Missouri Senator David Pearce, passed with bi-partisan support and was signed on July 8th, 2013 by Governor Jay Nixon.

The actuarial study, set to be completed by the end of 2013, will assess the cost of insurance coverage for the treatment of eating disorders in the state of Missouri. This study is a crucial step in the pursuit of insurance reform, as the analysis is required before a coverage mandate can be implemented. Missouri is paving the way for other states to implement similar initiatives. Appropriate insurance coverage for eating disorders can save countless lives.

Passionate advocates from the National Eating Disorders Association’s (NEDA) Solutions Through Advocacy and Reform (STAR) Program and NEDA Network member, the Missouri Eating Disorders Association, fought for the bill’s passage. NEDA’s STAR Program fights for legislative change that would improve the prevention and treatment of eating disorders.

Commented Taryn O’Brien, NEDA’s STAR Program Manager, “NEDA thanks our STAR Program advocates in Missouri for their dedication to fighting eating disorders. Through their hard work over the years, the team has made a large and lasting impact in the state. We look forward to future policy work to build on this monumental victory.”

Said Annie Seal, NEDA STAR Program Advocate and President of the Missouri Eating Disorders Association, “For those of us who have been personally affected by this terrible disease, we believe that complete, quality treatment is more cost-effective than limited, inadequate treatment. We are confident that similar to other state’s actuarial studies, the Missouri study will show costs to provide complete treatment are negligible. Many thanks to our bill sponsor, Senator David Pearce, our House bill sponsor, Representative Rick Stream and everyone in Missouri who worked so hard to make this happen.” n

Solutions Through Advocacy & Reform (STAR) Program

NEDA established the STAR Program to legislatively advocate for aware­ness, education, early intervention and prevention programs, funding for research, and improved access to treatment of eating disorders by speaking with legislators, mobilizing members, and forging alliances with other groups who share our vision. STAR is driven by passionate volun­teers. You don’t need experience to make a difference.

Contact [email protected] for more information. n 18

Transforming My Struggle into a Tool for Successful Advocacy By Claire Brady, NEDA Navigator, Missouri

ast fall I decided Navigator when my mom told me about That morning a group of us – a psychiatrist, to make a career the Missouri Lobby Day. a marketing director at a St. Louis Lswitch away from treatment center, that young woman advertising and towards Lobby day was cancelled due to a big and I – walked around the Missouri State medicine. Throughout snowstorm, and my mom wasn’t able to Capitol building pulling our senators and my own treatment for attend on the rescheduled date. Thus, I congressmen out of session to speak to anorexia nervosa, I ended up making the drive from St. Louis them. And, they listened. became increasingly to Jefferson City by myself that morning interested in health, psychology, and the having no idea what to expect. I walked It was encouraging. They listened and interconnectedness of the parts of the into the rotunda with a nervous smile. asked questions about our experiences body. I started a blog to share my experi- and what it takes to truly recover from an ences and promote awareness of eating What I received that day was more than eating disorder. We gave them statistics disorders. Finally, I realized I couldn’t see I could have ever hoped for. I was part of that hit home, like how their very own myself being happy in business, so I quit a group of people just as passionate, if sons and daughters could be affected. my job and am now a post-baccalaureate not more, than me about helping those We told them this disease wasn’t a premedical student. struggling with eating disorders get choice. the insurance coverage they deserve. My mother is a pediatrician who I was brought to tears hearing stories One of the most thrilling parts of Lobby specializes in adolescent medicine and of deaths far too young, and moved by Day was having SB161 pass in the Senate eating disorders. She is an incredible Miss America 2008, Kirsten Haglund’s while we were watching. Only two source of knowledge for me, keeping reflections on her own struggle. senators voted against the bill, and it was me updated on the latest research and the first step of many towards adding particularly the immense struggle for I was lucky enough to have the means to eating disorders coverage to Missouri insurance coverage that she deals with on pay for my treatment, but I was placed insurance plans. It gave us hope that a daily basis. I’ve attended eating disorder in a lobbying group with a young woman what we were doing would actually work. conferences with her and attribute much still in and out of treatment centers be- of my involvement to her guidance. I was cause she can’t afford care long enough Earlier this month, I woke up to an email already volunteering through NEDA as a to make a full recovery. from NEDA telling me that SB161 was signed into law by Governor Jay Nixon and the actuarial study would begin. My eyes lit up, and my heart beamed. We did it!

Within hours my mom had forwarded me the same email, just in case I hadn’t heard the news. I told my roommate and shared the email on my Facebook page, excited about the progress our state was making and the thousands this progress could save.

As I continue my journey towards medical school and ultimately becoming a physician, I’m more inspired than ever to advocate for better eating disorders care and removing the stigma surrounding mental illness. And, hopefully by the time I’m a physician, insurance will cover a full treatment for people just like me. People that were diminished by an eating disorder and wanted nothing more – deserved nothing more – than to have their health and vibrancy back. n

Miss America 2008, Kirsten Haglund, speaking at the Missouri Lobby Day 19

Fighting for Recovery in the Face of Health Insurance Denials of Care By Anonymous* INSURANCE

ighting for recovery from an eat- having my grueling deposition taken, I can denials of eating disorder treatment. ing disorder is not for the faint of breathe and enjoy my progress in recovery The National Eating Disorders Associa- Fheart. Recovery takes courage, without being constantly distracted and tion has partnered with family members self-compassion, dedication, endurance, traumatized by mounting treatment and and professionals from across the United relentless hard work, a sincere willing- legal debts. Despite my legal victory, I States who have experience fighting ness to challenge cognitive distortions view the fight as far from over. insurance companies to develop strate- and passion. I agree with the common gies for people looking for help. NEDA is sentiment that the journey to recovery is There are a number of actions that the a welcome resource for navigating and not to be underestimated. Unfortunately, eating disorder community can take on understanding insurance issues such as this journey is often complicated and this critical front: (1) Encourage your working to obtain coverage, securing rendered infeasible by a lack of financial legislators to make changes to the ERISA eating disorder treatment, managing resources. Due to the current state of statute such that claimants who sue an appeals process and more. Please legislation governing health insurance insurance companies are able to recover visit the NEDA Insurance Issues page: providers, these financial impediments www.nationaleatingdisorders.org/insur- to recovery are often compounded by ance-resources, or call the NEDA Helpline insurance companies’ questionably legal, for referrals and more information. yet clearly unethical, denials of care for eating disorder treatment. Every day, I was fortunate to be a lawyer with the some health insurance companies shirk resources to fight a legal battle against their responsibilities to their customers my insurance company. Others are not and deny critical care under the auspices as fortunate – it is my sincere hope that of a lack of “medical necessity.” through legal advocacy and bravery, the eating disorder community will be able My fight to recover from bulimia was to stand up to major health insurance rendered all the more difficult because corporations and be treated with the I had to fight my insurance company’s dignity, compassion and equality that we denials of care. While hospitalized and deserve. n hooked up to an IV, my insurance com- pany flouted the recommendations of my doctors and deemed my care not “medi- * The author of this article chose to cally necessary.” I had to leave treat- more than the mere cost of treatment remain anonymous in order to honor the ment prematurely because of insurance (as the law currently stands, only gov- terms of a legal non-disclosure agreement denials. Because I did not get the care I ernment employees and a few other with her health insurance provider. needed and deserved, I had to go back to uniquely situated claimants are entitled treatment again and again. Once back in to recover damages above and beyond treatment, the inevitable insurance deni- the cost of treatment–thus, there exists als began to accrue—this time, however, no incentive for insurance providers to when the denial letters reached a critical approve treatment early in the game mass, I decided, with the support of my because they cannot ultimately be held husband, that I would no longer submit liable for more than they would have had to the heartless whims of my insurance to pay for in the first place); (2) create a company. Instead, I took them to court legal advocacy fund that would cover the and prevailed. court costs eating disorder plaintiffs incur while fighting an insurance company As a lawyer, I never expected that I denial; (3) continue expanding an online would need to hire my own attorney “know your health coverage rights” to represent me in a case against my reference document whereby those who insurance provider. I never thought a large are denied care will know what steps to corporation would victimize someone like take in order to challenge an insurance me – I never thought I would have to fight company denial; and (4) create an online for what seemed so obviously just. Over portal to match clients with lawyers two years after the filing of the lawsuit and who are experts in insurance company 20

2013 Annual NEDA Conference A conference for individuals, families and professionals who care about eating disorders.

Of Monumental Importance Directing the National Spotlight on Prevention, Treatment, Research & Policy Washington D.C. | October 10-12, 2013 Hyatt Regency Washington on Capitol Hill

HE 2013 ANNUAL NEDA CONFERENCE, Of Monumental Importance: Directing the National Spotlight on Prevention, Treatment, Research & Policy, brings together professionals, researchers, educators, Tpeople in recovery and their families to connect and learn from one another. It’s an ideal opportunity to come meet others, share stories and foster connections in a warm, welcoming environment. And you won’t want to miss the opportunity to join us for the NEDA Federal Lobby Day on October 10th, co-sponsored by the Academy for Eating Disorders and International Association of Eating Disorders Professionals! Visit NEDAConference.org to see the full agenda and register today!

As an African American recovering from an eating disorder, I realize becoming an activist within my own community is just as important as my personal recovery. In 2012, knowing there are many in my community (family members, friends, colleagues, etc.) who are suffering in silence, I founded FAAED – The Foundation for African Americans with Eating Disorders and plan to launch a blog – The Forum for African Americans with Eating Disorders this year. My mission is to increase awareness and understanding of eating disorders in the African American community and to provide a forum for open discussions about eating disorders in our community. Attending the conference will help me foster connections with people in recovery and their families and learn from professionals, researchers and educators who are working on both local and national levels. — Gwen Vann, NEDA Conference 2013 Family Panelist

I first attended the NEDA Conference in 2009 and had the opportunity to hear Stephanie Covington-Armstrong share her inspiring story; allowing me to start my own journey to recovery & healing. Three years later, I found myself sharing my own recovery story at the NEDA Conference Family Panel. I look forward to returning this year and being surrounded by people who believe that recovery is possible. — Anahi Ortega, NEDA Conference 2012 Family Panelist

Attending NEDA’s Annual Conference reminds us all that we are not alone, whether you are a family member, someone struggling or a professional. Help is out there and stories of recovery are strong and inspiring. I am delighted to be able to share my own story of recovery and my perspective as a transgender man and professional in the field. — Ryan K. Sallans, MA, President/CEO of Ryan Sallans, Inc. and Scout Publishing, LLC.

I’m looking forward to sharing my story at this conference because I want other partners and spouses to know that they are not alone. Furthermore, I’m thankful for the opportunity to draw attention to the challenges that members of the LGBTQ community who struggle with eating disorders and their partners face. — Emily Farqhuarson, NEDA Conference 2013 Family Panelist 21

Calling All Dads – “There’s A Ball At The Castle” By Don Blackwell, Florida and Mike Polan, New York, PFN Steering Committee

hen the editors of Making healthy development and image of self; Connections approached us (2) although we may not always be the Wa few weeks ago and asked if best at communicating our feelings, Don Blackwell Mike Polan we would be willing to write an article dads care deeply about their children inviting fellow dads to join us at NEDA’s and have since the day they were born; disease process and are committed 2013 Annual Conference in Washington, (3) most dads are thirsting for an even to educating yourself; D.C., we jumped at the opportunity closer relationship with and a better • You want to learn the skills for several reasons. First, because understanding of their children; (4) while and techniques necessary to both of our daughters spent several the level of vulnerability and emotional constructively support them in all years battling eating disorders, we intimacy required to connect fathers and aspects of their recovery; and know intimately the unique challenges their children, particularly daughters, • You acknowledge the need for and that dads face in the treatment and in ways that meet their “dad needs” value of support from others, who recovery process. We know the sense of may not be intuitive to some men (i.e., either are going through or already skepticism that often accompanies the it may not always come naturally to a have successfully navigated these initial diagnosis, the seeming irrationality dad), with proper education, guidance diseases. of it all and the corresponding beliefs and encouragement dads not only are that can arise out of skepticism (i.e., that fully capable, but desirous of achieving The bottom line. We believe that all “it’s just a phase” our loved one is going that level of closeness; (5) the rewards dads stand to benefit from what this through, that our loved one is just “doing associated with being more vulnerable year’s annual NEDA Conference has to this” to garner our attention or affection, and with a heightened sense of father/ offer: the opportunity to avail ourselves that they almost certainly will “grow out child awareness and emotional intimacy of the finest treatment professionals in of it” or, worse yet, that the disease is a are well worth the effort it takes to the industry in better educating ourselves “choice” our loved one has misguidedly get there; (6) where disordered eating as to the complexities of eating disorders; made–a choice that they can just as behaviors are concerned, a dad’s the chance to learn how we can better easily “unmake” and return to “normal”) willingness to participate in his child’s support our loved one in their struggle to – none of which, of course, could be recovery on a more visible and intimate overcome their illness; and the invitation further from the truth. level may be the most important gift he to be part of a group committed to can ever give his loved one, his family raising awareness of the life-threatening We also understand the fear that sets in, and, ultimately, himself; and (7) healthy nature of these diseases. Finally, but as dads begin to more fully appreciate recovery from an eating disorder should no less importantly, the conference is the seriousness of these insidious dis- involve the entire family – including dads. invaluable because it offers dads, who, eases and the level of care and parental understandably, may feel isolated or involvement required to treat them. As Most importantly, however, we embraced overwhelmed (or both) the chance to importantly, we know the overriding the editors’ offer because it gives us a share their experiences and derive much desire that all dads, ourselves included, chance to encourage dads to utilize the needed support from other dads (and have to want to fix things and the some- opportunity their attendance at the parents in general), who understand their times overwhelming sense of helpless- conference affords to send critically struggle. ness that can set in when, despite our important messages to their loved ones, best efforts, our loved one continues to namely that: For all of these reasons (and more), struggle. Finally, we know the toll such • You appreciate the seriousness and Mike and I strongly encourage every illnesses can take on a family and on re- complexity of your child’s struggle; dad to join us in attending this year’s lationships with spouses, not to mention • You are fully invested in the annual NEDA Conference. You (and, as a dad’s psyche, as inevitably we begin process and prepared to do what is importantly, your loved one) will be glad questioning our adequacy as fathers, necessary to support their recovery you did! n while struggling to balance the everyday efforts; demands of work. • You understand the need to be “fully present” in their lives, We also seemed like a logical choice particularly at this difficult time; Family Package Registration because over the past several months, • You are willing to make sacrifices we’ve had the privilege of speaking to in your own life and busy schedule groups of eating disorder sufferers, solely for their benefit; Full Conference $410.00 treatment professionals and parents at • You’re love of and support for them various webinars and seminars across is unconditional, free of any sense Friday Only $205.00 the country. At each stop along the way, of “disappointment” and non- Saturday Only $205.00 we have shared our beliefs that: (1) a judgmental; dad’s unconditional love and support • You recognize the need to better are critically important to a child’s understand the intricacies of the 22

BlackStar Film Festival: Baby Steps By Stacey Sargeant, Filmmaker, Actress, New York City ARTS FOCUS

“I saw you coming down the stairs earlier and I thought you were absolutely beauti- ful. I would’ve never thought you were developing binge eating disorder, I Viewing my film, I was overcome with going through all this or felt this way literally swallowed my feelings with the type of emotion that comes when about yourself.” all the foods I wasn’t allowed to eat one reflects on all the obstacles they’ve before, until my dream lured me back overcome in life, the type of emotions his was the in. I found out about a training program that, had I not gotten under control by first comment that was created to give Black people the taking deep breaths, would have turned Tmade in the opportunity to train and perform classical me into a blubbering mess. While I know Q&A period after ballet. I auditioned and was put in a my therapist would say this is a good my short documen- beginner ballet class. After having been thing to be in touch with, this was not tary film,Though on pointe for almost two years at my I’m Not Perfect, previous school, how was this possible? and Lisa Cortés & When my mom and I inquired, we Shola Lynch’s film, found out that my acceptance into the Imagine A Future, screened at the 2nd class level I belonged in, the advanced Annual BlackStar Film Festival in Philadel- intermediate class in the pre-professional phia. This comment illustrated one of the program, was contingent upon me points NEDA Community Outreach Spe- losing weight. I was up for the challenge cialist, Ellen Domingos, and I were hoping because I’d done it before. I endured the to communicate: people often believe humiliation of going to a ballet class that eating disorders are about looks or are was beneath my level for a year and a a choice, but in reality they are complex half, until my appearance was acceptable illnesses that develop for many differ- to those I believed held the key to my ent reasons. For too long, eating disor- dream. Even after being promoted, ders have been known as only a young disparaging comments were made to the time or the place…I had to speak on white girl’s illness. This is a myth. Eating me, in front of my classmates about my a panel in a few minutes! I mean, there I disorders do not discriminate. While weight. The underlying message being was, a professional award-winning actress more research is needed in this area, we that I was still too big to be a ballerina, who has been in countless musicals and do know that the prevalence of eating regardless of my dance abilities. straight plays, been on television shows disorders is similar among Non-Hispanic such as Law &Order: SVU, Glee, and Whites, Hispanics, African-Americans, After realizing I would probably never Gossip Girl, and just worked with Chris and Asians in the United States, with attain my dream of being a ballerina, I Rock on his latest untitled film. There I the exception that anorexia nervosa is became attracted to acting. When I made was sitting next to Ellen Domingos of the more common among Non-Hispanic this known to some of my ballet teachers, National Eating Disorders Association, Whites. Another common misconception I was met with discouraging responses with a mission that goes beyond me … a is that someone suffering with an eating because they believed I didn’t have the mission to generate awareness and disorder can be identified based on their “ideal” body type to be in any aspect of discussion about eating disorders in the weight–this simply is not the case. I share the performing arts. This only fueled my Black community. I could not ignore how my documentary in the hopes of start- determination to pursue my new dream I have turned the lemons in my life into ing conversations that challenge many of of being an actor. lemonade, and not just for myself. these stereotypes, and encourage people who are struggling to reach out for help. My journey is the subject matter of my I must say, after having stayed two more short film, Though I’m Not Perfect. As I days in Philadelphia for the remainder Following my first ballet instructor’s sat in the audience while it screened at of the festival, our mission was accom- recommendation, I started dieting at the the BlackStar Film Festival, Ellen support- plished. Countless people stopped me ripe age of nine years old, with hopes ed me in sharing my story, as I confront- on the street and at other festival events that I would be accepted into the chil- ed my fears of how my film would be to share very personal stories. So much dren’s company of the school I attended. received. I made this film with my dad’s so, that I was late or missed events Though I lost weight, that day never digital camera, purchased a MacBook Pro altogether to simply listen. I learned that came due to other issues at play I was and taught myself how to edit in iMovie. my willingness to share my story gives unaware of; issues that had to do with Now I was screening this film in a festival people the courage to release the shame, the hue of my skin. deemed by Ebony Magazine as the, even if only for a moment, and share “Black Sundance;” you can understand their stories because they know in speak- Devastation set in. I gave up my my insecurity. However, after hearing ing with me, they are not alone. I learned dream and without worrying or even many audible responses from viewers, I that many artists are not even aware of being aware of the consequences of knew they were on the ride. ➥ continues on next page 23

 Baby Steps continued their own conditioning…how the beliefs a process, bringing about awareness of For more info on Stacey Sargeant they have about their bodies and food eating disorders in the Black community please visit www.staceysargeant.com are not their own. I learned that NEDA so that people can seek help and support and to learn more about her film visit and I have a lot of work to do in the Black will not happen overnight…but at least a www.thoughimnotperfect.com. community, but just as my individual dialogue has begun. n recovery started with baby steps and is Why We need the nedA Feeding hope Fund

The American Academy of Pediatrics states*: “The incidence and prevalence of eating disorders in children and adolescents has increased significantly in recent decades, making it essential for pediatricians to consider these disorders in appropriate clinical settings.” What is the The Feeding Hope Fund will raise restricted funds designated for the distinct purpose of providing grants to: • qualified clinical researchers who have been selected through our very competitive application process Feeding Hope Fund? • qualified clinical experts providing creative submissions for advancing the training and dissemination of evidence based treatments to fellow clinicians

What will my Your investment will address several key strategic goals of the Feeding Hope Fund. It will support and encourage clinical research in the field, it will provide models of dissemination and training and it will inspire investment do? others to step forward, so that treatments are improved and a cure is within our reach.

“...because they have the highest mortality rates of all mental disorders, further research to better understand eating disorders is critical... Research is our best hope for effective prevention and even better treatments in the future.” — Thomas Insel, M.D., Director, National Institute of Mental Health

* Clinical Report — Identification and Management of Eating Disorders in Children and Adolescents by David Rosen – Official Journal of the American Academy of Pediatrics 24

NATIONAL EATING DISORDERS ASSOCIATION NEDAWALK NEDA Walk Volunteer Spotlight uzi Heim is the coordinator of the Save a life. Sfirst Kansas City, Missouri NEDA Walk which took place in June 2013 and raised over $28,000. When her 21 year old daughter, Emily, took her own life, NEDA Walks bring communities together to increase eating after an exhaustive eight year struggle disorders aware­ness and raise funds for NEDA in a fun way. They with an eating disorder (ED), Suzi knew not only work to support the mission of NEDA, but also work she had to get involved. She manages this walk in an effort to bring awareness and education to the local communities in to prevent another family from experiencing a similar which they take place. NEDA Walks that are coordinated by NEDA loss. Suzi wants to raise awareness and make resources Network Members return a majority of the funds back to the local available for those individuals and families who are in need community, and 2013 will be the first year of the NEDA Walks of help. She strives to continue Emily’s battle against ED in scholarship program, which sends local Walk Coordinators to the hopes of making a difference for others. We are so grateful NEDA Conference free of charge. Help NEDA support individuals to Suzi for her work and are inspired by her strength and and families affected by eating disorders in local communities courage. n around the country by registering for a walk near you! n

Upcoming 2013 / 2014 NEDA Walks:

Greater Cincinnati, OH NEDA Walk Belle Mead (Central NJ) NEDA Walk Denver, CO NEDA Walk (Dearborn Trails, Lawrenceburg, IN) (Montgomery Park, (City Park, Denver, CO) Saturday, September 7, 2013 Belle Mead, NJ) Saturday, October 12, 2013 Sunday, September 22, 2013 Madison, WI NEDA Walk Terre Haute, IN NEDA Walk (Madison, WI) Chicago, IL NEDA Walk (Indiana State University, Terre Haute, IN) Saturday, September 7, 2013 (Lincoln Park, Chicago, IL) Saturday, October 19, 2013 Sunday, September 22, 2013 Indianapolis, IN NEDA Walk Westchester, PA NEDA Walk (Military Park, White River State Park, St. Louis, MO NEDA Walk (Farrell Stadium- West Chester Indianapolis, IN) (Tower Grove Park, St. Louis, MO) University) Saturday, September 7, 2013 Saturday, September 28, 2013 Saturday, October 19, 2013

Bowling Green, KY NEDA Walk Baltimore, MD NEDA Walk Asheville, NC NEDA Walk (Bowling Green RiverWalk, (Corner of West Chesapeake & (Carrier Park, Asheville, NC) Bowling Green, KY) Washington Avenue, Towson, Maryland) Saturday, November 2, 2013 Saturday, September 14, 2013 Sunday, September 29, 2013 Austin, TX NEDA Walk Minneapolis, MN (Twin Cities) NEDA Walk Boone, NC NEDA Walk (The Triangle, Austin, TX) (Mall of America, Minneapolis, MN) (Appalachian State University, Boone, NC) Saturday, November 9, 2013 Sunday, September 15, 2013 Saturday, October 5, 2013 Rockland County, NY NEDA Walk Elkins Park, PA NEDA Walk Champaign-Urbana, IL NEDA Walk (Rockland Lake State Park Valley Cottage) (Ogontz Park, Elkins Park, PA) (University of Illinois Main Quad, Sunday, November 17, 2013 Saturday, September 21, 2013 Champaign-Urbana, IL) Saturday, October 5, 2013 San Diego, CA NEDA Walk Pittsburgh, PA NEDA Walk (Mission Bay in De Anza Cove) (Schenley Park, Pittsburgh, PA) Summerville, SC NEDA Walk Saturday, February 22, 2014 Saturday, September 21, 2013 (Paths in Azaela Park, Summerville, SC) Saturday, October 5, 2013 Savannah, GA NEDA Walk Orem, UT NEDA Walk (Daffin Park, Savannah, GA) (Mt. Timipanogos Park, Orem, UT) New York City NEDA Walk Saturday, February 22, 2014 Saturday, September 21, 2013 (Foley Square, New York, NY) Sunday, October 6, 2013 ➥ continues on next page 25

Upcoming PFN Series Webinars

Eating Disorders 101 for the Spanish Speaking Community (conducted in Spanish) Thursday, September 26th, 2013, 1 to 2:30 PM EST

Recently Archived Webinars Eating Disorders in Type 1 Diabetes

Type 1 diabetes is one of the most common chronic diseases of childhood. Its management focuses on the relationship between blood sugar, insulin, and food. This may contribute to why individuals with type 1 diabetes have close to 2.5 times the risk of developing an eating disorder than those without diabetes. Many individuals with eating disorders and diabetes restrict medically necessary insulin doses as a powerful and dangerous calorie purge unique to diabetes. Insulin restriction is associated with an earlier onset of diabetes complications such as eye, kidney, and nerve damage as well as an increased risk of mortality. This free online webinar focuses on the complex combination of eating disorders and diabetes. Dr. Ann Goebel-Fabbri, psychologist at Joslin Diabetes Center and Assistant Professor of Psychiatry at Harvard Medical School, has published research on this topic and was involved in creating consensus treatment guidelines for this dual diagnosis. She presents a review of what is known about the problem with a focus on treatment strategies and common challenges. Asha Brown has had type 1 diabetes since the age of five years old and is recovered from an eating disorder. She is the Founder of “We Are Diabetes,” a non-profit organization devoted to providing support for type 1 diabetics who struggle with an eating disorder. Asha provides her personal story and insight on recovering from diabulimia. Recorded live on Wednesday, July 24, 2013

An Eating Disorder By Any Other Name: How EDNOS, OSFED, and other Eating Syndromes Can Be Just as Severe as Anorexia, Bulimia Nervosa and Binge Eating Disorder

While 1 in 200 U.S. adults have experienced full-blown anorexia nervosa, at least 1 in 20 (1 in 10 teen girls) have exhibited some of the key symptoms. Many silently endure the effects of anorexia, bulimia, and binge eating disorder, but most never address the issue because they don’t fully meet the diagnostic criteria. These individuals, suffering immensely, often feel invalidated when they are labeled with an acronym like EDNOS (DSM-IV) or FEDNEC (DSM-V). Jennifer Thomas, a clinical psychologist whose research focuses on subthreshold eating disorders, and Jenni Schaefer, an author who is recovered from an eating disorder herself, combine the latest research and clinical wisdom with inspiring recovery stories, including family member, Nancy Quetti. This webinar will provide practical guidance on how to support those who struggle with subclinical eating disorders, which are just as impairing, dangerous, and deserving of help as their officially recognized counterparts. Recorded live on Tuesday, June 25th, 2013

To register for an upcoming webinar, or view a recorded webinar, visit www.nationaleatingdisorders.org/webinars

 NEDA WALK 2013/2014 continued Loss Support Network Orlando, FL NEDA Walk The Loss Support Network offers those who have lost a loved one to an eating (Lake Eola, Orlando, FL) disorder a way to connect with others by: Saturday, March 1, 2014 1. Volunteering to support those new to a loss 2. Requesting support from a volunteer in the network Biloxi, MS NEDA Walk 3. Connecting with fellow volunteers. (Tradition Missisippi, Biloxi, MS) Saturday, March 22, 2014 If you have lost a loved one and would like to become a Loss Support Network volunteer or would like to request connection with a Philadelphia, PA NEDA Walk volunteer, visit the Parent, Family & Friends Network on NEDA’s website (Philadelphia Zoo, Philadelphia, PA) (www.nationaleatingdisorders.org/loss-support-network). Sunday, June 1, 2014 26

Network Spotlight NETWORK MEMBER

T.H.E. Center for Disordered Eating T.H.E. Center is hosting its 5th Annual OF WESTERN NORTH CAROLINA Voices of Hope: A Conversation about Eating Disorders event on September 26, he NEDA Network is a collaboration local schools in delivering Healthy 2013, and would like to announce the between NEDA and other like- Bodies and Full Of Ourselves prevention addition of a twice monthly teen support Tminded organizations dedicated to programs; educating the community group facilitated by licensed therapists our cause. Together, we provide a unified about eating disorders through a and a family led support group starting in voice of strength, advocacy and support lending library, community outreach, October. in the fight against eating disorders. annual conference, and events; and mobilizing a network of medical and Other developments this Fall include T.H.E. (Treatment, Healing, and behavioral healthcare professionals to participating as a partner in the NEDA Education) Center for Disordered Eating increase the availability of treatment Federal Lobby Day in Washington, is a 501(c)(3) organization dedicated resources for persons affected by eating D.C., co-hosting with Timberline Knolls to mobilizing support and resources disorders. Based in Asheville, N.C. and a complimentary (3 hour continuing for individuals and families affected by established in 2004, T.H.E. Center for education) seminar on eating disorders disordered eating in Western North Disordered Eating annually serves 367 and Dialectical Behavior Therapy on Carolina. T.H.E. Center accomplishes its participants through support groups, 324 November 1st, and kicking off our mission by providing free support groups attendees at workshops and events, and 1st Annual Asheville NEDA Walk on for men and women in recovery and approximately 155 calls come through November 2, 2013. All events can be for families and loved ones; supporting THE Center’s helpline. found at www.THECenterNC.org.

Meet the NEDA Staff! Staff Spotlight Claire Mysko, MA Proud2BeMe Project Consultant

laire Mysko alternative to dangerous pro-ana and has worked “thinspo” content. Above all, she loves Cas a project connecting with young people who want consultant to NEDA to share their stories and take action to since 2011, when she inspire personal and social change. came on board to oversee Proud2Bme Claire’s work with NEDA has been a Your Best Self, was named to the Amelia (proud2bme.org), the reunion of sorts: she served as the Bloomer List, a project of the American organization’s youth outreach program. director of the American Anorexia Library Association that recognizes Proud2Bme is an online community that Bulimia Association (AABA), an outstanding feminist books for young promotes body confidence and eating organization that merged with several readers. She is also the co-author of disorder recovery — goals that have been others to form what is now NEDA. This Does This Pregnancy Make Me Look Fat? central to Claire’s career in the worlds of was back in the day when treatment The Essential Guide to Loving Your Body eating disorder prevention, body image referrals were read to callers from a Before and After Baby. education and youth advocacy. three-ring binder and launching AABA’s first real website was a major milestone. Claire lives in Brooklyn and has a three- Proud2Bme is a dream project for Since that time, Claire has headed up year-old daughter who wants to be a Claire. Her day-to-day tasks range from online content and community for fire-fighting princess chef when she editing articles and creating campaigns SmartGirl and Girls Inc., among other grows up. n to speaking with reporters about the organizations. Her book for girls,You’re importance of providing a positive Amazing! A No-Pressure Guide to Being 27

Thanks for reaching out! How can we help?

The Helpline is often an initial step to help for those suffering from an eating disorder and those who support them. Helpline volunteers have extensive training to prepare them for their role providing support to find resources, information, treatment and support group referrals. The Click to Chat option is another way to speak with a live, trained Helpline volunteer, should you prefer instant messaging the Helpline instead of speaking to a volunteer over the phone.

Call our toll-free, confidential Helpline, Monday-Thursday from 9:00 am – 9:00 pm and Friday from 9:00 am – 5:00 pm (EST): CHAT WITH THE HELPLINE Feel more comfortable chatting online with a Helpline volunteer?

Submit a Book Review

Have you read a book recently that offered you insights, tools or helpful information? Write a review for the newsletter! All you have to do is submit a 1-page article to [email protected] that includes: ;; Your name and contact information ;; Title of book, author, publisher and copyright date ;; A brief summary of the content of the book ;; What you gained from the book: Hope, tools for recovery, strategies for self-care, encouragement, educational information, etc.

NEDA reserves the right to edit book review submissions prior to publication. If your review is edited, you will be provided the updated version for your approval prior to publication. National Eating Disorders Association 165 W. 46th Street, Suite 402 New York, NY 10036

Making Connections offers a place for our members to share their personal experiences and insights to support others. While we value these contributions, please note that the views, beliefs and perspectives expressed do not necessarily represent those of the organization.

National Eating Disorders Association Share Your Thoughts 165 W. 46th Street, Suite 402 New York, NY 10036 If you have an idea for an article, PHONE: 212.575.6200 FAX: 212.575.1650 a question you’d like us to HELPLINE: 800-931-2237 research, or would simply like to [email protected] share your story — we’d love to www.NationalEatingDisorders.org have you participate! Email us at [email protected]. Be Thank you to our generous Sustaining Sponsors for helping to make our programs and sure to include your full name, services possible. email address, and daytime phone Platinum: Rader Programs numbers so we can contact you. Gold: Eating Disorder Center of Denver and Remuda Ranch Making Connections is by parents, Silver: Rogers Memorial Hospital family, and friends for parents, Steel: Center for Eating Disorders at Sheppard Pratt, Eating Recovery Center, family, and friends! McCallum Place, The Renfrew Center, Timberline Knolls Bronze: Cambridge Eating Disorder Center, Center for Change, Columbus Park Collaborative, CRC Health Group, Fairwinds Treatment Center, Laureate Eating Disorders Program, Oliver-Pyatt Centers, Rosewood Centers for Eating Disorders, Tapestry, University Medical Center of Princeton at Plainsboro, Veritas Collaborative