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Trying to get eating disorder care as a person of color

Trying to get eating disorder care as a person of color

People of color are less likely to get the care they need or deserve in the current eating disorder treatment paradigm. Research shows that eating disorders are likely equally prevalent across races, yet they are chronically under-diagnosed and under-treated in people of color.

Racial bias is a serious issue that must be addressed to improve care to all communities, especially those that are not white and meet the criteria for low-weight anorexia diagnosis. Eating disorder professionals, including therapists and dietitians are almost all white and lack training on how race intersects with eating disorders.

Following is an interview I conducted with a person of color to find out her experience as someone who needs support for an eating disorder. Her experience is not unique or unusual, and I appreciated her vulnerability in sharing it with me. She chose to remain anonymous for this interview.

1. How do you describe yourself and your eating disorder?

I’m a woman, lesbian, and mixed African American/White. My eating disorder is both my best friend and my worst enemy. It’s as if it knows everything about me, but targets the weakest areas about myself and is ruthless in its pursuit to get me to be perfect.

I will only eat certain foods, at a specific time, in a specific order, and not above a certain amount of calories.  If I don’t do this my anxiety becomes too unmanageable, and if someone or something throws off my routine I become irritable and will refuse to eat. 

2. How did your eating disorder first present, and what is its current status in your life?

I was in college when I first began to have issues. I was no longer active in sports and I didn’t like my no-longer-in-shape body so I began to cut out foods I felt I was able to eat as an athlete. 

It didn’t work to my satisfaction so I began to restrict more. 

After college, I was able ‘to manage’ my eating. I gained weight, got married, had a great job, and things seemed to be OK. It was easy to act like I didn’t care about my weight gain (I very much did).

A few years ago I was prescribed Adderall for ADHD. For me, my ADHD contributes to my perfectionism and increased anxiety. This perfectionism encourages my eating disorder and vise versa. 

With ADHD, fixing a meal took a lot of ‘mind energy’ so I would grab and go, forget to eat, or just drink coffee because food is too complicated.

When I was prescribed Adderall these things lessened. It was like my brain sighed in relief, my anxiety was less, and I didn’t obsess as much about having to do things in a specific order, I would remember to eat.

I did okay on Adderall for a while, but due to the appetite suppression aspect, I lost weight. People complimented my weight loss, which ‘woke up’ the disordered eating part of my mind. The negative, persistent thoughts about my imperfections began.

I began to see a therapist two years ago for anxiety. I’ve since tapered off the Adderall at her suggestion. I work hard to follow her suggestions, but we butt heads when it comes to my eating disorder.

A large part of my energy is spent ‘managing’ my eating, I’ll be more honest, lack of eating. I’ve become sneaky about my eating again.

3. How have you attempted to get help for your eating disorder?

When I first started having stomach issues, I had an upper endoscopy done. The doctor asked me what I thought the reason for my weight loss was, and I told him, point-blank, I don’t eat, I had an eating disorder in college.

The doctor replied from what he had seen of my medical records, “You needed to lose the weight. I’m not worried about an eating disorder you had in college, and I won’t put it in your medical records.” 

I’ve not mentioned it again.

I went to a doctor who I gave my therapist consent to speak to. I agreed to taper from the Adderall to help with my appetite. This doctor told me I need more variety in my exercise when I pulled a muscle. I play tennis five days a week, ride my bike, and walk the other two. 

The same doctor told me I needed to tone my muscles and focus on lifting weights.

She said she was concerned about my weight, but on the BMI I was fine so, therefore “healthy.”

I made an appointment with a nutritionist over a year ago through this doctor’s office, and my first meeting left me confused. The nutritionist gave me a paper with a list of fruits and vegetables to give me more variety in my food choices. The advice was to try new foods.  I ended up throwing the paper away and not going back because that felt like impossible advice to follow.

4. What was your experience with getting help as a person of color?

It’s frustrating. I feel like I’ve been dismissed. People say things like “People of color don’t get eating disorders, your family wouldn’t allow it.”

When asked what I eat I was once encouraged to eat more fried chicken. I don’t like fried chicken, never have.

I’ve been told black people have more muscle mass, so I carry my weight well. (I don’t even know what that means)

I don’t understand the reason the BMI is used for people of color. If a doctor is going to tell me clearly I’m thin, and look underweight, but the BMI says I’m healthy, then why tell me I look underweight?

I’ve been told my blood pressure is low for someone who isn’t white.

I’ve been told my protein is low, and you’re losing muscle mass. ‘Eat more eggs.’ The same doctor told me I need more variety in my exercise. 

When I went to the doctor for my pulled muscle she told me, “It must really hurt because black people have a high pain tolerance.” I stopped talking about when I was in pain from over-exercising. 

5. What would you like to say to professionals whose racial bias has hurt you?

I would like for them to know this: There is enough shame, and secrecy around eating disorders, please don’t add to it because you think the color of my skin makes me immune to a mental health condition.

We may only have the courage and strength to voice our concerns once because the fear can be overwhelming and if we aren’t heard our eating disorder will likely silence us.

If you saw the same symptoms in a white person how would you respond? Respond the same way please, with the same compassion, urgency, and tenacity.  

Challenging an eating disorder alone feels impossible. Even if you don’t believe a person of color can have an eating disorder, fall back on your training, and act like they do. 

Refer us to someone who has the knowledge, error on the side of caution not the side of race.

Even if our bodies tell you the truth about your illness don’t ignore it because of some stereotype, because we will die without your help.

6. Do you have any examples of professionals treating you appropriately?

Yes. My therapist seems to understand how to approach me. She listens patiently. There isn’t a feeling of being challenged, condemned, criticized, or shamed. She didn’t dive into my ED, but once she’d gained my trust she asked me to see my doctor and get blood work completed, and my heart checked. She said it is for her peace of mind. 

I feel like she understands how my ED affects me. She asked me to see a nutritionist and I finally agreed.  

Because I value our therapeutic relationship, I want to keep my word, I want to fight my ED and prove it wrong, while it wants to prove me (and her) wrong,  I tell my therapist, “I’ll go to a nutritionist again but I’m only going to go four times.” 

She says, “Thank you. I knew you could do it.”

Because of her, I did get an appointment with a new nutritionist, and it went really well.  I was extremely relieved. She asked about my weight and I told her I wasn’t there for my weight. I know the scale is coming, but she rolled with it at the time.

She asked a lot of relevant questions, likes and dislikes, foods I won’t eat, and history. Not at all like my first experience with a nutritionist, which felt dismissive and terrible.

She did well reassuring me, “We’ll take this really slow.” When my anxiety about a topic showed, she challenged but didn’t press. 

I plan on going back to see her. I felt heard, not threatened, or shamed. Ultimately a glimmer of hope in the gentle approach she had. She didn’t try to take anything away from me or minimize my experience. She didn’t try and tell me what not to do but encouraged me to do small things. 

Thank you to my anonymous contributor who provided us with this insight. I appreciate you! xoxo

Ginny Jones is on a mission to empower parents to raise kids who are free from eating issues, body shame and eating disorders.

She’s the founder of and a Parent Coach who helps parents navigate disordered eating, eating disorder recovery, and other challenging emotional and behavioral issues.

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Mental health resources for BIPOC & LGBTQ+

Mental health resources for BIPOC & LGBTQ+

In this article, Janette Valenzo shares her eating disorder story and provides mental health resources for BIPOC and LGBTQ+. This article is also available in Spanish.

When I was asked to write this personal story, I was happy to help shed some light on eating disorders and how my Latinidad played a crucial role in the development of my health and recovery. But I quickly realized this would be the first time I am admitting on a public forum that I had an eating disorder. It’s terrifying. But I hope by the end you understand why I am choosing to share my story and these resources with you. My name is Janette Valenzo, I am a first-generation Mexican-American, and I have a history of bulimia, anorexia, and orthorexia.

Recently I put together mental health resources for BIPOC & LGBTQ+. Doing this helped ground me in my recovery and keep me focused on my own health. Sometimes when we help others, we help ourselves. Here’s my story.

Growing up Latina

Growing up, I was surrounded by the most gorgeous diverse bodies in South Los Angeles. My own body never came into question until my family moved to the suburbs. There I was surrounded by a majority of skinny white girls.

This was around the time puberty hit and my hips expanded, my stomach gained more rolls, and I became conscious of the space I took up.

My mom in her best attempts to make me feel beautifully special would say things like “It’s just how your body is.” It would sound really nice, but also contradictory when she and mis tías would also call me “gordita.” This is a term of endearment in the Mexican culture but it translates to “fatty.” What kid wants to hear that? What kid could possibly believe her body was beautifully special after being told fat in English did not mean beautiful?

So I stopped eating, hoping I could change my body. 

I stopped eating

Skinny did not come easy. And no matter how many pounds I lost, I would never be like the skinny white girls.

Because as my mamá would say, “no puedes cambiar tus huesos.”

In an attempt to embrace my Latinidad in high school, I began to look for bodies that resembled mine. To my dismay, the typical Latina portrayed in the media was curvy in all the right places. She was hourglass shaped and a sun-kissed tan. I had none of that.

I wasn’t white skinny, but I wasn’t Latina curvy either. Bulimia took a hold of me as I tried to fit in anywhere that would take me.

My parents tried to help

Behind our closed doors, my dad didn’t understand. Mom did her best to help in any way she could. She would talk about her own body and her own journey towards acceptance. But I could see her own insecurities take hold whenever she thought I wasn’t looking.

She tried other ways of helping. She would provide diet pills when I asked, monitoring them. She would suggest drinking smoothies with her and make them for us. But when I ran wild on my own with her suggestions, she ceased cold turkey.

I learned to hide my anorexia and bulimia even more. And let me tell you, I could hide that really well. Because no matter how many pounds I lost, no one ever knew what to call what was happening to me. I didn’t look skinny enough to have a problem.

I looked “average,” and average doesn’t mean “you have a problem.” So with no visible problems, my mom instead tried helping one last way she knew of: feeding me with love.

Food is love

In our culture, food is love. We eat because we love. Someone cooks for you, you eat because you love them. You cook because you want them to love you as much as you loved cooking for them.

So when I turned away from enchiladas, tortillas, and so much more, I was building walls between my parents and myself. Food became an invisible barrier between my parents and me. We already disagreed on so many things. It was hard on them that I was becoming assimilated to mainstream American culture. They couldn’t understand my hope to fit in with white and skinny. 

The turning point

Unfortunately, my father got cancer and lost a lot of weight from the disease. That brought me face to face with my eating disorder. As he struggled to eat, I would watch him look at food in ways that broke my heart. Here was love in a physical form and he could not take it in.

All the smoothies my mother once made me, she made to keep him nourished and loved. I ate enough for the both of us in hopes he could stay.

But when he left, my orthorexia flared because I didn’t want to take up space that could have been his. I also didn’t want to get sick. And the way society tells us to not get sick is by eating healthy and exercising. Well, I took it a bit too far and ended up back in a psychiatric hospital. 

How my mother helped

My mom sat me down outside the hospital and asked me what had led me here. She asked what could keep me from getting back here and urged me to do it. Whatever I needed to do, do it, because she didn’t know how to help me anymore. She had her own struggles, and seeing me fall this hard was hurting her as well. 

And that was it. I saw that what I really needed from her was communication. Having raw conversations about how we are hurting inside, and how we could hurt others, too, without realizing we are.

I had been so focused on my pain inside that I never saw the part I was playing in other people’s journeys.

My mother’s admission that she was just as lost had me see her in a new light. Yes, she was my mother, but she was also her own person and she too had been struggling. I began to speak and interact with her as a person first, and my mother second. It has helped us so much when we both are not at our best.

This leads to the second conversation that would bring me one step closer to committing to my recovery.

How my sister helped

My younger sister told me that seeing me struggle was hurting her as well. It shocked me. Not because she was hurt but that she was scared to tell me. It was a cycle repeating itself.

I was terrified of ever telling my parents what they did was hurting me. But here was my sister unable to tell me that I was hurting her. So I told her enough is enough. This ends now. What can I do to help you? She laid it out all for me and I really listened to her.

Everything I wish my parents had known, I now teach my younger sister. The calorie counting, the nitpicking in the mirror, the body comparisons, all of it had to stop with me. It is a slippery slope and I refuse to see her do the same. I have made it explicitly clear to my aunts that weight is not to be mentioned as an indication of how a person is doing, nor who they are. I ask my sister to share what she loves about herself. I show her a diverse range of beautiful dancing bodies because she’s a dancer and I know that comes with pressure to look a certain way. 

Communicating and learning

Whenever I see my worries reflected in my sister, I step back and ask myself if I am harming myself or her.

And it’s true that sometimes the need to be better for her outweighs my want to be better for myself. Sometimes it’s easier for me to commit to her health than my own. And for now it’s working for both of us. I commit myself to recovery hoping she will never have to endure what I did.

And I see the difference communication has done for my family. Where my mother would not say anything when I only ate one small meal a day or went on a run in 100-plus degree weather, now she’s the first to say to stop and offer to take  us out to lunch to talk. I smile knowing how far we have come.  

Safe places for BIPOC

Growing up, I didn’t see a safe space that reflected who I am. I realized that this was the biggest deal breaker in asking for help. Perhaps in a BIPOC community I could have been vocal without feeling judged.

Because I’m both Latina and queer, I really felt stranded at times by straight white American culture. That’s what inspired me to create mental health resources for BIPOC & LGBTQ+.

Mental health was not really a thing we spoke about in my Mexican household. In fact, I was told to never mention it. When I started to recover, I started asking why. Why aren’t we talking about this? I think some of it is personal, some cultural, some gender-based. But not talking about mental health is really about stigma, fear and judgement. And I want it to change.

Mental health resources for BIPOC & LGBTQ+

I created mental health resources for BIPOC & LGBTQ+ because my orthorexia and anorexia have been flaring up during this pandemic. If me, a queer Latina who has spent a decade gathering resources and learning about mental health, is struggling with her recovery, how are others doing? We need to know that there are spaces for us, especially since we’re feeling increasingly isolated during this time.

I compiled this list by going through Instagram, the social media platform where I find myself comparing myself to other bodies. If I transform Instagram into a resource rather than scrolling for hours wishing I was this and that, then I could take some control back of my own health. Each day I worked on this list, I felt less alone.

But even as I worked on it, I saw that I had to hold myself accountable in my recovery. I would work on the list and “forget” to eat. But after the second day, my mother cut through crap and called me in. My sister said I was running on empty and that would help no one. And I finally opened up to my boyfriend that I really appreciated when he would cook for me, because it reminded me of what food really has always been to me: love.

No food meant no love, and with each bite I remembered the root of food in our culture.

I’ll admit I cried writing the sentence above. It scares me to reveal I am still struggling now even as I share these resources. But this vulnerability is important. I’m not perfect, and I don’t know everything. None of us do.

Advice for BIPOC parents*

*Please take this as you will. I understand everyone has a different experience and I would never want to tell someone how to raise their child. 

My specific suggested advice to BIPOC parents is this: listen and don’t be afraid of not getting it right the first time when trying to help your child. Know that there will be a struggle for your child to accept your own cultural beauty and health ideals because White America has such a powerful influence on our version of ideal beauty and health standards. 

For the parents of first-generation children, understand that there is a learning curve. It makes sense that the societal ideals of the new home country and ideals from the previous home country clash.

Accept that your child is just as lost as you, and they need you to be open to learning with them. Talk about your own journeys with body image and food. Share the pressures you have faced and how you may still face, and listen to how your children need you. Because that’s the thing: we sometimes may know what we need but are too afraid to say anything. Just like I was with my mother, and like my sister was with me. 

To those BIPOC and LGTBQ+ children struggling, you are not alone. There are spaces that reflect you. I hope this helps.

Janette Valenzo

Janette Valenzo is an actor, a teaching artist, and a mental health advocate based in Southern California. She is also a writer and has performed original spoken word in D.C., LA, and the OC; while her acting has taken her to various stages throughout the country. She loves to travel internationally and locally. You can follow her on Instagram @janettevalenzo

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Recursos de salud mental para BIPOC y LGBTQ+

Recursos de salud mental para BIPOC y LGBTQ +

En este artículo, Janette Valenzo comparte su historia de trastornos de la alimentación y proporciona recursos de salud mental para BIPOC y LGBTQ+. Este artículo también está disponible en inglés.

Cuando me pidieron que escribiera esta historia, estuve alegre que podría ayudar a traer un poco de luz a los trastornos alimenticios y cómo mi latinidad juego un papel crucial en el desarrollo de mi salud y en la recuperación. Pero rápidamente me di cuenta de que esta sería la primera vez que admitiría en un foro público que tenía un trastorno alimentario. Tuve miedo. Pero espero que al final entiendan por qué elijo compartir mi historia y estos recursos con ustedes.

 Mi nombre es Janette Valenzo, soy primera generación Mexicana-Americana, y tengo una historia de bulimia, anorexia y ortorexia.

Recientemente compuse recursos de salud mental para BIPOC y LGBTQ +, hacer esto me ayudó a cimentar mi recuperación y a mantenerme enfocado en mi propia salud. A veces, cuando ayudamos a otros, nos ayudamos a nosotros mismos, esta es mi historia.

Creciendo Latina

Creciendo, estuve viviendo con los cuerpos más hermosos y diversos en el sur de Los Ángeles, mi propio cuerpo nunca fue cuestionado hasta que mi familia se mudó a los suburbios, allí estaba rodeado por una mayoría de guerras delgadas.

Fue alrededor de esta época en que llegó la pubertad y mis caderas se expandieron, mi estómago en gordo y me di cuenta del espacio que ocupaba.

Mi madre, en sus mejores intentos por hacerme sentir maravillosamente especial, decía cosas como “Así es como es tu cuerpo”. Se escuchaba muy agradable, pero también contradictorias cuando ella y mis tías también me llamaban “gordita.” Este es un término cariñoso en la cultura mexicana, pero se traduce a “fatty”. ¿Qué niño quiere escuchar eso? ¿Qué niña podría creer que su cuerpo era maravillosamente especial después de que le dijeran que gorda en inglés no significa hermosa?

Así que dejé de comer con la esperanza de poder cambiar mi cuerpo. 

Dejé de comer

Flaca no me salió fácil. Y no importa cuántas libras perdiera, nunca sería como las guerras delgadas.

Porque como decía mi mamá, “no puedes cambiar tus huesos.”

En un intento por abrazar mi latinidad en la escuela secundaria, comencé a buscar cuerpos que se parecieran al mío. Pero la típica latina retratada en los medios tenía curvas en todos los lugares correctos,tenía forma de coca-cola y estaba besada con el sol, yo no tenía nada de eso.

No era una guerra flaca, pero tampoco era latina con curvas. La bulimia me tomo mientras trataba de encajar en cualquier lugar que me llevara.

Mis padres intentaron ayudarme

Detrás de nuestras puertas cerradas, mi papá no entendió, Mamá hizo todo lo posible por ayudar en todo lo que pudo ,  ella hablaría sobre su propio cuerpo y su propia aceptación, pero cuando ella pensaba que no estaba mirando, podía ver que tenía sus propias inseguridades. 

Intentó otras formas de ayudar. Ella me daba pastillas para adelgazar cuando se lo pedía, supervisandolo. Sugeriría beber batidos con ella y me los preparaba,  pero cuando me fui con sus sugerencias sin ella, dejó de hacerlo.

Aprendí a ocultar aún más mi anorexia y bulimia. Y déjame decirte que podría ocultar eso muy bien. Porque no importa cuántos kilos perdí, nadie supo cómo llamar lo que me estaba pasando. No me veía lo suficientemente delgada como para tener un problema.

Me veía “promedia” y promedia no significa que “tenía un problema”. Entonces, sin problemas visibles, mi mamá intentó ayudarme con la última manera que conocía: alimentarme con amor.

La comida es amor

En nuestra cultura, la comida es amor. Comemos porque amamos. Alguien cocina para ti, comes porque los amas. Cocinas porque quieres que te amen tanto como a ti te encantaba cocinar para ellos.

Entonces cuando me alejé de las enchiladas, las tortillas y mucho más, estaba construyendo paredes entre mis padres y yo. La comida se convirtió en una barrera invisible entre mis padres y yo. Ya estuvimos en desacuerdo en muchas cosas. Para ellos fue difícil entender porque me quería asimilar a la cultura estadounidense. No podían entender mi esperanza de ser guerra y flaca. 

El punto que todo cambio 

Desafortunadamente, mi padre contrajo cáncer y perdió mucho peso debido a la enfermedad. Eso me puso cara a cara con mi trastorno alimentario. Mientras luchaba por comer, lo veía mirar la comida de una manera que me rompía el corazón. Aquí estaba el amor en forma física y él no se lo podía comer.

Todos los batidos que mi madre me preparaba una vez, los hacía para mantenerlo nutrido y amado. Comía para los dos con la esperanza de que se pudiera quedar.

Pero cuando se fue, mi ortorexia llegó porque no quería ocupar un espacio que podría haber sido de él. Tampoco quería enfermarme. Y la forma en que la sociedad nos dice que no nos enfermemos es comiendo sano y haciendo ejercicio. Bueno, lo llevé un poco lejos y terminé en un hospital psiquiátrico. 

Cómo me ayudó mi mamá

Mi madre me sentó fuera del hospital y me preguntó qué me había llevado hasta aquí. Me preguntó qué podía impedirme volver aquí y me instó a hacerlo. Cualquier cosa que tuviera que hacer, que lo haga, porque ella ya no sabía cómo ayudarme. Ella tenía sus propias luchas, y verme caer tan fuerte la estaba lastimando también. 

Y eso fue todo. Vi que lo que realmente necesitaba de ella era comunicación. Tener conversaciones honestas sobre cómo estamos lastimamos por dentro y cómo podríamos lastimar a los demás también, sin darnos cuenta de que lo estamos haciendo.

Estaba tan concentrado en mi dolor que nunca vi que estaba jugando un papel en las historia de los demás.

La admisión de mi madre de que estaba igual de perdida me hizo verla bajo una nueva luz. Sí, ella era mi madre, pero también era su propia persona y ella también había estado luchando. Comencé a hablar e interactuar con ella primero como persona y luego con mi madre. Nos ha ayudado mucho cuando no estamos en nuestro mejor momentos.

Esto me lleva a la segunda conversación que me acercaría un paso más a comprometerme con mi recuperación.

Cómo me ayudó mi hermana

Mi hermana menor me dijo que verme doler también la estaba lastimando. Me sorprendió. No porque  estaba lastimada, sino porque tenía miedo de decírmelo. Fue un ciclo que se estaba repitiendo.

Creciendo estaba aterrorizada de decirles a mis padres que lo que hicieron me estaba lastimando. Pero aquí estaba mi hermana incapaz de decirme que la estaba lastimando. Así que le dije que ya es suficiente. Esto termina ahora. ¿Qué puedo hacer para ayudarte? Ella me lo explicó todo y yo la escuché.

Todo lo que desearía que mis padres hubieran sabido, ahora se lo enseño a mi hermana menor. El conteo de calorías, las minucias en el espejo, las comparaciones, todo eso tenía que terminar conmigo. Es una pendiente resbaladiza y me niego a verla hacer lo mismo. Les he dejado explícitamente claro a mis tías que el peso no debe mencionarse como una indicación de cómo está una persona ni de quiénes son. Le pido a mi hermana que comparta lo que ama de sí misma. Le muestro diferentes  hermosos cuerpos de baile porque ella es bailarina y sé que eso viene con la presión de verse de cierta manera. 

Comunicarse y aprender

Siempre que veo que mis preocupaciones se reflejan en mi hermana, doy un paso atrás y me pregunto si me estoy haciendo daño a mí misma oa ella.

Y es cierto que a veces la necesidad de ser mejor para ella supera mi deseo de ser mejor para mí. A veces es más fácil para mí comprometerme con su salud que con la mía. Y por ahora está funcionando para los dos. Me comprometo con la recuperación con la esperanza de que ella nunca pase lo que yo pase.

Y veo la diferencia que la comunicación ha hecho por mi familia. Donde mi madre no decía nada cuando solo comía una comida pequeña al día o salía a correr en un clima de más de 100 grados, ahora ella es la primera en decir que pare y ofrece llevarnos a almorzar para hablar. Sonrío sabiendo lo lejos que hemos llegado.  

Lugares seguros para BIPOC

Al crecer, no veía un espacio seguro que reflejo quién soy. Me di cuenta de que este era el mayor factor decisivo al pedir ayuda. Quizás en una comunidad BIPOC podría haber hablado sin sentirme juzgado.

Porque soy latina y quuer, a veces me sentia perdida en la cultura americana guerra y heterosexual. Eso es lo que me inspiró a crear recursos de salud mental para BIPOC y LGBTQ+.

La salud mental no era realmente algo de lo que hablamos en mi hogar mexicano. De hecho, me dijeron que nunca lo mencionara. Cuando comencé a recuperarme, comencé a preguntarme por qué. ¿Por qué no estamos hablando de esto? Creo que las razones son personales, algo con la cultura, algo de género. Pero no hablar de salud mental se trata realmente de estigma, miedo y juicio. Y quiero que cambie.

Recursos de salud mental para BIPOC y LGBTQ +

Creer los recursos de salud mental para BIPOC y LGBTQ + porque mi ortorexia y anorexia han regresado durante esta pandemia. Si yo, una latina queer que ha pasado una década reuniendo recursos y aprendiendo sobre salud mental, está luchando otra vez con su recuperación, ¿cómo les va a los demás? Necesitamos saber que hay espacios para nosotros, especialmente porque nos sentimos cada vez más aislados durante este tiempo.

Compilé esta lista revisando Instagram, la plataforma de redes sociales donde me comparo con otros cuerpos. Si transformo Instagram en un recurso en lugar de desplazarme horas deseando ser esto o aquello, entonces podría recuperar algo de control sobre mi propia salud. Cada día que trabajaba en esta lista, me sentía menos sola.

Pero incluso mientras trabajaba en ello, vi que tenía que responsabilizarme por mi recuperación. Trabajaría en la lista y me “olvidaría” de comer. Pero después del segundo día, mi madre me llamó a esto. Mi hermana dijo que me estaba quedando vacía y que eso no ayudaría a nadie. Y finalmente le dije a mi novio que realmente apreciaba cuando cocinaba para mí, porque me recordaba lo que la comida realmente siempre ha sido para mí: el amor.

Sin comida no tenía amor, y con cada mordida me recordaba la razón detrás de la comida en nuestra cultura.

Admito que lloré escribiendo la oración de arriba. Me asusta revelar que todavía estoy luchando, incluso cuando comparto estos recursos. Pero esta vulnerabilidad es importante. No soy perfecto y no lo sé todo. Ninguno de nosotros sabe.

Consejos para los padres de BIPOC*

*Por favor tome esto como quiera. Entiendo que todos tienen experiencias diferentes y nunca le quiero decir a alguien como criar sus hijos. 

Mi consejo específico y sugerido para los padres de BIPOC es este:   escuchen y no tengan miedo de no hacerlo bien la primera vez cuando intenten ayudar a su hijo. Sepa que su hijo tendrá que luchar para aceptar sus propios ideales culturales de belleza y salud porque lo guerrero de los Estados Unidos tiene una influencia tan poderosa en nuestra versión de los estándares ideales de belleza y salud. 

Para los padres de niños de primera generación, entiendan que existe una curva de aprendizaje. Tiene sentido que los ideales sociales del nuevo país y los ideales del país de origen anterior choquen.

Acepte que su hijo está tan perdido como usted y necesita que usted esté abierto a aprender con él. Habla de tus propios problemas con imagen y comida. Comparta las presiones que ha enfrentado y cómo puede que todavía se enfrente, y escuche cómo sus hijos lo necesitan. Porque esa es la cosa: a veces podemos saber lo que necesitamos, pero tenemos demasiado miedo de decir algo. Como estaba con mi madre y como mi hermana estaba conmigo. 

Para aquellos niños BIPOC y LGTBQ + que luchan, no están solos. Hay espacios que te reflejan. Espero que esto ayude.

Janette Valenzo es una actriz, poeta, y defensora de la salud mental en el sur de California. También es escritora y ha actuado sus poemas en D.C., LA y OC; también su actuación de teatro la ha llevado a diferentes lugares en el país. Le encanta viajar internacional y localmente. Puede seguirla en Instagram @janettevalenzo 

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My story: perfectionism and eating disorders

My story_ perfectionism and eating disorders

In this personal story written by Emily Formea we learn about the link between perfectionism and eating disorders. She has some wonderful advice for parents facing similar challenges.

I struggled with an eating disorder for 10 years of my life! In fact, I suffered from multiple types throughout my decade-long war between me, my body, and my plate.

I was diagnosed with anorexia in the seventh grade. My eating disorder turned into the binge-restrict cycle as I entered college. Later, I became an obsessive dieter and restrictive eater. For as long as I can remember, I struggled with food, and for as long as I remember it was because of what it promised me.

I think there’s such a misconception around why people suffer from eating disorders. I always thought, “I must have just made up these rules in my head.” Or maybe I am wired differently for no apparent reason. But the truth was there was a very specific reason and personality profile that I possessed that kept me in my eating disorder for so long. It was perfectionism mixed with fake fairytales.

Perfectionism and eating disorders

I was a perfectionist to a tee. Organized, obsessive, and always controlling, I constantly tried to better myself, to achieve something, to feel worthy. Approval is something I sought in other people. My self-worth was based on earning straight A’s and achievements.

I was obsessed with trying to be ‘perfect’ and when diet culture entered my sights, my body became the target of my perfectionism. I later learned that eating disorders and perfectionism often go hand-in-hand.

So many people saw me a gifted kid, such a blessing, such an outstanding example of a young adult, etc. But deep down, I didn’t know how to calm down. I didn’t know how to relax, how to focus on myself and my well-being, how to not try to always fix others or fix my parents. I needed to be told that I was enough just as I was, and it wasn’t my job to always try to be perfect.

And this filtered into the way I struggled with food and my body image. I tried to ‘perfect’ my diet and my weight. My belief was that if I was perfect in all areas of my life, my parents would give me the acceptance and recognition I craved.

From a young age, social media, celebrities, TV shows, commercials, magazine covers, and more, taught me that successful, beautiful, rich, adored people in this world are thin. They don’t eat a lot and are always dieting or working out at the gym. They shoved this version of human value down my throat every second of every day. It’s so easy to fall into eating disorders when you suffer from perfectionism.

The fake fairytale of being thin

For me, perfectionism plus this fake fairytale in which success is measured by weight loss equaled eating disorders.

Eating disorders portray this false narrative where if you just lose some weight, all your problems will go right out the window! If you just lose 10 more pounds, then you’ll never be sad or feel insecure again. If you just eat fewer carbs, then people will love you and you’ll get a date to prom.

It’s this toxic mentality that got me deep into my disorder. I believed that if I was ‘perfect’ enough with my food, I would have a ‘perfect’ body and I would never feel sad. I would never feel lonely or anxious again.

This is the belief we must break to recover.

My parents were normal

My home life was normal! In fact, my dad hated diet foods or diet trends. He never let my brother or me count calories or fall into that mentality with food or body image. The only thing I believe that could have had a relationship to my food struggles and my home would have been that my mom was diabetic, so I think a small part of me always feared becoming diabetic. She was always counting her carbs or counting her sugars, and she needed to.

I don’t blame my mom! However, I think a part of me was more hyper-aware of food, calories, carbs, etc. than other kids were just because I was around it when I was growing up. But overall, my dad always wanted us to be active, but healthy and enjoy food freely! My parents never had a scale in our home. With food and body image, my parents were very safe and supportive of my brother and me! 

What I wish my parents knew

My parents have asked, “How could we have helped you? How could we have stopped it?” I think it’s challenging because my parents always felt scared to approach the subject with me. They felt like they were letting me down, they had done something wrong, etc.

I remember my mom telling me she just didn’t know what to do or how to help me when she knew I was hurting so much!

To parents, I always say, “Understand that telling your child to just eat more or telling your child to stop dieting won’t solve any problem.” I am the perfect example of that! My parents would comment on how I never ate enough or try to make me feel guilty for not having dessert with them.

I think they thought food was the core issue when in reality my core issue was my perfectionism and my low sense of self-worth or self-esteem. I wish my parents had not treated my disorder as something to whisper about or something that I was too silly to understand. Strangely, I think parents not only blame themselves, but they also don’t believe that the child knows what is going on or can help themselves.

For me, I always felt watched by my parents. My parents knew I wasn’t eating enough or was losing a lot of weight quickly, but they never came to me with that worry. They never brought up the subject with me. They never really asked me how I was doing or was I really hurting. It was more than just watching me to make sure I was eating enough, and if I wasn’t, they would make me eat more. 

My parents did the best they could

I think my parents did the best that they could! There is so little information out there for parents who have kids with eating disorders. They didn’t know how to help me or what was truly going on in my head. I would say to parents:

1. Don’t treat your child like they don’t know what’s going on. I knew I was struggling with an eating disorder. I just didn’t know how to stop it.

2. Don’t just keep pushing food into them. Try to find the root problem or pain that caused them to struggle with food in the first place.

3. Make them feel safe. That you don’t blame them for having an eating disorder. Let them know that you trust them, love them, and want to help them.

4. Never make them feel watched. I know this one is hard, but this created a separation between my parents and me. It seemed like I was always being watched or talked about, but never talked to. I felt like my parents sometimes thought I was trying to trick them or bamboozle them by not eating instead of recognizing how much pain I was enduring and how I just didn’t know how to help myself.

How I recovered

I finally recovered after battling a 10-year eating disorder in 2019 just after I graduated college. My parents were not involved in my treatment. Part of me wishes they were involved, but part of me does not. Let me explain:)

I think I would have gotten more frustrated had they been involved once I was an adult. When I recovered, it was because I wanted it for myself. I set my mind to it on my own. So I took control of my recovery. But I wish my parents had approached the subject sooner rather than me having to come to them with all this baggage from years and years!

I think just knowing that they loved me, that they were there, that they really had always tried their best, made me confident to seek treatment on my own.

What finally did help me was being open and honest with them and having them apologize for not fully understanding. It also helped that they renewed their trust in me. I know that I broke my parents’ trust by hiding food or lying about it. But when I started to recover, I needed to know that they supported me and trusted me!

I needed them to understand that I didn’t want to not eat, I just needed time to heal.

Here’s what I think kids need from parents during recovery:

  • See them as trustworthy
  • Help your child feel safe and supported
  • Don’t act like your child brought this upon themselves
  • Give them time to heal
  • Don’t speak about eating disorder recovery as if it’s really as simple as just eating more
  • Help them feel seen and heard
  • Listen with an open heart
  • Don’t get frustrated

My parents definitely did the best they could. And their support once I entered recovery was important! I’m so glad to be on the other side of my eating disorder now.

Emily Formea is the founder of Sincerely, XO Emily. She provides eating disorder recovery coaching specifically for people who identify as perfectionists. Her 6-week Food Freedom online course includes topics like food obsession, identity, perfectionism, and control. Her book, Gaining a Life, is her story of eating disorder recovery.

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Our daughter’s multi-state, multi-facility anorexia treatment process

Our daughter’s multi-state, multi-facility anorexia treatment process

By Ariel Selwyn

In the Spring of 2018 my 13-year-old daughter wanted to “eat healthy.” There is nothing wrong with eating healthy, I thought. I am a certified health coach and am a huge advocate of eating healthy. My daughter began reading food labels on some things and I thought, I’ll keep an eye on that. This went on for a few months with no other signs of anything unusual.

Until, one day we were riding in the van with my daughter and her two younger siblings and the two littles asked if we could grab some lunch. I happened to look in the rearview mirror at the same time. My daughter had a look of fear come over her face. That’s the instant I knew that something more serious was going on. I made a mental note to talk to her later that day.

Later on I asked her, “are you just wanting to eat healthy or do you feel guilt or shame when you aren’t able to eat a certain way?” She burst into tears. Yep, this was more serious than I had originally thought. I told her I would get her professional help and not to worry. We would handle this and it would be ok.

Parenting for positive food and body

She said that she didn’t feel fat, but she was afraid to eat certain foods and she wasn’t sure what was happening. She said she would feel out of control sometimes with food and feel the need to exercise in her room to make up for it. I knew these feelings all too well, as I had battled an eating disorder myself.

I Googled professional help in the area and the closest I could find that looked like an appropriate place that also took our insurance was a center in Northern VA, about an hour and a half from our house. I made an appointment right away. It took a few weeks to get my daughter seen and in the weeks leading up to the appointment I found out there were days that she was only eating cucumbers and blueberries. I began to sit with her at every meal to make sure she was taking in food. At this time my daughter obliged as long as I was there sitting with her.

Finally, our appointment came and after several hours of many thorough questions we admitted my daughter to an intensive outpatient program which was an all-day program six days per week. It was exhausting with the traffic and the long drive on top of work, but it was worth it. My daughter was there for about a month.

However, things snowballed as the eating disorder became stronger and my daughter’s weight dropped as she ate less and less. She was admitted to Children’s National Hospital in Washington DC and a feeding tube was put in place. My husband and I took turns staying overnight with her. She was there for about five days and transferred from there to a treatment center in NC where she remained for four months.

During her time in NC, she was on a rigid meal plan with goals put in place by her team. If she didn’t meet those goals with food intake, they would present her with an Ensure supplement. If she didn’t intake enough by mouth of the food and/or Ensure, then the feeding tube would be put back in place. The tube went in and out at various times during the four months.

Even though we knew she needed this level of care, including a therapist, psychiatrist, primary care doctor, around the clock nursing staff, dietician and around the clock therapist assistants, she also unfortunately picked up other behaviors from being around other patients, including self-harm. Maybe this would have happened anyway. There is no way to tell. But some other patients there were engaging in self-harm, and my daughter hadn’t engaged in this previously.

My husband and I took turns traveling to NC every weekend. We took off work most Fridays to be down there as much as we could. We got special permission from her team to eat as many meals with her as possible, and I coached her through as many meals as I could, battling the lies of the ED with her.

However, once observing these new behaviors (e.g. self-harm), we decided it was time to move towards getting her home more quickly to get her away from the environment so she wouldn’t pick up any more behaviors. We also thought home would be the best environment for her.

parent coach

Unfortunately, this plan backfired. Although we had come home with a meal plan and were trying to put an outpatient team in place, it wasn’t enough. Once we saw that she had lost weight in two weeks we knew something was up. We asked, and she told us she had been hiding and throwing away food without us knowing. This was partly our fault as parents for not watching her closely enough. However, there also needs to be responsibility and trust on the child’s part or it will never work. They need to want recovery or it will never be lasting.

At this point we had to admit her back to Children’s Hospital. While at Children’s Hospital they reinserted the feeding tube and said that they would not allow her to return home until she was eating 100% of all meals and snacks. She hated it at the hospital, so she obliged and was home in a week.

Unfortunately, it didn’t end there. She stopped eating again as soon as she got home, and we had to re-admit her back to the treatment center in NC. She stayed there for seven months with a feeding tube the entire time other than two weeks with no food intake at all other than a couple of snacks. She seemed to have lost all motivation, and the eating disorder was stronger than ever. She shut down emotionally as well. She no longer wanted to talk to us as parents and didn’t see any point in talking to her therapist.

It was devastating and hopeless. We had family therapy and group therapy, but we weren’t getting anywhere. My husband and I were exhausted from the traveling, and I was emotionally exhausted from worrying and feeling hopeless. It was draining on the entire family. The other kids were tired of mommy and daddy being gone and didn’t understand why she couldn’t just get better. We all knew it wasn’t her fault, but it was hard to hear her say things like, “I don’t want to recover” when we were trying so hard.  

After around Month 5, her team said that they could no longer help her and they wanted to transfer her to another facility. This was like a punch in the stomach. How long would this go on? They wanted to transfer her to another state even further away. How would we handle that? It was already so stressful on the family. We have three other children.

Although the two-month process of submitting applications to one treatment center after another was long and difficult, we are overall thankful that one door closed after another as far as the long-distance facilities were concerned. After the long wait, a spot opened up closer to home in Northern Virginia, only a little over an hour away.

The transfer was difficult and there were many adjustments that had to be made, but we are thankful that she has opened up to us again and gained some motivation. We are thankful that she began to take in food by mouth again.

It wasn’t all rainbows and sunshine. After only one day in the eating disorders unit, she had a self-harm episode and had to be transferred to the mental health unit for two weeks. Thankfully, she hated this unit so much that it was enough motivation for her to stop the self-harm, at least for now. We are thankful for this improvement. This facility is not perfect. We have had some issues with the nurses and director not being kind and we have had to address this. However, there have been positive things that have come out of it like my daughter getting some motivation back and her clicking with her therapist.

It has been  a long journey. It is so hard when the eating disorder takes over and you have to hear your child say they don’t want recovery. My heart would break when I spoke to my daughter, and I couldn’t fix it for her. My heart breaks when she is sad, and overwhelmed and scared and hopeless and I can’t make it all better. My heart breaks that there are treatment centers all over the US and even worldwide because our children are suffering with this and there are children out there not getting the help they need.

If you have a child who is suffering, please get them professional help and know that you are not alone as a parent either. They need you. They need to know that you are there for them without judgment. They need to know that it isn’t their fault because they didn’t ask for it and they don’t know what is happening to them.

There are times that I am not proud of. There are times that I let my frustration and exhaustion get the best of me. There are times I forgot that it was the eating disorder speaking and acting out and not my daughter. Looking back, I wish at those times I would have had more patience. So, for you, get help. See a therapist. You need support too. It wasn’t until towards the end I realized I needed that support too. Hugs, my friend. You can do this.

Thankfully, after trying many medications, the right dose of Lexapro was what did the trick for my daughter. She is finally home and living and eating freely. We are SO thankful to have her home again and to witness the freedom she is enjoying with food. We know that the chance for relapse is high, and I know that from my own experience as well. 

I battled my own eating disorder. Mine started in college and I relapsed multiple times as an adult. I didn’t get control of mine until my mid-thirties when I was put on the right dose of Lexapro. For more on my eating disorder story and recovery, you can find my book, Though the Mountains be Shaken

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Helping a child recover from an eating disorder prepared me for parenting in a pandemic

by Oona Hanson

Some of the most poignant essays about parenting during the coronavirus have come from families who have already experienced a quarantine or the sustained care of an immunocompromised loved one.

I started thinking about how living through a child’s serious illness helped build my own family’s resilience and confidence as we prepare to weather this current storm. 

Having a child develop a life-threatening eating disorder and undergo a number of different treatment programs (all of which were traumatic in their own right) taught us so many skills that are applicable in this moment. I am deeply grateful for the painful lessons we learned.

1. Opting out of socializing is nothing new to us

During certain phases of the illness and treatment, we were house-bound. For nearly a year, eating in restaurants wasn’t an option because it would paralyze our sick child with fear. Staying home to monitor meals and physical activity became a new normal. At other times, we simply didn’t have the energy to see friends. Even though I’m extroverted by nature, I had a physical aversion to being in a group or making small talk. Self-isolating was the choice I had to make for my own self-care, even when it meant making sacrifices. Knowing I turned down the chance to cheer on my beloved Dodgers (from a private box!) reminds me I can survive without longed-for special outings and celebrations.

2. Panic-buying, hoarding, and rationing don’t ruffle us

The responses to seeing long lines or empty grocery store shelves make perfect sense when you consider how evolution has primed us to endure the threat of famine. A feeling of scarcity can trigger a variety of behaviors intended to boost the chances of survival for an individual or their family group. Understanding these biological reactions helps me withhold judgement of others and keeps my own anxiety from spiraling when I see certain supplies running low.

3. We aren’t afraid of meals and snacks that aren’t “fresh,” “perfectly balanced,” or what diet culture would deem “healthy”

We had to kick the diet mentality to the curb a long time ago, so we already follow this mantra: all foods fit. Comfort food is always welcome, and we know it’s normal to have particular, often nostalgic, cravings during times of uncertainty. Rather than worry about calories or micronutrients, we know we’re better off reducing our anxiety around nutrition and that neutralizing foods–not elevating or demonizing them–decreases their power over us. Our new approach to eating, more relaxed and peaceful, is actually healthier than ever. 

4. We learned how to menu-plan

I had long aspired to be someone who could plan ahead and shop for a week’s worth of groceries, but I never seemed to follow through–until I had to. During the nutritional rehabilitation phase of family-based treatment, we had to plan out three meals and three snacks a day–taking into account the need for variety, high energy content, and systematic exposure to “fear foods.” Meal-planning and shopping became like a puzzle that demanded focus, creativity, and flexibility–skills we are using regularly during this new normal of socially-distant, hit-or-miss grocery shopping.

5. We know it’s okay to mourn the little things

Although health and safety are always the top priority, we learned how important it is to grieve the loss of other parts of life–the cancellation of long-planned adventures, once-in-a-lifetime experiences, and what-would-have-been annual traditions. It’s important to let ourselves feel sad when our hopes and dreams–and even our ordinary expectations–are dashed.

6. Relaxing certain rules can be healing and joyful

At an intensive eating disorder treatment program, we were shown the power of meal-time distraction for patients learning to eat again–in the form of watching old episodes of “The Office.” It was hard at first to let go of our old “no-TV-at-dinner” rule (other than during baseball playoffs, that is!). It helped us see there are times for putting aside rigid rules when the game changes; different seasons of life call for different approaches–not to mention the fact that enjoying humor as a family can buoy you through some really stormy days.

7. We’ve learned how to discuss hard things

Talking openly about mental health is a skill we had to develop. It’s such a relief now to be able to check in with each other and be able to speak more matter-of-factly about painful feelings. Being open and direct about the tough stuff didn’t come naturally to us, but it got easier with practice.  

In our darkest days, it was hard to find hope, particularly as eating disorder recovery is seldom a linear process. Fear, especially of the unknown, can make it nearly impossible to function. But it doesn’t have to break you. 

I believe wholeheartedly in the possibility of post-traumatic growth. And I recognize it’s a great privilege to have access to the support and care you need to get through pain and loss in one piece.

All parents are struggling in one way or another right now. And I’m hopeful families will come through this experience even stronger, with deeper wells of gratitude, resilience, and wisdom. In the meantime, we need to go easy on ourselves and remember that this, too, shall pass.

In education for over twenty years, Oona Hanson works as a parent coach, supporting parents of teens and tweens. Passionate about helping kids develop a healthy relationship with food and their bodies, she runs the Facebook page “Parenting Without Diet Culture” and gives parent education workshops on body image resilience and eating disorder prevention. She holds a Master’s degree in Educational Psychology and a Master’s degree in English. Oona lives in Los Angeles with her husband and two children. You can follow her on TwitterInstagram, and Facebook: “Oona Hanson–Parent Coaching.” To learn more, visit

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A mom’s story: An eating disorder? No, not my child!

A mom's story: An eating disorder? No, not my child!

Following is an excerpt from the book By Their Side: A Resource for Caretakers and Loved Ones Facing an Eating Disorder. The book is filled with personal anecdotes and helpful advice for parents who are facing a child’s eating disorder diagnosis and recovery.

An eating disorder? I didn’t even know what an eating disorder was! But what I did know was that something was not right with my child. Actually, something was terribly wrong!

A missed diagnosis

Her lips were blue—why was that? The pediatrician said the erratic behavior, crying, defiant reactions, odd immaturity, and withdrawal were just hormonal and that this, too, would pass. She actually commented on Sten’s weight loss and how she must have taken good care of herself that summer at camp.

“You look good,” she told Sten.

The pediatrician was wrong. It did not pass.

I have lived a colorful life, seen some of the worst the world has to offer, and experienced the best. Gifted with wisdom, experience, street smarts, and a strong female psyche, I was afraid of little. But this? This confused me.

I did get scared. I was afraid. I could not tap into my own wisdom for answers, and my forty-two years of experiences did not offer me any peace.

My young daughter, at thirteen years of age, was just as confused as I was. Neither of us had experience with anorexia, and neither of us knew the destructive, self-loathing force we were about to face!

Parenting for positive food and body

The fog of guilt

For two years, I lived in a fog of guilt after my child was diagnosed with an eating disorder by a specialist and then hospitalized. I constantly questioned myself, wondering how in the world my child could have this problem: No, not my child. I know her better than anyone else on the earth. She’s complex, but no way could she have a mental disorder!

I’m a great mother. What did I do wrong? I have given all of myself to raising children. Our family is good, well respected, and resourceful. We functioned as a perfectly healthy family. I’m a really loving mom, and I have a grounded marriage and great kids. How could this have happened?

Well, it did happen, and sadly, I lost my confidence those two precious years to self-ridiculing guilt. All those things I’d wondered were from my misguided perspective on how I viewed my healthy life.

Keeping secrets

I was tight lipped about my daughter’s illness because I thought it would protect her from others’ judgment. I did not want her to be labeled. I was also hesitant to admit to my child’s illness, so I did not confide in friends or family.

I did not want to put this type of pain on my siblings, mom, or dad, so I pushed them away, acted strong, and thought I could fix my daughter’s issues because . . . for God’s sake, I was her mom.

I was scared. Scared to death of losing my child to anorexia, scared of losing my own self, and scared of life imploding around me. Internally, I was sad and constantly obsessing. I blamed my husband, I blamed family genetics, I blamed athletics and unprofessional doctors, dietitians, and teachers. I was lonely but wrote the loneliness off to being misunderstood.

My marriage was almost destroyed, and the way I handled—or should I say neglected—my other two children had moments of negative dysfunction. By being secretive about the illness, I was protecting my child’s reputation—or so I thought. Really, maybe I was worried about my own!

My feelings were real, but it was my perspective that kept the guilt alive. The guilt was about me! There was no need to air all our dirty laundry, but there was a desperate need to ask for help.

Asking for help

Then, finally, I realized there was no shame or weakness in asking for help. So I did. It was at that point that the hard work of healing began and I refocused my energy. I asked for help from friends, family, and professionals.

Just like my child and my family, I, too, began learning coping skills. That was twelve years ago.

Today, after family counseling and intense honesty, we are comfortable being not a perfect family but an honest, loving family. With hard work, our marriage has made it, and it is more robust and based in truth than before.

Yes, we had bruised hearts, and it hurt like hell—really hurt. But with commitment to genuine, unconditional love, we healed. And yes, there is scarring, but we’ve learned how to address the past blamelessly and honestly.

We were forced to dig deep into our psyches and sincerely lean upon our faith. Our love and respect for one another is far greater than it was a decade ago.

parent coach

The aftermath of an eating disorder

Today, we are great together. We know more about who each of us really is and accept the differences, all while working to prop up one another’s hopes and dreams.

Our daughter, who battled a severe eating disorder for eight years, just graduated college and is living in another state, having fun, working full time, being social, interesting, and responsible, and enjoying a healthy life. There was a moment in time when her success was against all odds. But she beat the odds; we beat the odds, and we are better people for it.

Are we perfect? Absolutely not! There is no perfect. But we have forgiven each other, and we have forgiven ourselves.

—A once-scared mother

By Their Side: A Resource for Caretakers and Loved Ones Facing an Eating Disorder

By Their Side: A Resource for Caretakers and Loved Ones Facing an Eating Disorder provides an excellent overview of what loved ones need to know about caring for someone who has an eating disorder. Written by a collection of families, friends, and healed advocates, it includes stories of what it’s like to love someone who has an eating disorder as well as helpful information about eating disorders and treatment options.

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What to do when your loved one has an eating disorder

by Reba Tobia

If your loved one has an eating disorder, you may have a lot of feelings that you don’t know how to handle. As someone who has been through eating disorder recovery, I’d like to offer you some insight. 

Helping a loved one who has an eating disorder isn’t easy, but your love can make a world of difference. I’ve identified three main points that I know will give you clarity, a new understanding, and support.  

First off, give yourself a pat on the back. You’ve already taken the first step, which is accepting that your loved one has a problem. Eating disorders are serious, and they are rarely spoken about or understood. By accepting your loved ones’ eating disorder and seeking understanding, you’re already helping. You have chosen to not ignore the facts or sit silently in fear. Instead, you have taken action to understand. I’m glad you’re here! 

Here are three things that I think everyone should know when they have a loved one who has an eating disorder: 

1. Your loved one doesn’t know how to help you 

Your loved one has just been diagnosed with an eating disorder. Hearing this diagnosis can be terrifying and invoke feelings of denial, fear, anger, sadness and pure, utter, confusion. The last thing this person knows how to do is to help you. They are suffering immeasurably. Their focus, right at this moment, is trying to figure out how to un-hear the words, “you have an eating disorder.” 

In fact, their only goal right now may be to convince you that you don’t need to do anything. That you don’t need to worry. They may also be desperately trying to convince those around them that they’re “okay” and that “it’s not that bad.” They are not going to be able to vocalize to you what they need, because in reality, they don’t know what they need. 

I know it would be a lot easier if your loved one came to you and said “I’m suffering, and this is what I need.” I wish that were the case, but it’s rare. Most often, people who have eating disorders ask the opposite of those who love them: don’t pay attention. Don’t look. No need to worry about it. This is because the disorder has become an important part of how they deal with living.

While reading this, you may be feeling extreme frustration; and that is okay. It can be so difficult to know how to help. It’s hard when the person you love dearly is not able to tell you what they need. This is your opportunity to step up to the plate, to rise to the occasion and educate yourself about eating disorders.

Connect with a therapist who can help you understand, read articles and books, listen to podcasts and attend seminars. Never, for one minute, believe that it is your job to do nothing because your loved one hasn’t “told” you what to do. 

You see, the person struggling with this illness may not be able to tell you how to help for a long time. They must grapple with their diagnosis first. With their team, they will learn new information and ways of thinking. Attending groups and therapy sessions will, slowly but surely, help them learn to ask for help. Do not give up on them, and please, remind them how much you love them, every single day. They need to hear it, even if you think they don’t. 

2. Recovery takes time

Most eating disorders are not instantly or easily overcome. It takes time, sometimes lots and lots of time. There is no timeline to healing, and everyone’s journey is vastly different. Healing from an eating disorder is rarely linear, and requires tremendous patience and endless hope from loved ones. 

There is no prize for the fastest recovery. And many times a slow recovery is exactly what your loved one needs to be healthy. I understand how hard it can be to watch your loved one struggle. 

Please don’t tell them that they aren’t working “hard enough” or that they’re moving “too slowly.” I’m not saying you don’t get to be frustrated – you do! It’s just better to explore your frustrations with your own supports. Telling your loved one to pick up the pace of recovery won’t help them recover.

Your loved one’s body will likely change during the recovery process. But even though some eating disorders are visible, many are not. And most of the time you can’t see an eating disorder any more than you can see recovery. So don’t assume that because your loved one looks healthy to you that they are fully recovered. 

The real work, the grit, sweat and painful stuff of eating disorder recovery can’t be seen. And it typically happens long after they body appears stable. The mental work is the most challenging, most heart-wrenching work of recovery. It takes time and patience. So please don’t cut off treatment based on how your loved one appears. 

3. Your loved one will change

Eating disorder recovery changes a person in the most beautiful, astonishing and remarkable ways. Maybe you adore the changes you are seeing, and maybe you don’t. In recovery your loved one will grow, find their voice, and figure out who they want to be. 

It’s possible that the process of doing this will be messy and hard for you. Maybe their new values don’t seem to align with yours. That doesn’t mean they’re doing it wrong or that you can’t love them. Remember that the person you loved was engaged in an eating disorder, and their recovery will require them to change. 

Recovery often feels like stripping away everything you had and knew. For a long time, your loved one lived with a mask on. They were hiding under fear, shame and guilt that was wrapped up as an eating disorder. As recovery progresses, this mask is removed, and that person is the person you love. 

You may notice that as your loved one recovers, they stand up for what they believe in. They advocate and protect themselves more than ever before. At the same time, they may be more vocal and display more assertive communication skills. 

This is actually part of eating disorder recovery. Your loved one is learning how to effectively communicate their needs. But that also means telling people when something doesn’t feel good. This is what it means to live recovered – to live without a mask. And it can be a hard adjustment for everyone. 

Yes, your loved one will change. They will not be the same person you knew when they were in their eating disorder. They will be stronger, braver, more empathetic and sensitive than ever before. They will have a beautiful array of coping and communicative skills. Eventually, they will even have a mindful and peaceful relationship with food, which is truly rare. 

Please let them discover who they are and allow them to freely grow. You don’t have to agree with everything they say or do. But you do need to respect this new self they are coming home to.

My own experience

In my case, I can honestly say that my heart has most certainly grown bigger by going through eating disorder recovery. My love for those who support me is deep, and my compassion for others with mental illness is vast. I am brave. I am strong. I am curious. I am playful. I am silly. I am love. 

I am thankful to be at a point in my process where I am grateful that having an eating disorder is a part of my life story. I am proud of who I am. And I am who I am today because of my recovery. I found my heart and purpose in this world.

So hold on and don’t give up. Let your loved one deny, grieve, cry, and fall. And then, watch them grow. 

Reba Tobia, a Massachusetts native, is the creator and founder of The Brave Box, which offers gift boxes for loved ones in recovery. She has been in recovery from an eating disorder for the past 5 years. She is passionate about sharing her story, and reminding others that they are not alone. Visit The Brave Box Website

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Our family’s story of our 13-year-old daughter’s recovery from anorexia with Family Based Treatment (FBT)

family based treatment for anorexia

Many families who have a child with anorexia nervosa will hear about Family Based Treatment, or FBT. It is an evidence-based treatment and for anorexia. Here’s one family’s story:

By Anonymous

My daughter had a brain tumor at age two. It caused morning vomiting through age 6.* She survived due to early intervention. This included craniotomies and physical therapy.

She was diagnosed with social anxiety at age 6. She refused to drink water at school because she did not want to use the bathroom at school. I remember her telling me about a teacher who commented negatively on her snack of a cupcake. She also had a paraeducator telling her that sugar is as addictive as cocaine.

These are some of the memories I have that help me make sense of the anorexia. It seemed to develop in a matter of weeks.

We compiled a list for the doctor:

  • Changes in diet (won’t eat whipped cream, butter, regular cheese, ham)
  • Cooks, but doesn’t eat what she makes
  • Eats really slowly and seems to play with food more than eat. After she eats, it looks like a mess (food all over the place)
  • Eats really small portions
  • Feels guilty after eating (cries)
  • Fascinated by cooking shows and recipes, but doesn’t eat
  • Does jumping jacks after eating
  • Smells like fingernail polish remover
  • Moody and Emotional
  • Seems cold and wears big jackets all the time
  • Sleeps a lot
  • Wants me to take her to the gym all the time
  • When she takes off her big sweatshirt, I’m shocked because she’s very thin

My husband and I met with the doctor first. He asked us if we have a scale in the house. We do. He told us to take it out of the house. Once it’s gone, she notices it is missing and I say it’s broken. It has been “broken” ever since.

Visiting the doctor

That night, I tell my daughter that we are going to see the doctor. When I check her phone I find that she has visited a website that tells her how to “cheat the doctor.” I’m devastated. I’m angry. She just got the phone a few weeks ago, and this is what she’s looking up? This is the moment I am certain that my daughter has an eating disorder.

The doctor meets with my daughter and evaluates her. He tells her she needs to gain weight. At home, she spends hours crying. He calls later and says she needs blood work and an EKG. He gets her admitted to the hospital. We feel relief. The children’s hospital doctors tell me that my daughter is very ill. She must be hospitalized for at least 5 days, but maybe a few weeks. She is told she must eat or she will get an NG tube. There is no negotiating or pleading, this is just the way it is.

Family based treatment for anorexia

Anorexia nervosa is a monster and it has a stronghold on my daughter. It also has a 20% mortality rate (often suicide). This is the highest for any mental illness, so I’m scared to death of it taking my daughter’s life.

She’s 13. The best chance of recovery from anorexia is Family Based Treatment, or FBT. This includes intensive meal support, and we parents oversee three meals and three snacks daily. I check for hidden food (sleeves, cheeks, pockets, trash can, etc). I check that food is eaten and swallowed (mouth check before leaving the table).

After leaving the table, she has to sit with the family and play a game, watch TV or do homework. She is not allowed to use the bathroom (for fear of purging or flushing food she somehow hid). We can’t let her go to her room, because she does jumping jacks to compensate for the meal she just ate.

So much sadness

Our daughter is suffering and there is a lot of crying and sadness.

We have to encourage her to eat at a decent pace (ideally less than 30 minutes). She wants to cut her food in tiny pieces. She’ll move it around her plate and let it fall to the floor. We make her eat it at a swift pace. She is not allowed to plate her food and must eat everything on her plate. In fact, everyone at the table has to clean their plate.

We band together as a family, my husband, myself and my 10 year old. We fight the monster (anorexia) that wants to starve my child. My child who has anorexia can not help with grocery shopping or food preparation. I black out the calorie content of any prepared package food I serve to her.

She tells me about low fat alternatives and wants to eat vegan. We do not allow this, but we allow her to choose 3 foods that she can refuse to eat. The food she chooses to reject are tomatoes, bananas and eggs.

Pulling together as a family

Every week, we attend family based therapy. At the beginning of each session my daughter is weighed. If she puts on 1-2 pounds, we parents are applauded, and my daughter cries the rest of the session. If she does not put on weight, she smiles and we work with the counselor to develop new strategies.

I learn that is difficult for an adolescent to put on weight. So I buy high calorie snacks and nutritional drinks to help with the weight gain. The counselor tells us that we cannot only serve “safe” foods (pop-chips, salad, whole wheat pasta with lean chicken). We must also serve “fear” foods (caramel, chocolate, soda pop and pizza). We give her fear foods when we are feeling strong enough to take on the monster. Sometimes I trembled after those meals.

The impact of family based treatment for anorexia

My younger daughter misses eating pizza and ice cream with her older sister. She seems sad as her older sister’s personality changes for the worse. At one time, my younger child told me she wished she could die. I realize it is really important to get her out of the house away from the disease. Trouble is, she doesn’t want to leave. Perhaps she is scared of losing her sister?

Personal fallout

The stress gets to me and I see a counselor for anxiety. I see a medical doctor for anxiety medication and an occupational therapist. I developed Irritable Bowel Syndrome and suffer from frequent back aches.

The only part of my life that is a break from the disease, my job, is something I felt forced to resign from. There were so many appointments (individual counseling, nutrition therapy, family counseling and medical). And my manager felt I wasn’t pulling my share of the weight at work. FMLA would have protected my job during this period of intense caregiving. But before I knew of the illness, I switched jobs. I was still on probation when she was diagnosed.

After eight months of FBT, the family counselor thought it best for the me to send my daughter away for therapy full time. I felt some relief at the thought of a break, but my daughter started gaining weight after we talked about “sending her away”.

Sometimes I find moldy food hidden in slippers or spit in trash cans and I cry. Will the anorexia take my child’s life?

We share very little about the disease with friends, for fear of adding to my daughter’s stress. Our goal is to avoid exposing her to the potential stigma associated with mental illness. We feel very isolated.

The recovery from anorexia with family based treatment

We sign up to be volunteers at the local food bank. She enjoys volunteering and we make it a routine. She wants to play volleyball, go to the gym, or play softball. As she gains weight, she is allowed to practice softball for an hour a week. Hours are added back based on her recovery.

Eventually, 13 months in, she hits her fear weight and she doesn’t cry. She asks us to buy her candy. The monster seems to be gone.

At a healthy weight

Now it is 17 months later and my daughter is much better. At her last medical visit she was a very healthy weight. Her fear foods are no longer and we don’t supervise every meal. She can play softball everyday after school and she can participate in PE class.

She still has problems making and keeping friends. Recently, when she broke with a good friend, we caught her drinking from our hard alcohol. Now we lock our alcohol in a safe. We have made contact with a counselor at school who would love to help her. She is refusing further counseling, so we decide to limit her freedoms instead.

I cringe at every mention of “clean” or “healthy” food or trendy diets. I just wish we, as a society,  could focus on teaching our children to enjoy food and love their bodies. I’m tired of this anti-obesity campaign. It could kill my child.

* A recent study conducted by USC found that pediatric brain tumor patients face increased risk of interpersonal and emotional distress.

  • 25% of respondents reported that the patient had trouble making and keeping friends
  • 20% reported that the patient feels isolated and alone.

Interpersonal and emotional distress has been correlated with eating disorders. So while this child’s childhood illness is not a stand-alone “cause,” it is an important part of this family’s anorexia story.

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My adult child hid her eating disorder from me for decades – here is what I would change about how I raised her

by Anonymous

My sweet girl slipped right through my fingers. A lovely, well-adjusted child right up until puberty began at about 11 years old, she spent her adolescence and young adulthood battling an eating disorder that I didn’t even know about. I missed the symptoms and cries for help, and I’m still struggling with my guilt that I did not help her.

I did the best I could. I know this. I love her and gave her the best care I was able to. But the fact remains that she was hurting, and I can see that there are signs I missed and steps I could have taken to help her.

Today, I see more clearly the things I could have done differently for my daughter. When I found out about her eating disorder, I was faced with two choices: bury my guilt or examine my role. The funny thing is, burying my guilt, which I did for a while, was actually more painful than shining a bright light on my parenting and allowing my past mistakes to inform my behavior today. I have found peace in giving myself compassion even as I learn more about our past and intentionally build our future. I can’t say it’s easy, but I am much happier today than I was when I was trying to avoid looking at my role in my child’s eating disorder.

I did the best I could. I was young. I didn’t understand what my daughter needed from me. She was hurting, and I didn’t know what to do. I can say this with self-compassion and without shame because my daughter is still here. There is still time for me to be the parent she needs.

Here are the lessons I’ve learned in hindsight and the things I’m doing to help my adult daughter recover from her eating disorder.

1. Hold her closer

My daughter seemed happy and well-adjusted in elementary school. When she entered puberty, she changed. She seemed angry and secretive and started to pull back from me. The truth of the matter is that I had a lot going on at the time, and I was both hurt and relieved when she seemed to need less of me. I allowed myself to believe that all teenage daughters are “difficult,” which protected me from the hurt I felt every time she lashed out at me or ignored me.

Now I can see that my daughter desperately needed me to be an active parent, but I behaved like a hurt child. I’ve learned that my own parents set the stage for how I handled my daughter during adolescence, and it was with a 10 foot pole! My sweet girl needed me to hold her closer, but I sort of just held my breath, hoping we could emerge intact when she “got through” her teens.

Today my child is an adult, and we did get through her teens. But it came at a cost to her health and our relationship. I can’t go backward and re-do her adolescence or take away her eating disorder, but I am talking to her while she’s recovering, and I know that I can still help her. I keep learning what I can, showing up, asking her questions, and reflecting on my behavior as she navigates eating disorder recovery. I look carefully at my automatic, defensive responses when something she says or does triggers me. And I do the best I can today with what I know now.

2. Listen, don’t lecture

When she was a teenager, my daughter was infuriating to me. She was sometimes sneaky and lied. I knew she was doing something “wrong,” but I didn’t really know what. I spent a lot of time lecturing her about morality and good behavior. She sat silently through my lectures with a smirk, which just enraged me further.

Now I know that my daughter was actually lying and sneaking around – with her eating disorder. Yes, there were other things she was doing, but her most fundamental “crime” in adolescence was her eating disorder, which she hid with great skill. I’ve learned that people who have eating disorders hide what they are doing, but that doesn’t mean they don’t want to be discovered, especially by their mothers. I didn’t realize this at the time, but by lecturing instead of listening I missed the opportunity to catch the hints she gave me along the way. My lectures just drove the eating disorder deeper into hiding.

Today I’m learning to listen. I’ll be honest – it’s hard. I feel compelled to give my daughter advice to help her navigate her recovery faster so that she can feel all better. I keep reading about eating disorders, and I really want to give her advice and information about what I’ve learned. But I’ve been practicing mindfulness, and instead of saying everything that comes to mind, I watch thoughts go through my mind and stick to listening instead of lecturing. I am not always successful, but I’ve noticed that the more I listen, the more my daughter relaxes with me, and the more she speaks up about how she feels. I know that her being able to speak to me about her feelings is an excellent sign that she is recovering from her eating disorder.

3. Learn about myself

When my daughter went into teenage rages or sulks, I often shut down emotionally. I just didn’t know how to handle the slamming doors, the tears, and the painful silences. In my family, my own mother ignored us when we “acted up,” and I learned quickly to never express how I felt, especially “bad” feelings like anger. I learned to hide how I felt when I was a child, and so when my own child “acted up,” I didn’t know what else to do than to shut myself down. Sometimes I would yell back or tell her that I didn’t like what she was doing, but more often, in the heat of the moment, I just disappeared inside of myself when she was doing something that made me emotionally uncomfortable.

I now know that a mother’s withdrawal from her child’s emotional expression is experienced by the child as abandonment. It feels brutal to me to think that my daughter felt I was abandoning her because of course, that’s not what I was trying to do. I was just doing the best I could and trying to get through the day. And yet, this emotional abandonment impacted her relationship with me and with herself.

Today I’m learning about my own emotional landscape. I’m learning that my defense mechanisms didn’t come out of nowhere, and they impacted my child, whose happiness drives my own happiness. Luckily our children always crave unconditional acceptance from their mothers, and so I still have a chance to be better and to give her what she needs. While she’s in recovery for her eating disorder, I frequently feel emotionally uncomfortable. I desperately want to withdraw and hide. But I’m staying with her, compassionately reminding myself that we can both tolerate feelings, no matter how big and terrifying they seem.

My daughter has been in eating disorder recovery for a while now, and I am enjoying the new aspects of her personality that are being uncovered. What I thought at first was just an “eating problem” I now see was a problem with her sense of self and her ability to express herself. I’m proud of her, and I’m also proud of myself for being able to face my own fears during this process.

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An eating disorder is more than a weight-based illness, by Therese Roeser

I was raised in a home where there seemed to exist a great deal of permission around food.  There was a large variety of food available in our pantry and refrigerator. Friends would flock to our house to eat “sugary” cereal and “junk” food.  In addition, appealing, balanced meals were served on a predictable schedule.

However, my mother was at times on a diet or “watching it.”  When she plated our dinners, she served herself noticeably less food than the rest of us. At lunch, she would sometimes eat “diet” food typical of the 80s: grapefruit, cottage cheese, canned tuna, rye krisp crackers and diet shakes.  One of my older sisters would also diet from time to time. It was not discouraged. My father ate pretty erratically and, after dinner, would spend a lot of time eating snacks while standing in front of our pantry. He had a larger body and believed strongly in fasting.

So there was this idea that young children had permission to be normal eaters and to just exist in their bodies but all bets were off for adults. They needed to control what they ate.

The summer before I began high school, I experienced my first episode of depression and, for the first time, experienced a significant loss of appetite. It felt like a funny blessing…this state, this apathy toward eating, that my family members had been trying to achieve just sort of fell into my lap.  So, I began to hone it by “healthying up” my diet. At the same time, my depressive symptoms began to lift as I became more engrossed in my restriction.

As my weight changed, my size became an important part of my self-esteem. I was becoming a skinny girl! This was something new I could be good at!

My family was not overly concerned. I think that my parents normalized my restrictive behavior as a “phase girls go through” or just normal initiation into womanhood. In my family, as in many, a slender body was admirable and preferred.

My body continued to noticeably change and it became my primary focus. It was apparent to the few friends I had that I was not just dieting. I became reluctant to socialize because I did not want to be pressured to eat or for my behaviors around food to be scrutinized. I grew more irritable and sensitive. I needed my behaviors; I relied on them to assure me of my attractiveness, likeability, and success, essentially my worth as a person. They defined me.

My days became a series of rigid eating and exercise rituals. My skills, passions, and dreams dwindled in favor of my behaviors. My parents vacillated between denial and alarm. My father insisted that I was merely “athletic” and had remarked that it was better for me “to be underweight than the alternative.”  My mother, on the other hand, expressed genuine concern over my body, which was now “clinically” anorexic. She took me to the pediatrician who was dismissive.

On the one hand, I felt that I had safely slipped under the radar. Another part of me, however, desperately wanted someone else to take over and rescue me.

The August following my freshman year in high school, I reached my lowest weight. It was a number much lower than I had ever anticipated reaching. On the one hand, I felt a rush and, on the other, I was terrified by how far this had gone.

My sister confronted me about my behaviors as well as the state of my health. She comforted and reassured me, and she talked with my mom about my eating disorder since I was not ready to do so. Later that month, I began outpatient therapy and nutritional counseling.

Over the course of this initial recovery period, my mother accompanied me to a weekly eating disorders support and psycho-education group for several weeks.  She even took me to listen to a lecture by Joan Jacobs Brumberg.

My family always supported my eating during recovery. However, I wish my parents knew that fatphobia, which continued in our family, was a huge barrier to recovery.

During this recovery period, I began to binge. Biologically and psychologically, this made some real sense. My body and brain were starved. My family, therapist, and dietician were overjoyed that I was eating again. However, I was still trapped by my feelings about weight and food.

I wish my parents had known that an eating disorder was more than a weight-based illness.  After I reached my “target weight,” my treatment stopped. My underlying anxiety and depression were never recognized or treated.

For the next several years, my weight fluctuated greatly and much of my eating remained compulsive albeit at a less severe level. What remained constant and unresolved was the sense that I was deprived and could never get enough. The eating disorder served a larger purpose in my life and now there was a void.

While away at college, I yearned to be “normal.” I hoped to recover the untainted relationships I once had with my body and food before the onset of my disorder. I started a recovery group, and we all believed the solution to our problems lay in being able to change how we viewed and used food or how we felt about our bodies. What we didn’t consider was the why in the equation. Why did we maintain our behaviors? How did they serve us and what did they represent?

During my senior year of college, I sought the help of a therapist and a dietician again. I was no longer clinically ill but I still didn’t exactly feel comfortable in my own skin and eating would, at times, cause me to feel guilt, shame or self-reproach. This period of therapy gave me more stability, and I went on to complete a Masters degree in Social Work.

My first year out of graduate school, I suffered from my second episode of depression. With the help of a psychiatrist over a period of several years, I started to understand more of the “why” in my eating disorder. I discovered that I used my behaviors to manage my depression, stress, and anxiety. When circumstances or emotions became seemingly unmanageable, my eating disorder provided constancy and refuge.

Through therapy, I slowly started to see myself as much more than a jumble of pathology and failures. I came to witness my strength, competence, and value as a human being. I started to trust myself again.

I stayed well through the pregnancies and births of my two children. When my son was diagnosed with autism, I felt terrified, powerless and as though I had failed in life. Once again, I slipped back into some of my old behaviors. I channeled all of my pain and exhaustion into destructive eating patterns. This went on for about 6 months when I began to see a psychologist and registered dietitian that specialized in eating disorders.  

They encouraged me to uncover my faulty thinking and challenge it. They helped me to find my voice again, to state my needs, to ask for help and establish my boundaries.  Mostly, they taught me the incredible value of self-care. I cannot nourish and nurture others if my own well is depleted.

I used to imagine how things might have been different for me if my family was different, if I weren’t so driven or if I wasn’t a woman.  As I began to understand myself more clearly, I accepted that the development of the eating disorder was part of my life history. It is a mental illness that I work to keep in remission. I don’t blame myself for its having existed much like one would not blame oneself for having had cancer or asthma.

In the beginning, the function of the eating disorder was to comfort and soothe myself. It relieved a lot of the stress and anxiety in my life. For me, the eating disorder was a compass giving me direction while bypassing the difficulties of the present. It also gave me a false sense of success. My behaviors became my automatic “go-to” anytime I experienced a difficult emotion and needed to retreat. They were coping mechanisms.

For a long time, I strove to be “cured” because I was so ashamed of ever having had an eating disorder. Learning to see recovery as a process and treat myself more gently and less critically has helped me maintain forward momentum.

The loving support of my husband, my family, and my very closest friends truly help me to remain grounded.  My two children are my main reason to be well. I strive to have energy and a love of life that I can share with them. I have discovered joyful movement in a variety of way: walks, yoga, swimming, dancing and lifting weights. I do not abide by any exercise routine or schedule, though.  I fully embrace intuitive eating. I take medication to treat my mood disorder and I still see a psychiatrist and therapist in addition to my general practitioner. I also make a lot of irreverent and fun artwork.

As a parent, I feel it’s important to eat with your children and enjoy the same foods together.  So my kids see me eating pizza, ice cream, hamburgers, etc. I follow the Ellyn Satter philosophy on eating: parents decide what is served at a meal and the time of the meal while the individual child determines what and how much of each food they will eat.  We also talk about how bodies change as we get older and we all grow at different rates and have unique bodies. One of my favorite books to read is “Amanda’s Big Dream.”

Recovery for me is about trying my best to stay truly engaged in life, all the while learning more about myself.

You can see Therese Roeser’s recovery artwork on her Instagram account, @healingcrayons

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I wanted someone to notice, by Amanda Kulanda

Over the span of 8 years, I kept my eating disorder a secret, from my parents, best friends, boyfriends, and everyone in between. I thought that one day I would be able to just stop. I would binge and purge and just say to myself “it’ll be okay tomorrow, this won’t happen again.” Well, that didn’t happen. The bulimia got worse to the point where it was addicting.

I remember growing up and dreaming of looking like the women I saw in the media. I always wanted to be skinny with perfect hair, makeup, etc. I also heard a lot of body shaming from the women I grew up around. I would constantly hear “I look fat” or “I need to lose weight.” Even things like “This looks terrible on me” or “I can’t wear this.” Hearing these women talk so badly about themselves gave me a negative outlook. Sometimes I would get comments from people around me hinting that I gained weight. I eventually started to turned to food for comfort in any stressful situation, as many others do too.

Food was my comfort but I also wanted to have a great body. I eventually started to purge. Sometimes it wouldn’t even be after a binge. I would freak out if I thought I ate too much or ate the wrong thing. I would work out in the gym for hours a day, sometimes twice a day. Most times I felt like I was going to pass out. It was a scary thing. I was in a dark place that no one knew about.

I had lost my Dad junior year of high school. He battled kidney failure my whole life. I watched as he was in and out of hospitals, had hundreds of surgeries, and still managed to support us. He was my hero. About four years later two more tragic and sudden deaths in my family really rocked my sense of safety. The combination of all of these, seeing my family die right before my eyes, caused my disorder to spiral out of control.

My comfort was binging and purging. My family and friends thought I was emotionless at times. I would hold everything in and take it out with bulimia. As much as I wanted to stop I couldn’t. It wasn’t until two years ago. I met someone who changed my life forever. Someone who made me want to help myself because I wanted a future. Before this, I had no idea what I wanted. I felt helpless.

My boyfriend helped me every step of the way. I read a book about overcoming bulimia and I took charge of my life again. It was extremely hard but worth it. I can’t even put into words how happy it makes me that I have a normal life now. Bulimia was controlling what I did for too long.

As I look back and reflect on my past and the bulimia I start to wonder if it would’ve been different if someone noticed. Would I have been able to stop sooner? At times I wanted someone to notice, I didn’t want to go through that anymore. I wanted someone so badly to notice that I would get up and go to the bathroom after I just ate enough food for an entire family. I wanted someone to notice my mood changes, how I didn’t want to go out with my friends anymore, or how I slaved away at the gym for hours and hours only to return to do the same thing over. I wanted someone to notice the hell I was putting my body through. I don’t blame anyone for not noticing any of these signs because most people don’t know the signs of an eating disorder.

Eating disorders are more common than people think. If people are educated more about the signs of an eating disorder, maybe people would be able to be saved from them. The majority of people with an eating disorder will not open up about it and reach out for help on their own. Many feel ashamed, embarrassed, and extremely self-conscious. I know this because I was there. I was in their shoes and there were so many times where I just wanted to scream it.

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What I wish my parents knew about eating disorders, by Gillian Elizabeth

This article is part of our “My Story” series written by people who have experienced eating disorders.

I wish we could talk about it

When I was struggling with an eating disorder my parents seemed to avoid the subject. My dad responded to people that asked about my sudden and dramatic weight loss by saying that I was on a “special diet.”

I realize this can be a tricky subject. Some parents become over-involved and obsessed about “fixing” the eating disorder. This means they talk about the eating disorder all the time, which isn’t necessarily helpful, either. I felt as if I was unseen and unheard much of the time. This is part of what fed my eating disorder.

It’s not really surprising that this environment that led me to feel unseen and unheard couldn’t change overnight when I developed an eating disorder. Of course, it takes time. But this is what I wished at the deepest level – that my parents would become intimately involved with me, and truly see what was going on and understand that I was in pain.

I was so lonely

I wish my parents could have seen my loneliness. I deeply wanted to be hugged and encouraged. In our family, physical affection and emotional intimacy weren’t natural but they were exactly what I wanted.

When I look back at my childhood, I remember constantly saying the words “play with me,” “spend time with me,” and “read to me.” I remember sitting close to people and desperately trying to get the physical affection I craved.

I understand how busy my parents were, but at the same time, I think it was more about them not noticing how lonely I was. I don’t think the time I would have taken to feel known and loved would have been that much, but it would have made all the difference in my life.

What I want parents to know

If you are a parent reading this looking for help for your child, try asking, “What do you want?” Tell your child “I recognize and accept your individuality and sense of self.” Allow your child to express who they really are and watch them blossom into the amazing human being they are.

Gillian Elizabeth

Gillian Elizabeth struggled with an eating disorder in High School. She learned how to truly nourish her body through intuitive eating, mindfulness, and self-love, which inspired her to become a wellness coach. In addition to her online phone and video one-on-one coaching for people who have eating disorders, Gillian is the author of Break Up With Your Diet: A 21-Day Workbook & Journal for Intuitive Eating. Visit her website here.

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Longing to be seen. Wishing to be held. Kristen’s story about her eating disorder

My eating disorder began when I was 18. At the time of its initial inception, I would have met the criteria for anorexia but, by the time I entered treatment some 20 years later, my diagnosis was bulimia. Either way, I had an eating disorder that had consumed most of my adult life.

During a psychological assessment that I was required to undergo prior to beginning treatment, I was also diagnosed with social anxiety and major depressive disorder. It was also suggested that I’d probably had major depressive disorder for most of my life.

I stop here to reflect on that and wonder how things may have been different had a diagnosis of depression been made far earlier in my life. I think about my behavior as a teenager. I didn’t take well to rules. I was quiet and introverted. I skipped school. I talked back to teachers and parents. Ultimately, I was labeled a rebel, the black sheep, the dark horse. But, was it really just depression?

I think perhaps it was but the labels made it difficult to step beyond. I became locked into this idea that I was the outsider, wrong in every way when really, I was a rather petrified and lonely girl.Hindsight is 20-20 of course. I blame neither my parents nor myself at this point, but it’s worth giving thought to the possibility that perhaps fear is at the root of a child’s behavior issues, not bad character.

Regardless, I lived my life with the idea that I was wrong and bad. I carried that with me throughout the years until I could not carry it any longer. When I finally sought treatment, I was at the end of my rope. I was in so much physical pain. I was tired all the time. And my mood was drastically low. I was unraveling. It was do or die time, literally.

Due to my state when I began treatment, I was highly motivated and thrilled to be finally getting help. I’m not sure why but I was also overly optimistic when I began treatment. I thought that all I would have to do was attend group, follow the “rules” of treatment and then, 25 weeks later, I would be well. I’d walk away a superstar!

It didn’t happen that way at all though. I struggled my whole way through group. It wasn’t that I didn’t do the work. In fact, I couldn’t have worked harder. I followed my meal plans. I constantly challenged myself with new goals. I spent time journaling and doing all of the cognitive homework that was assigned.

I was doing everything right. Unfortunately, I just felt that everything I was doing was wrong. Even despite the praise and encouragement I was receiving from my treatment providers, I could not see any of the good work that I was doing. And, while I had essentially normalized my eating by the end of the 25 weeks, I was still binging and purging (though not as frequently) and my mood was terribly low. I left my last group session feeling extremely ashamed of myself.

Luckily though, I was offered the opportunity to attend an extended group that was offered. This was for people who, like myself, had completed the initial group but who were still struggling with symptoms of the eating disorder. I graciously and humbly accepted the invitation.

It was during my time in extended group that it was finally suggested that I rethink antidepressant medication. I had resisted for a time but eventually began to realize that something was at work in me that was beyond my control.

I conceded, and the results were nothing short of miraculous. Within what seemed to be a few short weeks, the fog began to lift and I was able to begin seeing the progress I was making and the good work I was doing. Shortly after that, I left treatment.

I’ll be clear here before I proceed, that medication was not a quick fix nor did it make recovery easy. This is the best analogy I can give. With an eating disorder, I looked in the mirror and saw a distorted image of myself. The distortions were in my mind and when I started to work on cleaning up those distortions through treatment, I should have been able to see my reflection more clearly.

With depression though, the distortions in my mind weren’t the only ones that existed. The mirror itself was warped. So, it didn’t seem to matter how much work I was doing on myself, I still couldn’t see a sharp image in the mirror. The reflection was still distorted.

Medication smoothed out the distortions of the mirror to allow me to start to see myself more clearly. I still had to do all the internal work, but the external environment, the mirror, was taken care of with the medication.

I spent the next year after treatment continuing to work on body image issues, normalized eating,and plain old daily living. It was hard. But, I just felt more in control.

And, after having lived 20 years in the throes of bulimia, binging and purging almost every single day over that time period, I finally managed to experience more than a year and a half of symptom-free living. It was beautiful!

Though I did experience a period of relapse after that time as well as an extremely painful and dark encounter with depression, I am today in full recovery and more in control of my life than I ever have been.

During my relapse, I was able to draw on all of the things I had learned in treatment to help get me back on track. And, I also began exploring alternate strategies, including mindful meditation, which has been one of the most pivotal practices to my continued success and progression. I practice mindfulness and engage in meditation every single day. 

Throughout my journey through the eating disorder and into treatment and recovery, I have had to navigate much of the landscape on my own. I did not have a great deal of help or support. From this perspective, I can only speculate on how things could have been different or what would have helped. 

For example, my parents knew about my eating disorder but said nothing. I asked for help once when I was 18, was taken to the doctor, and it was never spoken about again. I understand they didn’t know what to do and, perhaps were even afraid that any attempts to intervene would push me away but, I wasn’t after answers. I didn’t even want someone to tell me what to do to get better, to make things better, or to tell me what I had to eat and when.

What I longed for was someone to hold me, to tell me that they were so sorry for the pain that I was in.

I longed for someone to tell me that while they didn’t know what to do about it, they would walk with me through it. They would let me choose and still make my own choices and support me as I needed and would always just be there, holding the space of love and support for me.

I wanted to hear someone say that it would be okay and that somehow, someway, we’d figure it out.

My husband knew about my eating disorder before we got married. He never mentioned it either. I longed for him to get to know me, to work with me through it. He always said he supported me in whatever I chose to do but that seemed to be only insofar that he didn’t have to get involved.

Ultimately, I only wish I’d been acknowledgedand supported openly. 

Often, people are afraid to get involved because they don’t have the answers. What I’d like to say, though, is that it doesn’t matter. I didn’t want answers, but I didn’t want to have to do it alone. I also didn’t have the courage to ask someone to support me either.

Oh, to have had someone say, without me asking, “I’m here and I’ve got your back!” It may not have changed much about my situation but oh, how it might have made me feel.

Kristen writes a blog about her recovery called Making Friends With Ed – turning enemies into allies. You can reach her at

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My story: life in the fitness industry after an eating disorder, by Kortney Karnok

I feel like I have lived my whole life in the framework of having an eating disorder. It was my identity above all else. It was a label I started to identify with as a 14-year-old, after my first real “diet.” My mom was a chronic dieter, and it seemed like the natural thing to do. We even had a bathroom scale in the kitchen!

My parents did their best to help me. I attended three different inpatient treatment centers and was sent to various therapists and outpatient treatment programs. My parents were desperate to help. They paid for treatment and supported me and just wanted me well.

How I recovered

I don’t think I went a single year without an eating disorder relapse until recently. The biggest thing leading to a full and committed recovery for me finally was a complete reconditioning of my beliefs and values system around appearance and self-worth, specifically body size. But it really took a long time. And is probably still a work in progress. The introduction to feminist theory, Health at Every SizeⓇ, and Intuitive Eating were really the catalysts that solidified my perspective and recovery. Finally.

What I see in the fitness industry

There’s still a lot of dietary dogma floating around in gyms. Everyone needs their diet belief systems to cling to, and I get it, it’s how we’ve all been conditioned. It’s impossible to avoid. But I wish it wasn’t so, and I’m working on changing the conversation. I’m hoping to incorporate some programs for body image/body acceptance, and possibly an introduction to the principles of Intuitive Eating in the future.

What I’d like to see in the fitness industry

I’d like to see more larger bodied people portrayed as successfully engaged in fitness, athletics, movement, dance, whatever activity, etc. Let’s see the larger bodied people enjoying movement! I think it would illustrate to all people in all bodies that fitness and health is accessible to all types, and it’s not about weight. It’s about enhancing the quality of life – whatever that looks like to every individual.

I’d love to smash the lean fitness ideal.

What I’ve noticed about bodies at the gym

Most people are not happy with their bodies, particularly their stomachs. I work with a lot of moms in this situation. So many moms come to the gym and are distraught about their bodies. I recommend a list of people to follow on Instagram so they can see the diversity of healthy body types in the world. I think it takes a lot of time and focus and commitment to undo the social conditioning about weight stigma and fatphobia.

My gym rule is that you should never speak badly about your body or any body. Do not admire lean, ripped bodies in the gym as if that is superior to other types of bodies. Do not shame people for eating treats or admire others for being so “good” for eating “healthy.” These behaviors are all really common at the gym but are also really unhealthy.

How I talk to people about bodies

When people talk about their bodies, I try to redirect them to thinking positively about their capabilities. Most of the clients I’m working with are able-bodied and in relatively good health. They’ve just been conditioned to dislike aspects of their bodies.

I try to deemphasize body weight and weight loss and diet talk and redirect negative body talk to appreciation if possible. I try to draw the focus to the amazing things women’s bodies have done, like grow babies! I admire moms for their strength and try to encourage them to see that, rather than their “flaws.”

Any time someone expresses a negative body comment, my easy go-to is to get them to acknowledge something awesome they just did. “Yeah, but didn’t you just do 20 pushups like a badass?! Yeah, thought so. That body’s not so bad after all!”

What I tell parents about their kids’ bodies

My clients often talk to me about their kids’ bodies. I try to emphasize focusing on letting kids have fun with moving and learning new skills. I’m pretty direct about how food shaming and policing kids about their food habits (or their bodies) can be a recipe for eating disorders.

I have had several distressed parents confide in me about troubling eating behaviors with their kids. It’s clearly a challenge for parents, especially parents who have children living in larger bodies. I steer parents towards HAESⓇ resources and professionals who may be able to support a body positive approach to the family’s eating behavior rather than keeping the focus on one individual’s body and/or behavior.

What fitness is good for … and what not to do

Fitness can promote positive self-esteem, mental health, accomplishment, and overall wellbeing. However, it should be fun and not forced. And, for the love of God, please do not make it about weight control, weight loss, or building muscles.

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Kortney Karnok is a body positive Crossfit coach and soon-to-be certified Intuitive Eating Counselor living in Beloit, Wisconsin. Her online coaching business “Fueling Strength” helps women find their way out of diet culture, food, body, and exercise obsession. You can follow her on Facebook and Instagram.