The Eating Disorder Journal
(February 2022, Vol. 23, No.2)
This journal is emailed to over 141,995 readers
THE EATING DISORDER SPECIALISTS SINCE 1999
Contents:
For Professionals - Calendar of Events
Continuing Education and Other Resources
Weighing In on Eating Disorder Issues
How to add a submission to The Eating Disorder Journal
Instructions on how to unsubscribe to The Eating Disorder Journal
Current Research and News:
We examine the clinical research and current happenings in the eating disorder field to find the most interesting and useful current information available.
Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa. Anorexia nervosa-focussed family therapy (FT-AN) is the first-line treatment for adolescent anorexia nervosa (AN), but the predictors of poor treatment response are not well understood. The main aim of this study was to investigate the role of attachment and mentalization in predicting treatment outcome. The secondary aims of the study were to investigate therapeutic alliance at 1 month as a predictor of outcome, and to test the associations between alliance and baseline attachment and mentalization. 192 adolescents with AN and their parents were recruited as they began family therapy in out-patient specialist eating disorder services. Self-report measures of attachment, mentalization, and emotion regulation were completed at the start of treatment by adolescent patients and one of their parents. Self-reported alliance scores were collected at one month. Higher scores on the Certainty Scale of the Reflective Functioning Questionnaire, completed by parents, which indicate over-certainty about mental states, were the strongest predictor of poor outcome (Odds Ratio: 0.42, CI: 0.20-0.87). Similarly, for adolescents, higher Lack of Clarity scores on the Difficulties in Emotion Regulation Scale, representing being unclear about one's feelings, were predictive of positive treatment outcome (OR: 1.10, CI: 1.00-1.21). Higher alliance scores at 1 month predicted positive outcome, and were associated with attachment security and mentalization. These novel findings suggest that, particularly in parents, a tendency towards excessive certainty about mental states in others may predict poor outcome in FT-AN. Further research is warranted to replicate the finding and characterise families at risk of poor outcome. Keywords: Anorexia nervosa; Attachment; Family therapy; Mentalization; Therapeutic alliance. PMID: 34967934 DOI: 10.1007/s00787-021-01930-3. Eur Child Adolesc Psychiatry. 2021 Dec 30. doi: 10.1007/s00787-021-01930-3. Online ahead of print.
Effectiveness of olanzapine in the treatment of anorexia nervosa: A systematic review and meta-analysis. Objective: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by starvation and malnutrition, a high incidence of coexisting psychiatric conditions, and treatment resistance. The effect of pharmacotherapy has been controversial. Method: A systematic review was conducted for evidence of an effect of olanzapine versus placebo in adults or its effect as adjuvant treatment of AN in adolescents. Results: A total of seven articles (304 patients with AN) were identified. There were four double-blind, randomized studies examining the effect of olanzapine in the treatment of AN. The mean difference in body mass index (BMI) at the end of treatment between olanzapine and placebo was 0.67 kg/m2 (95% confidence interval (CI) 0.15-1.18 kg/m2 ; p = 0.01; I2 = 0%, p for heterogeneity < 0.79). The olanzapine groups showed a significant increase in BMI of 0.68 kg/m2 (95% CI 0.22-1.13 kg/m2 ; p < 0.001; I2 = 0%, p for heterogeneity = 0.74) compared to the placebo groups. Only two studies examined the effect of olanzapine as adjuvant treatment in adolescents and showed an increase in BMI of 0.66 kg/m2 (95% CI -0.36 to 1.67 kg/m2 ; p = 0.21; I2 = 11%, p for heterogeneity = 0.32). Discussion: Olanzapine showed efficacy in the treatment of AN with an increased BMI at the end of treatment in adults. The effect of olanzapine as adjuvant treatment in adolescents remains unclear. PMID: 35020271 DOI: 10.1002/brb3.2498, Brain Behav. 2022 Jan 12;e2498.
Clinical meaning of body temperatures in anorexia nervosa and bulimia nervosa. Objective: Bradycardia is one of the common cardiac abnormalities in patients with eating disorders. It ensues from hypometabolism, which results from reduced caloric intake and consequential weight loss. Hypothermia is another consequence of hypometabolism. While at-rest metabolism and body mass index (BMI) are typically used to assess hypometabolism and estimate potential bradycardia, we hypothesised that body temperature, which is easy to measure, could also capture the presence of this threatening cardiovascular condition. Method: We monitored heart rate continuously for 72 h, measured resting energy expenditure (REE) and assessed body temperature in 12 body parts for 58 patients with anorexia nervosa (AN) and 29 patients with bulimia nervosa (BN). Results: Palm temperature reflects bradycardia in both AN and BN, explaining 18% of its variance (p < 0.001), capturing this aspect even more efficiently than BMI. We also observe different correlations between palm temperature, abdominal temperature, BMI, REE and levels of physical activity. Conclusion: Palm temperature could be used as a warning of bradycardia, a serious cardiovascular condition which can be difficult to detect in short visits with outpatients. Further studies are needed to determine how useful bradycardia and palm temperature could be to assess severity and prognosis of the disorder. Keywords: anorexia nervosa; body temperature; bradycardia; bulimia; thermoregulation abnormalities. Eur Eat Disord Rev. 2022 Jan 17. doi: 10.1002/erv.2886. Online ahead of print. PMID: 35037343 DOI: 10.1002/erv.2886
Self-perception in anorexia nervosa: When the body becomes an object. Objective: Women with anorexia nervosa (AN) act as if they have a larger body, as evidenced in obstacle avoidance tasks, where an allocentric perspective is adopted. This alteration emerges not only when they perform, but also when they imagine movements. However, no previous study has investigated own body centered tasks. As such, in this study we aim at documenting if women with AN show an altered behaviour also when the task requires a first-person perspective. Method: We explored the performance of eleven woman affected by AN compared to eighteen matched controls, in two motor imagery tasks based on a self-frame of reference, the Hand Laterality Task and the Mental Motor Chronometry Task. Moreover, two control tasks relative to visual imagery were administered. Results: In the Hand Laterality Task, affected participants did not adopt a motor strategy to judge hands laterality (i.e. no biomechanical constraints effect). Crucially, they also showed an altered behavior in the control task. Similarly, they did not show the expected isochrony in the Mental Motor Chronometry Task, when actions pertained the left (but not the right) hand, in absence of any difference in the control task. Conclusions: Our findings reveal altered imagery processes in AN. Specifically, affected participants adopt a third-person, rather than a first-person perspective, even when the task requires to imagine their own body in an internal frame of reference. In other words, participants with AN objectify body stimuli. Different mechanisms (i.e., checking behaviour; mirror self-reflection; altered multisensory integration) can explain such an altered imagery in AN. Keywords: Anorexia nervosa; Body in action; Mental imagery; Motor imagery. Neuropsychologia. 2022 Jan 14;166:108158. doi: 10.1016/j.neuropsychologia.2022.108158. Online ahead of print. PMID: 35033502 DOI: 10.1016/j.neuropsychologia.2022.108158
Calendar of Events for Professionals:
February 2022:
National Eating Disorders Awareness Week (NEDA Week) is an annual campaign to educate the public about the realities of eating disorders, and to provide hope, support, and visibility to individuals and families affected by eating disorders. NEDA Week 2022 will take place during the week of February 21 - 27, 2022. For further information visit: https://www.nationaleatingdisorders.org/get-involved/nedawareness
November 2022
Save The Date - The 32nd Annual Renfrew Center Foundation Conference for Professionals – Responding to a Changing World: Treating Eating Disorders with Compassion & Inclusion. Beginning November 11, 2022. Since 1991, the Conference has been dedicated to providing eating disorders education and training for professionals and creating a stimulating environment in which to discover, debate and share the best of what we bring to our profession. Conference 2022 will explore the clinical and relational challenges of navigating the impact of change and trauma in recent years. Covering an array of topics – social media, intersectionality, neuroscience, evidence-based care, and the therapeutic relationship – we will honor the best of the past and the advancements of the future while remaining grounded in the present. More information coming soon.
Treatment Centers Spotlight - Multiple State Locations, Alabama, California, Florida, Indiana, Ohio, Oklahoma
Multiple State Locations:
Veritas Collaborative provides a full continuum of care for individuals of all ages, including Inpatient, Acute Residential, Partial Hospitalization, Intensive Outpatient, and Outpatient levels of care – supporting their belief that access to the right level of care at the right time is key to lasting recovery. Veritas Collaborative is committed to providing access to care for individuals, their families, and communities of support – as well as providing support and resources to providers. Their multidisciplinary treatment teams in North Carolina, Georgia, and Virginia share a passion and a mission inspired by a collaborative community of care and are committed to providing individualized, evidence-based treatment in a gender diverse and inclusive environment. Veritas Collaborative’s Intake & Admissions Team, consisting of Masters-level clinicians, is available seven days a week to provide an assessment, and ensure you, your loved one, or your patient are receiving the right level of care at the right time. For more information or to schedule an assessment, please visit https://veritascollaborative.com/ or call 855-875-5812.
At Alsana, we recognize that vegan clients deserve a safe and welcoming place to begin or continue their recovery journey. For a client with an eating disorder, a commitment to veganism may precede or intertwine with eating disorder behaviors. Alsana offers a vegan menu with balance and variety to fully nourish the body while honoring client beliefs that transcend eating disorder behaviors and work together to separate and heal those that do not. In a survey we conducted with hundreds of dietitians who specialize in eating disorders, we found that 98% of eating disorder dietitians saw clients who followed a vegan eating style. Of these, 75% of vegan clients realized that their eating disorder was enmeshed with veganism, while 25% of clients realized the eating disorder was separate and veganism was a true value in their belief system. Without a higher level of care option for vegan clients, that 75% didn’t have a place to learn that veganism is keeping them trapped in the eating disorder, while the 25% who found it is a true value didn’t have a place to recover. Spearheaded by Tammy Beasley, our Alsana leadership team worked tirelessly for over 1.5 years to create a robust program for vegan clients that integrates our high culinary standards within our in-depth treatment process. This carefully and lovingly thought-out process has allowed us to confidently open our doors to clients with eating disorders who are also following a vegan lifestyle. To learn more, call us today at (855) 915-0213.
Alabama:
Columbiana, AL: Magnolia Creek Treatment Center for Eating Disorders is a private treatment center for women 18 years and older located outside of Birmingham, Alabama that specializes in the treatment eating disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder, other specified/unspecified eating disorders, rumination disorder, pica, and avoidant/restrictive food intake disorders. Magnolia Creek, dually licensed as an eating disorder and mental health treatment center, can tailor the program for co-occurring mental health conditions such as mood disorders, obsessive compulsive disorder, post-traumatic stress disorder, attachment disorder, dissociative disorders and personality disorders. Peacefully situated on thirty-six wooded acres, we offer a strength-based and collaborative program that looks beyond the symptoms and behaviors of an eating disorder to honor the strength within. We emphasize acceptance, validation, and empowerment at every stage of treatment, and acknowledge the client as the most important member of the treatment team. Treatment at Magnolia Creek is active rather than passive, collaborative rather than imposed, and personal rather than detached. Our setting provides residential and partial hospitalization programs. Our home and cottage are across from a serene seven-acre lake, peaceful, wooded walking trails, outdoor therapy areas, and a recovery garden. The surrounding beauty and the slow pace of nature help healing begin. We believe that clients can fully recover, not simply manage, their disorders. If you or a loved one is experiencing symptoms of an eating disorder, we can help. For more information, please contact us at 205-678-4373 or visit us at www.magnolia-creek.com.
California:
Long Beach, CA: Shoreline Center for Eating Disorder Treatment. We Integrate Recovery with Life. Since 1995, Shoreline Center for Eating Disorder Treatment has successfully been helping individuals achieve recovery from anorexia nervosa, bulimia nervosa, and binge eating disorder for all genders, ages 13 and over. We offer personalized, compassionate programs, delivered by highly-trained and experienced eating disorder experts, many of whom are recovered themselves. The journey of recovery from an eating disorder can be scary and challenging. Not only for the individual trying to break free from the dominating and familiar sounds of their thoughts and behaviors, but also for the family and friends who are trying to support their eating disorder recovery process. For more information, visit us at www.shorelineeatingdisorders.com or call us at 562-434-6007.
Florida:
Coconut Creek, FL: Residential College Programming Now Available At The Renfrew Center Of Florida. College life often brings with it complex and difficult paths for students to navigate, particularly for those with an eating disorder. For college-age students who choose to participate, The Renfrew Center of Coconut Creek, Florida has integrated specialized Residential programming to address the many challenges students face while attempting to balance recovery with the demands of school. Programming includes: Designated Study Time - Students have blocks of time set aside each weekday to focus on academics, study and complete course assignments. Additionally, they have a designated space and computer access to complete their work. Individual Workstations and Group Collaboration Area - A collegiate-only space, separate from other residential common areas, includes computer workstations, quiet study space and collaborative working areas. Young Adult and College Life Groups - Therapy groups that focus on developmental and psychosocial issues salient to college-age students. Access to Educational Resources - The Collegiate Program Manager serves as a liaison between the treatment team and each student’s school to develop an individualized academic plan and ensure that necessary accommodations are agreed upon before entering treatment. For more information, please call 1-800-RENFREW or visit www.renfrewcenter.com to learn more.
Tallahassee, FL: Canopy Cove, Christian-Based Eating Disorder Treatment for Women and Girls. All major insurances accepted, 30 years’ experience in the field of eating disorders. A boutique program with an immense focus on individualized treatment. They provide each and every client with a great deal of attention and care. A beautiful, serene healing environment located on 55-acres of private land with 6 horses on site. Clinicians on campus during the day, in the evenings, and on weekends. Warm weather in a beautiful, home-like setting. They have a high number of clinical staff and small group sizes. Evidenced Based Treatment. Individualized Treatment Planning. Equine Therapy. Family-Based Program. 24/7 Supervision. Compassionate and Caring Staff. CARF Accredited. For further information call 888-245-6555, email admissions@canopycove.com or visit www.canopycove.com.
Indiana:
Anderson, IN: Selah House is committed to providing clinically excellent and Christ-centered care for girls and women, ages 12 and over who struggle with an eating disorder such as anorexia, bulimia, and binge eating disorder. Selah's program provides medical monitoring, psychiatric care, individual therapy, family therapy, groups, equine-assisted psychotherapy, art therapy, nutritional counseling, spiritual counseling, and more. Our levels of care include inpatient, residential, and a partial hospitalization program. At Selah House, we also have an Adolescent Program, dedicated to treating adolescent and teen girls who struggle with an eating disorder. We take pride in understanding every teen’s academic growth, overall wellbeing, and safety should be the top priority. Therefore, our teacher on-staff will work with you and your child’s school to implement a continuing education plan during treatment. The common thread that runs through all Selah programs is our love for our clients and their families, and our complete dedication to their healing. We provide a safe place for clients to explore the truth of who they are and who God is without feeling pressured to believe a certain way. We value and respect each person's unique faith. Clients from a variety of faiths and backgrounds have been through our programs and have felt seen, heard, understood, and comfortable while participating in our program. Selah House is a stable, loving, and comfortable environment for healing. Our path together begins with a phone call to schedule a free assessment through our Intake Coordinator. www.selahhouse.com
Ohio:
Toledo, OH: At Toledo Center for Eating Disorders, we take an innovative approach to guide you on your journey. Backed by evidence-based outcomes and compassion for each client, Toledo Center meets clients where they are, with an up-front, honest approach to treatment. We treat all genders, ages 10 and over, helping them to reclaim their lives, health, and futures. Our mission is to provide specialized and cost-effective treatment for those suffering from eating disorders, such as anorexia nervosa, bulimia nervosa, and ARFID. We follow a well-established therapy model that integrates individual, group, and family therapy. Since each eating disorder is unique, an individualized treatment plan is developed and customized for each client. Treatment plans are tailored to meet client's specific needs, based on the initial assessment, then applied within the framework of evidence-based treatment principles, and periodically revised as changes occur during treatment. Our levels of care include an adolescent residential program and an adolescent and adult partial hospitalization program. At Toledo Center, we are dedicated to helping adolescents in our program continue their education while in treatment. We provide tutoring and coordinate with schools, so clients can continue their academic growth while in eating disorder treatment. We work clients and families to set realistic treatment goals and guide them through the treatment process. Clients learn how to address symptoms and how to identify and resolve the emotional issues that have contributed to unhealthy coping behaviors. The Toledo Center is located in a modern, spacious and tranquil setting in Sylvania, Ohio. www.toledocenter.com
Oklahoma:
Tulsa, OK: The internationally recognized Laureate Eating Disorders Program in Tulsa, Oklahoma, is personalized to meet the individual needs of women and girls from all over the world. With a therapist-to-patient ratio of 1:3, program participants experience intentionally small milieus, allowing for meaningful connection with peers and clinicians. Because Laureate philosophy centers on the healing power of relationships, patients work with the same physician, therapist and dietitian through acute, residential and partial levels of care. As a not-for-profit organization, Laureate provides values- and mission-driven care in a peaceful, nature-focused campus on 47 private acres. Experienced eating disorder specialists provide evidence-based care and an experience tailored to your unique needs that includes individual or group sessions utilizing principles of DBT, CBT, ACT, IPT, EMDR, IFS and relational-cultural theory. Other group or individual experiences include exploring spirituality, sexuality, relapse prevention, gratitude, yoga and movement, art process, body image, cooking, shopping and therapeutic swimming exposure. Appropriate patients may be eligible to participate in ongoing eating disorders research studies conducted by the Laureate Institute for Brain Research, whose teams focus on identifying new, effective treatments for eating disorders. Current studies include the impact of floatation therapy on body image. Adult women are eligible to apply for Magnolia House, Laureate’s group home focusing on independent living for women in recovery from eating disorders. The first thirty days of Magnolia House are provided at no cost to residents. To learn more about Laureate Eating Disorders Program, call 800-322-5173 or visit saintfrancis.com/laureate/eating-disorders-program/.
Continuing Education and Other Resources:
Live/Online Course: (33 CEs) Neuroscience Advances Eating Disorder Recovery—The Behavior Decoding Method™ (BDM™) for Clinicians: An evidenced-based system of tools and strategies that quickly reveal the deeper meaning, messages, and intended positive outcome in a client’s current unwanted or detrimental, but survival-based behaviors. Clients begin to easily re-wire neuro-patterning for safety and survival, allowing for new beliefs, behaviors and identity to form and sustainably replace the disordered ones. This decoding tool also uncovers how a client may disengage and be resistant to treatment and how to turn it around. Imagine clients discovering their own unique solutions that engage and keep them empowered to stay in treatment for full recovery. Dr. Barbara Birsinger, creator of the BDM™, a 33-CE, Certification Program for Licensed Professionals, is offering an innovative course with client video demonstrations and consultations on how to create T-NLP-informed, brain-based transformation of disordered eating and weight-related behaviors, across the spectrum, in a Health At Every Size® context. Dr. Birsinger presents a system of simple yet comprehensive, take-away, hands-on tools that therapists, nutritionists and treatment teams can implement with their clients right away. Live and recorded Consultation/ Q+A sessions with Barbara Birsinger, ThD, MPH, CEDRD, special guests Ellyn Herb, PhD, CEDS and Anita Johnston, PhD, CEDS, and others on Decoding: Food Cravings in Emotional/Binge Eating; Food Restriction/Anxieties; Weight/Size Wishes; Body Judgments; Body Checking Obsessions; Other’s Comments on Food and Body; Movement Blocks; Compulsive Over-Exercise; and Bulimia. Click here for a Video Demonstration and more details. Contact Dr. Birsinger: 707-799-2982; Barbara@BarbaraBirsinger.com.
Register Now for The Renfrew Center Foundation’s Free Virtual CE Trainings. The Renfrew Center Foundation is dedicated to eliminating eating disorders by advancing education, prevention, advocacy, research and treatment. #Triggered: Social Media Literacy and Eating Disorder Recovery on Friday, February 11th from 8:45 am - 10:30 am (ET). Open to professionals in Kentucky, Maryland, Virginia and West Virginia. Making Peace With Your Mother: Rewriting Your Story on Friday, February 12th from 8:45 am - 10:00 am (PT). Open to professionals in Arizona, California, Colorado, Idaho, Nebraska, Nevada, Oregon, Texas, Utah, and Washington. Helping Families Navigate Their Emotions to Enhance Recovery Support on Friday, February 18th from 8:45 am - 11:00 am (ET). Open to professionals in Alabama, Arkansas, Florida, Georgia, Mississippi, South Carolina, and Virginia. Eating Disorders and College Students: Best Practices to Support Complex Students and Navigate On-Campus Treatment Challenges on Friday, February 25th from 11:45 am - 2:00pm (ET). Open to college and university professionals. Navigating Complexity: Ethical Considerations in the Treatment of Eating Disorders on Friday, March 11th from 8:45 am - 11:00 am (CT). Open to professionals in Arkansas, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Missouri, and Wisconsin. For more information or to register for these events, please call 1-800-RENFREW (736-3739) or visit www.renfrewcenter.com.
Job Opportunities:
Add Your Job Openings Here. Get your message out there to over 143,000 readers in the eating disorder community. The Eating Disorder Journal is a great way to get your job listing out to this population. We allow advertising for our members and one-time insertions for non-members. Use the following link to learn more about our extremely effective and low-cost means of reaching those in the eating disorder community: https://www.edreferral.com/Journal-Requirements. View all the listed job opportunities on the EDReferral Jobs page at https://www.edreferral.com/classifieds.
Books and Book Reviews:
Beth Moore: The Courage to be Willing by Shirley Fessel. Before her death, Beth Moore, a member of Overeaters Anonymous, gave permission to have her journals published in the hope it would help others recover from compulsive overeating while also dealing with multiple chronic health challenges. From the age of 5, Beth had a compromised immune system, and was then traumatized by discovering her brother covered with blood in the bathtub after he suicided. Later in life, she was forced to have a hysterectomy without painkillers and was subsequently diagnosed with diabetes and Hodgkin’s lymphoma. A cascade of ongoing mounting health crises followed, and ongoing medical interventions often provoked harmful reactions such as hallucinations and staph infections. Despite her declining health, Beth found OA in the late 1990’s which provided her with a spiritual and emotional safe home as she became abstinent from her trigger food of sugar. Her journals spoke with gratitude about the loving OA fellowship, enjoying the tool of journal writing as well as her love of her spiritual growth and choosing a God of her personal understanding. She learned that given her food addiction, abstinence meant “One bite is too much and one bag is not enough.” Beth adds, “Each day we wake up, why not have a thankful heart and share the unconditional love we have been given by the God of our understanding and our fellow OA members to all we meet, including ourselves.” She wittily spoke about the 12 Steps of the Program as Give Up, Look Up, Clean Up, Keep Up, and Show Up. She found OA to be a lifeline of support and sustenance as she learned to recover from compulsive eating while her body was also shutting down and dying. Shirley Fessel narrates Beth’s story and adds, “She surrendered [her power] in order to live abstinently until that day on her death bed when she refused a taste of ice cream so she could die abstinently.” Some readers may find Beth’s last act to be heroic, while others will find it deeply sad that the pleasure of a last taste of ice cream before your death had to be rejected.
Shirley Fessel writes about women’s issues and has herself has embraced a recovery journey from an eating disorder. ShirleyFessel.com
Book review submitted by Mary Anne Cohen. Mary Anne's books French Toast for Breakfast: Declaring Peace with Emotional Eating and Lasagna for Lunch: Declaring Peace with Emotional Eating are available in paperback and Kindle. Continuing education credits for mental health professionals are available at https://www.ce-credit.com/courses/102201/french-toast-for-breakfast-declaring-peace-with-emotional-eating. Her latest book, Treating the Eating Disorder Self, is published by NASW Press. To read the Introductions to her three books: www.EmotionalEating.Org
Have Your Book Reviewed - We are actively looking for good eating disorder books to review. Mary Anne Cohen is the EDReferral.com professional book reviewer. One book will be reviewed each month. There is a small fee and the journal insertion is included at no additional cost. If you want your eating disorder related book reviewed in this journal and for more details, contact Mary Anne Cohen at: macohen490@aol.com.
Find the previously reviewed eating disorder related books at the EDReferral.com Books page here: www.EDReferral.com/books
Weighing In on Eating Disorder Issues:
Body Image Issues for Older Women By Susan Kolod, Ph.D. Some say that women’s bodies become invisible after a certain age. Most women experience changes in their weight, fat distribution, and metabolism as they age. Wrinkles appear, hair turns grey, and their sex drive becomes less pressing. These changes can lead to dissatisfaction with one’s body and sex life which is exacerbated by a culture that overvalues youthful appearances especially in women. Maintaining a positive body image as one ages is challenging, especially for those who have struggled with an eating disorder. An important task of middle age is to take stock of one’s life. What do I want to change, what do I want to keep doing, and what do I want to try that I haven’t tried yet? Rather than comparing oneself to some impossible external standard, this is a time to reflect on who you are and what you are still becoming. In many ways, how you feel about your body is more important than how you look. Body image is defined as the subjective picture or mental image of one’s own body. Outside factors, such as the way a culture views the body of an older woman, affects one’s subjective view. Cultural denigration of the body of an older woman will, no doubt, affect her subjective view or mental image of herself. Some older women have internalized an extremely negative body image: “I am ashamed of my aging body and ashamed that I am ashamed. I believe women pay an enormous price of cultural biases related to gender and age.” Others were able to embrace their bodies: “I have earned every scar, every age bump and every grey hair. It sags and it aches but it keeps me upright and going.” As a woman ages, hopefully she has a tendency to be less reactive to external messages and more focused on how she feels about herself. Caring less about appearance and more about health and functionality are the keys to adaptive aging in both men and women. Adaptive aging is a goal, not an endpoint!
Susan Kolod, Ph.D., is co-Chair of the Committee on Public Information and co-editor of the blog “Psychoanalysis Unplugged" at the American Psychoanalytic Association. She is a supervising and training analyst, and faculty in the Eating Disorders, Compulsions and Addictions Program at the William Alanson White Institute. Dr. Kolod has a private practice in Manhattan and Brooklyn. www.susankolodphd.com
EDReferral.com's monthly column is entitled “Weighing In On Eating Disorder Issues.” If you would like to share an innovative concept/treatment strategy/case example that you are working on, please forward it to us for possible inclusion. Our Eating Disorder Treatment Community is a vibrant source of knowledge and expertise that we can all learn from. This is a forum of ideas not a professional profile about your practice, and we offer it free of charge. Your submission should be a maximum of 300 words including a one sentence bio sketch. Please send to Mary Anne Cohen, Editor, at macohen490@aol.com.
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