how to know if your relationship with food is unhealthy

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What thought was flitting through your mind when you clicked the link to this post?

Maybe it was something like, "I am so tired of this. Maybe this isn't really 'normal.'" Or perhaps it was a variation of, "I wish she understood that what she's doing with food isn't healthy. How can I get her to see it?" Or maybe you were just curious.

Whatever reason you clicked on this post, I'm glad that you're reading this, because chances are pretty good that you and/or someone you know (make that half the people you know) have some kind of disordered relationship with food. It's hard to find accurate statistics on disordered eating, because so many people (more often women, but a fair amount of men, too) don't seek help or wouldn't meet full diagnostic criteria for an eating disorder, so they often fall between the research cracks.

What the Research Does Say...

Need some convincing? In one study published in the International Journal of Eating Disorders, 91% of women surveyed on a college campus had tried to control their weight by dieting, and 22% of them dieted “often” or all the time. The same study reported that 35% of “normal dieters” progress to pathological dieting, and of those, 20-25% progress to partial or full-syndrome eating disorders.(1) This study was published twenty years ago — as much as I'd love to give more updated statistics, funding for research in this area is not where it needs to be, so these are still figures that eating disorder organizations like NEDA and ANAD are posting. And I probably don't need to tell you that things have only gotten worse over the past two decades.

In 2008, SELF Magazine collaborated with the University of North Carolina's Eating Disorders Program, polling its readers in an online survey that received over 4,000 responses from women age 25-45. SELF's then-editor, Lucy Danziger, stated that the purpose of the survey was to "discover the unfiltered reality of the eating habits of American women, and ultimately, to help women develop less obsessive, more accepting attitudes toward their bodies and a healthier relationship with food." (Sidebar: The irony here is not lost on me. Danziger authored the book The Drop 10 Diet, faced controversy after excessive slimming of Kelly Clarkson's 2009 SELF cover photo, and was let go in 2014 after the magazine mocked a woman running a race in a tutu that turned out to symbolic of her cancer battle. The PR snafu was probably just the last straw for Danziger, who was already on thin ice with Condé Nast for the magazine's slumping sales.)75% of the respondents reported disordered eating behaviors or symptoms consistent with eating disorders. You read that right: THREE OUT OF FOUR.

It's too bad the survey results weren't a wake-up call for SELF about the kind of content its readers really need. And while you could make the argument that these results are not representative of the general population since they are already readers of a magazine geared toward "women's health" (aka dieting and fitness), SELF is pretty mainstream, and I would say its reader is not terribly far from the "average American woman." The survey also found that:

  • 67 percent of women (excluding those with actual eating disorders) are trying to lose weight
  • 53 percent of dieters are already at a healthy weight and are still trying to lose weight
  • 39 percent of women say concerns about what they eat or weigh interfere with their happiness
  • 37 percent regularly skip meals to try to lose weight
  • 27 percent would be “extremely upset” if they gained just five pounds
  • 26 percent cut out entire food groups
  • 16 percent have dieted on 1,000 calories a day or fewer
  • 13 percent smoke to lose weight
  • 12 percent often eat when they’re not hungry; 49 percent sometimes do

What Are the Signs of a Problem?

Do any of those behaviors above sound familiar? Even at times before and after I had a diagnosable eating disorder, I would have answered "yes" to a lot of those questions. And here's some more that I would add for you to consider if you're wondering whether you or someone you care about might have disordered eating:

  • Do over 25% of your thoughts throughout the day revolve around food and/or your body? 
  • Do you ever weigh yourself more than once a day?
  • Do you keep clothing that has not fit for a substantial amount of time, as "motivation" to lose weight? 
  • Would you have anxiety if someone took away your scale?
  • Are you rigid with your workout routine? (i.e. if you don't get ___ minutes, RPM, calories burned, or pounds lifted, ___ times a week every week, you get anxious?) 
  • Do you think of your food intake as "clean"/"good" vs "gross"/"dirty"/"unhealthy"? 
  • Do you get anxious about birthday parties, work happy hours, etc. because of the food?
  • Do you use exercise in a compensatory way. i.e. "I ate that much so now I have to work out ___ amount"?

If your answer to some or a lot of these is "yes," just know that you are SO not alone. There's nothing to be ashamed of, because our culture basically breeds disordered eating. But also know that you don't have to accept this as your "normal."I had resigned myself to that, and I've met many other women (and some men) who have also accepted disordered relationships with food as "just the way things are."

Why It's Worth it to Work on Your Relationship with Food

It's hard for me to articulate exactly what it feels like on the other side of that hill without sounding totally cheesy, but believe me — it's worth the work it takes to get here. It feels like freedom to not be trapped inside a mental prison of FOODFOODBODYCALORIESWEIGHT all the time. It's a process of relearning how to eat and how to have a relationship with self. 

And the truth is that it's really, really hard to climb out of it alone. I might even say impossible. Developing a healthy relationship with food and body looks different for each person, but you need to have the support of people who've been in those trenches, who get what it's like, and who are far enough out of them that they're not just going to try to sell you on the latest diet or workout sensation that they're excited about this month.

If you see yourself anywhere in this post, sign up here to be the first to get details about the eBook on Intuitive Eating & Body Image that I co-wrote with dietitian Lauren Fowler, scheduled to release next month. 

Ready to go even deeper? Check out my coaching page to see if we might be a good fit for 1-on-1 work.

1. Shisslak, C.M., Crago, M., & Estes, L.S. (1995). The Spectrum of Eating Disturbances. International Journal of Eating Disorders, 18 (3): 209-219.

Graffiti photo by Duncan Hull, Creative Commons license. 

orthorexia: a real eating disorder with real mental + physical health risks

You’ve met them at various points in your life:

  • The friend who brings her own food everywhere she goes (or skips out on eating at social gatherings altogether)
  • The co-worker who never partakes in the office birthday cake
  • The family member who gets anxious at the thought of travel outside of large food-conscious cities
  • The health food store evangelist who wouldn’t dream of ingesting anything with high-fructose corn syrup on the label

Diagnosed food allergies aside, the above examples all describe people who may have orthorexic eating patterns. What is orthorexia?

In 1997, Dr. Steven Bratman coined the term “orthorexia” to describe a rigid devotion to healthy eating that becomes obsessive to the point of actually creating health risks and interfering with a person’s quality of life.

Orthorexia starts out with a true intention of wanting to be healthier, but it’s taken to an extreme,” says eating disorder specialist and Academy of Nutrition and Dietetics Spokesperson Marjorie Nolan, MS, RDN. “If someone is orthorexic, they typically avoid anything processed, like white flour or sugar. A food is virtually untouchable unless it’s certified organic or a whole food. Even something like whole-grain bread – which is a very healthy, high-fiber food – is off limits because it’s been processed in some way.

Though still sorely misunderstood, anorexia nervosa and bulimia nervosa are well-known disorders, and binge eating disorder has now finally made it into the DSM-V, the diagnostic manual for mental disorders. Orthorexia, on the other hand, is newer to the scene, not included in the DSM-V, and less behaviorally clear-cut than the aforementioned eating disorders.

So, is orthorexia a real eating disorder?

The answer will certainly depend on whom you ask, but for many in the mental health field including myself, an eating disorder therapist, it’s a definite “yes.” While anorexia involves restricting the amount of food, orthorexia similarly involves restriction of the type of food or ingredient. Often, the restriction can start off more or less benign, such as simply adopting a vegetarian, vegan, gluten-free or dairy-free diet, but can develop into orthorexia when someone continues to restrict and their list of “allowed” foods gets smaller and smaller.

Read the full post at Adios Barbie. 

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Valerie Martin

Valerie Martin, LMSW, is a Primary Therapist at The Ranch residential treatment center, where she works with eating disorders, addiction, trauma, and co-occurring mental health issues. Valerie focuses on a holistic treatment approach of mind + body integration, using Acceptance & Commitment Therapy (ACT), somatic and bioenergetic therapy, Dialectical Behavior Therapy (DBT), psychodrama, 12-step, and shame resilience. She is also a Certified Sexual Addiction Therapist (CSAT) Candidate. Valerie received her Bachelor of Science degree in Communications and Master of Science degree in Clinical Social Work at the University of Texas in Austin. She is an active member of the First Unitarian Universalist Church in Nashville, and emphasizes spiritual exploration in her work with clients.

reframing "being triggered" + things that "push your buttons" {healthy relationships}

triggers-healthy-relationships A couple things happened at work yesterday that, on their own, weren't a big deal -- but back-to-back and with my particular brand of baggage (not designer, might I add), were painful experiences. Afterwards, I found myself pushing play on the old tapes: "Crap, here it is again. All my insecurity and inadequacy stuff is being triggered. I hate this." I started to slide into self-pity and doubting my abilities and choices.

PAUSE button, engage!

This is one of those "you teach exactly what you need to learn" things. I know I will never be totally rid of my inadequacy thoughts, because I'm of the belief that doing so would require some special witchcraft I have yet to encounter. But I do believe that I can take certain steps to recognize the tape for what it is and reconnect with myself and what I need in that moment, which will help me to avoid spiraling into full-on crazytown. And that, friends, is what I call (realistic!) progress.

One of the things that helped me yesterday actually came from a recent professional training I attended. The training was on a rather specific and intense topic (sex addiction therapy, anyone?) -- but one of the teachers, a talented therapist with a thick Mississippi accent, made practically all the concepts relatable and valuable for life far beyond this particular area.

He focused a lot on boundaries and communication in healthy relationships, and accountability vs. victim mentality. These two gems really stuck with me:

Be careful with the word "triggered" (and the mindset it carries). 

For example, saying "The way she worded that email really triggered me" is actually passive, and thus, you're giving your power away (victim mentality). Instead, you could take ownership of your feelings and reactions by saying "I got reactive when I read the email she sent." If you're not in the therapy/coaching world, you may not use the actual word "trigger" very often, but you might still create a story around certain situations with that passive mentality: i.e.  "look at what happened to me that made me feel this way." It really helped me today to use that frame of "I'm noticing I'm getting reactive to what just happened and feeling sadness and shame." Those are my  feelings, and even though they may have been precipitated by an event,

Similarly, notice what it feels like to say "He/she is really pushing my buttons."

(Chances are, it doesn't feel too empowering.) The teacher at the training said,  "The only button you have is a belly button, and no one's pushing it." Just like with the point above, giving someone else the power to "push your buttons" ultimately puts you in a helpless place (again, victim mentality)  where you give away your power. Sure, don't deny the feelings that arise when certain things happen, but remember that those are your feelings, they're about your stuff, and no one has the power to make you feel a certain way.

I feel ten times better about what happened yesterday by just reframing my reaction, owning my feelings, and talking about it with someone I trust. I hope these tips also help you next time you're faced with a challenging situation. Until next time -- xo!

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Valerie Martin

Valerie Martin, LMSW, is a Primary Therapist at The Ranch residential treatment center, where she works with eating disorders, addiction, trauma, and co-occurring mental health issues. Valerie focuses on a holistic treatment approach of mind + body integration, using Acceptance & Commitment Therapy (ACT), somatic and bioenergetic therapy, Dialectical Behavior Therapy (DBT), psychodrama, 12-step, and shame resilience. She is also a Certified Sexual Addiction Therapist (CSAT) Candidate. Valerie received her Bachelor of Science degree in Communications and Master of Science degree in Clinical Social Work at the University of Texas in Austin. She is an active member of the First Unitarian Universalist Church in Nashville, and emphasizes spiritual exploration in her work with clients.