“To the Bone” – Professional Review of the Netflix Movie

All in all, To the Bone focused on recovery, while it has initiated the needed conversation around eating disorders and its addictive nature. If we continue to shove this topic under the rug – this disease that affects millions of individuals – then we perpetuate its “disorder,” and it becomes as secretive as the sickness itself.

We glorify movies that highlight shootings, killings and violence. Shows featuring those addicted to drugs and alcohol are now mainstream. When it comes to documentaries about individuals struggling with eating disorders, these features become the white elephant in the room.

In the eating disorder community, there has been much drama around the recently released, To the Bone, featuring Lily Collins and Keanu Reeves. The greatest concern has been the potential of the film to “trigger” those who are currently struggling with an eating disorder.

As a certified eating disorder specialist, who previously owned and operated an eating disorder treatment center prior to its acquisition, our former treatment team would not walk on eggshells to prevent our clients from being “triggered.” Triggers are a part of everyday life, and it is the job of a competent professional working in an eating disorder treatment setting to acclimate clients to triggers. Triggers are not bad, they exist to push our clients to become aware, along with grow and transform.

If you feel your clients will be triggered by watching this and similar documentaries, ask yourself:

“What makes you uncomfortable as a treatment professional, and why?”, “What do you identify personally with in the respective triggers?”, and “Are you invested in the recovery process of your clients?”

When informational programs regarding diabetes and/or heart disease are featured on television, do medical professionals become concerned that these programs could trigger those individuals who are afflicted with these conditions? I think not.  Our clients with eating disorders don’t walk around with blinders. We are not shielding them from anything they don’t already know.

Our clients want to be pushed. They don’t want to be handled with kid-gloves. It is our job to continue push their buttons. An astute eating disorder practitioner is not one that receives rave reviews because they were good listeners and colluded with their patients. A skilled eating disorder professional receives reviews that exude, “My therapist/doctor challenged me and pushed me out of my comfort zone. I often left our session in tears…and gained insight.”

The film did not clarify for the audience what was unconventional about Dr. Beckham’s treatment approach. In addition, although diversity of individuals with eating disorders were portrayed – vs the stereotype – along with eating disorders across the spectrum, Anorexia Nervosa was still highlighted as the top of the food chain per usual.

All in all, To the Bone focused on recovery, while it has initiated the needed conversation around eating disorders and its addictive nature. If we continue to shove this topic under the rug – this disease that affects millions of individuals – then we perpetuate its “disorder,” and it becomes as secretive as the sickness itself.

Mindfulness – Tools to Assist the Registered Dietitian in Working with Clients who have Eating Disorders

Many eating disorders coexist with other mental disorders such as
depression. Studies have discovered that mindfulness can bring out
positive emotions and suppress negative emotions and stress…

Scenario
Mindfulness is defined as maintaining a moment-by-moment awareness
of thoughts, feelings, bodily sensations, and surrounding environment.
It also means being aware of these thoughts and feelings without
passing judgment on oneself. Its origins come from a Buddhist
meditation practice and philosophy. Mindfulness is considered an
effective practice with or without the religious context of Buddhism6.
The objective of mindfulness is to live a life that is more internally
centered, meaningful, and with deeper inner peace by using its
practices.

Continue reading Beverly Price’s article here, as written for Academy of Nutrition, Sports, Cardiovascular, and Wellness Nutrition (SCAN), Disordered Eating and Eating Disorders subgroup (DEED).

Three Essentials for an Outpatient Eating Disorders Program

In order to run a successful outpatient eating disorders program, the institute can’t stand alone…there has to be heart. Are you in this work for the right reasons? Is it only your left toe that is in the water, or are you all in? A passionate professional is committed to everything they do…

The essentials in the development an outpatient eating disorders treatment program are many, ranging from business planning to financial management. However, without vision, passion, and determination, the plan and financials mean very little. This article is written for those who have created, cultivated or work in outpatient eating disorders programs who want to be the best at what they do, and who are determined to do whatever it takes to continue to have their program be of service to patients.

via Three Essentials for an Outpatient Eating Disorders Program – Eating Disorders Catalogue

Diabetes and Eating Disorders: Yoga as an Adjunct

For someone struggling with diabetes and an eating disorder, Yoga can be a powerful adjunct to treatment. Read my article here-re posted from We are Diabetes:

http://www.wearediabetes.org/articles/166/diabetes-and-eating-disorders-yoga-as-an-adjunct

New Jersey Administrative Law Judge Rules in Favor of Kantor & Kantor Client in Eating Disorder Case

If you are an eating disorder treatment professional, Lisa Kantor  is an important person to know. We are all advocates on behalf of our patients, who need to focus on treatment, while we fight for their care.

Eating disorders professionals, when providing insurance-based treatment, need to check benefits thoroughly and document who they spoke to–checking twice is not a bad idea to determine any inconsistencies in the health plan reporting of benefits. Document the health plan representatives that you spoke with, including date, time and reference number.

When you admit the patient to your program or service, make sure to obtain the health plan document from the patient – the long 100 plus page document – that the health plan is required to provide the patient. The patient can also obtain this from their human resource department.

Previously, I was a guest blogger on Lisa Kantor’s blog when I as the owner of an eating disorders treatment center.  You can read more tips here on the blog that I wrote regarding advocating for your patient.

I have also shared Lisa Kantor’s recent victory in the link below – how appropriate for the upcoming Independence Day holiday where in our frame of reference, this type of victory is in fact a large step to our own internal freedom. Enjoy your holiday!

Kantor & Kantor, LLP provides exceptional representation for clients who need help with ERISA and insurance claims. Call our California attorneys today.

Source: New Jersey Administrative Law Judge Rules in Favor of Kantor & Kantor Client in Eating Disorder Case

The Things That Make You Strange Are The Things That Make You Powerful

The message that Ben Platt delivered at the end of his Tony Award acceptance speech was, “Don’t waste any time trying to be anyone but yourself, because the things that make you strange are the things that make you powerful.”

If you have seen the movie Pitch Perfect, you may remember Jesse’s eccentric roommate Benji, played by Ben Platt. This talented 23-year-old recently won the Tony Award for lead actor in the musical, “Dear Evan Hansen.”

The message that Ben Platt delivered at the end of his Tony Award acceptance speech was, “Don’t waste any time trying to be anyone but yourself, because the things that make you strange are the things that make you powerful.”

Artists come in many forms – actors, writers, singers, dancers and even business professionals. With the latter, the architect of the business strives to make his or her platform stand apart from similar entities. Its uniqueness is often questioned and rejected- mainly out of fear. A leader will plow through with the idea, for they stand in their truth.

The philosopher, Arthur Schopenhauer said that, “All truth passes through three stages. First it is ridiculed. Second it is violently opposed. Third, it is accepted as self-evident.”

If it wasn’t for the individuals who dared to step out of the box, we wouldn’t enjoy many of the great luxuries we have today, nor benefit from the great healing methods of those who challenged the norm.

This past issue of AARP magazine focused on those in their mid to late 50s – illustrating the trailing baby boomers who are more settled and bring in wisdom and confidence. They are also not afraid express themselves. Christina Ianzito, AARP writer summed it up with, “Ah who cares? I can be who I want to be.”

So, no matter what age you are – for those of you who feel stifled, don’t be afraid to unleash your creativity. This is true authenticity. An unknown author said, “When you dance to your own rhythm, people may not understand you, they may even hate you, but mostly they wish they had the courage to do the same.”

The Concurrent Nature of Eating Disorders and Substance Abuse: Yoga as an Adjunct to Treatment

Mindful Yoga and meditation can affect the cerebral cortex, improving focus and awareness. The cerebral cortex is the center of the brain that is responsible for impulses, irrational thoughts and behaviors. Activating the cerebral cortex can diminish the impulsivity along with irrational thoughts and behaviors involved in eating disorders, substance abuse and related addictions.

The National Center on Addiction and Substance Abuse at Columbia University has concluded that at least one half of women who suffer from an eating disorder also suffer from a substance use disorder (SUD). While eating disorders, and substance use disorders are linked to higher risk for mortality than all other psychological disorders, the two are present together result in a much more damaging outcome.

The rate of comorbidity varies among eating disorder classifications with the prevalence of SUD in individuals with Bulimia Nervosa or Anorexia Nervosa purging type much greater than individuals with Anorexia Nervosa, restricting type. Researchers have reported a higher use of stimulants, sedatives, and cocaine in individuals with Bulimia Nervosa, with marijuana and hallucinogen use in those with Anorexia Nervosa.  It is speculated that the heighted impulsivity of those with Bulimia may reflect their more frequent use of these drugs along with the appetite suppressing nature of the drugs in individuals with Bulimia and those with Anorexia. It is also speculated that the escape offered by the drugs maybe appealing to those who suffer from anxiety associated with eating disorders.

Researchers at the University of Washington concluded that the onset of an SUD could be predicted in individuals with Anorexia Nervosa and Bulimia Nervosa if the individual had attempted suicide, or had been hospitalized. Furthermore, the severity of the bulimic symptoms could also be used to predict a future SUD.

For professionals working with eating disorder patients, a thorough knowledge of and specialized training in substance abuse is warranted, along with understanding the research regarding eating disorders and co-occurring substance use disorder. In a therapeutic setting, a thorough history needs to be completed in order to assess an individual’s comorbidity. It’s not acceptable for the clinician to omit an SUD diagnosis because the individual did not report substance use to that respective clinician – especially when the SUD is clearly documented in the individual’s history. If it is not documented, digging deep is a must for the clinician, given the concurrent nature of eating disorders and SUD. A thorough history can determine the degree of co morbidity in eating disorder patients and may also be used in determining treatment options that suit the patient’s unique coexisting disorders.

Behavioral therapies alone, or along with medications can be a highly effective for of treatment that can lead to more positive outcomes. Another treatment option for co-morbidities is Yoga therapy. Yoga therapy is the process of empowering individuals to progress toward improved health and well-being through the application of the philosophy and practice of Yoga. Yoga therapy incorporates a number of positive mind and body practices such as deep breathing, relaxation, deep meditation, and postural exercises. It adapts the practice of Yoga to an individual’s specific condition, and in the treatment of co-occurring eating disorders and substance abuse disorders, can be adapted to enforce a positive mental outlook, improved self-awareness and acceptance, and can relax and ground a patient.

Gamma-Amino Butyric acid (GABA) is an amino acid which acts as a neurotransmitter in the central nervous system. It inhibits nerve transmission in the brain, calming nervous activity. In recent studies, Yoga has been shown to increase the levels of GABA in the brain by more than 20 percent. This is important because people dealing with substance abuse usually exhibit low levels of GABA.

Mindful Yoga and meditation can affect the cerebral cortex, improving focus and awareness. The cerebral cortex is the center of the brain that is responsible for impulses, irrational thoughts and behaviors. Activating the cerebral cortex can diminish the impulsivity along with irrational thoughts and behaviors involved in eating disorders, substance abuse and related addictions.

The Concurrent Nature of Eating Disorders and Substance Use Disorders – Yoga as an Adjunct to Treatment Two (1) contact hours Tuesday June 20, 2017 11:45 am – 1:00 pm at Henry Ford Maplegrove, West Bloomfield, MI – Speaker BEVERLY PRICE, RD, MA, E-RYT 200, C-IAYT, CEDRD-S, IAEDP For more information or to register: Jessica Jacobs LMSW, MSW, CAADC (248)788-3011.

A special thank you to Bridgette Grabowski, NDTR, who researched the original content for this article.