As we enter the New Year, we are suddenly bombarded with advertisements pushing weight loss products and filling our minds with the idea that, in order to be our “best selves” this year, we must follow some new diet and exercise regimen. For many individuals—especially those struggling with eating disorders (ED)—this time of the year can make us particularly vulnerable to feelings of guilt and shame as we are faced with increased pressure to “undo” the indulgences of the holidays.

For individuals struggling with an ED, food-related guilt and body image shame is often dealt with through self-punishing behaviours; for example, following an overly restrictive diet and excessively exercising. On the other hand, some individuals cope with body image shame by hiding under baggy clothes in an effort to avoid painful feelings of guilt and shame. However, in my practice as a therapist, I’ve found that such self-punishing and avoidance behaviours are unsustainable and ultimately perpetuate the cycle of guilt and shame.

Instead, consider these three more sustainable tips for coping with post-holiday food guilt and body image shame, none of which involve dieting or pursuing weight loss:

1.   Don’t criticize yourself: Practice self-compassion and Radical Acceptance

Instead of beating yourself up, or running away from feelings of shame (literally or figuratively), try working towards greater self-compassion. Be gentle with yourself and be reminded that shame is a fleeting feeling, not an identity; just because you are feeling bad, does not mean you are bad. Another self-compassionate approach to dealing with shame is practicing Radical Acceptance, a skill used in Dialectical Behavioural Therapy (Dimeff & Linehan, 2001). Rather than ignoring, avoiding, or wishing the situation were different, accept things exactly as they are, including the painful emotions of shame and guilt. Radical Acceptance can help you regulate feelings such as anger, guilt, and shame by approaching them with kindness and self-understanding rather than self-judgment.

2.   Ask Yourself: Whose Shame is it Really?

When working with clients who struggle with body image shame, I often ask them to reflect on who their shame really belongs to. This question is meant to facilitate differentiation, the process of recognizing the extent to which one’s body image shame has been taken on as a result of someone else’s shame. This can help you detach from and “disown” feelings of shame by identifying that perhaps your shame does not belong solely to you. Differentiation can protect you from internalizing—and thus negatively reacting to—body shame-inducing comments made by others.

3.   Swap your “Clean Eating” Plan for a Social Media Cleanse

Research shows that exposure to media promoting the “thin ideal” or “athletic/muscular ideal” increases body image dissatisfaction and can also lead to negative emotions, depression, and disordered eating (Huang et al., 2021). We now have the ability to control what shows up on our timelines, so consider unfollowing any accounts that promote diet culture and start following body-positive or body-neutral content online. Doing so will ensure such shame-inducing content no longer appears on your feed or negatively impacts your well-being this year.

Loreana La Civita (B.A.Hons) is a Registered Psychotherapist (Qualifying) at the Centre for Interpersonal Relationships (CFIR) working under the clinical supervision of Dr. Jean Kim (C.Psych). Loreana provides psychological services to adolescents and adults and has a special interest in treating individuals with eating disorders (e.g., Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, ARFID), body image concerns, neurodiversity (e.g., ADHD, ASD, OCD) and trauma. She integrates emotion-focused therapy (EFT), cognitive-behavioural therapy (CBT), and dialectical-behavioural therapy (DBT) informed techniques to support individuals struggling with concerns regarding eating, weight, and body image.  

SOURCES

Dimeff, L., & Linehan, M. M. (2001). Dialectical behavior therapy in a nutshell. The California Psychologist, 34(3), 10-13.

Huang, Q., Peng, W., & Ahn, S. (2021). When media become the mirror: A meta-analysis on media and body image. Media Psychology, 24(4), 437-489.

Recognizing our hunger signals is an essential ability to ensure we are fueling our bodies properly. Without food energy, it isn’t easy to function cognitively, physically, socially, or emotionally. But have you ever noticed a difference between your physical and emotional hunger? 

Physical hunger is defined as a feeling of discomfort caused by a lack of food. Typical cues for this type of hunger include stomach growling, headache, feeling faint or weak, loss of energy, and irritability. When we recognize this physical need and tend to it with food, we’re usually satisfied and relieved. 

Emotional hunger does not stem from a need to eat. It arises from an emotion that we are not giving enough attention to. It is a sense of emptiness, a feeling that something is missing, a craving for comfort. In other words, emotional hunger does not come from the stomach; it’s derived from an unmet emotional need. 

“Emotional hunger does not come from the stomach; it’s derived from an unmet emotional need.”

According to the American Psychological Association, there is a strong connection between negative emotions and food. More than 35% of adults reveal turning to food to cope with their feelings monthly, and more specifically, seeking high-calorie and high-fat foods during periods of stress. This behavioral cycle can lead to different difficulties, including feelings of guilt and shame, heightened anxiety and lower mood, body image concerns, and disordered eating behaviors.

Being able to distinguish our physical hunger from our emotional hunger is, therefore, a valuable skill. Here are some questions to ask yourself to help meet your real needs, whether physical or emotional.

“Did my hunger come suddenly?”

Have your hunger cues developed progressively, or did they appear spontaneously? If your hunger is emerging gradually, eating a snack or a meal will be helpful. However, if the urge to eat is sudden and you are craving specific comfort food, you may be experiencing emotions that need your attention. 

“Is my hunger located in my stomach or not?” 

If you are not experiencing physical signals of hunger (e.g., stomach growling, feeling sluggish, headache), it can be worthwhile to ask yourself how you feel and what you need right now. Is it possible that you are feeling stressed, sad, or simply bored? What would help to cope with these emotions?

“Why am I still hungry after a full meal?”

If your hunger is still present after a typically satisfying portion, it may be necessary to employ coping or self-care strategies to support your emotional needs. These can include reaching out to a friend, journaling, doing breathing exercises, moving your body, or doing an activity you enjoy.

Our hunger signals can inform us on how we are feeling and what we are needing, and it can be valuable to learn how to understand them better. If you need more support to cope with difficult emotions or are experiencing overwhelming body image concerns or problematic eating behaviors, professionals at CFIR can work collaboratively with you. 

Dr. Karine Côté, D.Psy., C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Côté provides psychological services to individual adults and couples experiencing a wide range of psychological and relationship difficulties related to mood and anxiety disorders, trauma, eating disorders, sleep disruptions, and interpersonal betrayal. She works from a humanistic approach and integrates therapeutic techniques from gestalt and object relations psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioral therapy (CBT).

(originally posted via National Initiative for Eating Disorders (NIED))

I started the National Initiative for Eating Disorders (NIED) back in 2012. At the time, our daughter had been suffering from anorexia and bulimia for two decades – it still feels impossible to reconcile the amount of time it’s had a grasp on her life. 

The life of a caregiver supporting someone living with a mental illness is a series of never-ending harsh realities. Here is mine: 

Twenty years ago, the word “caregiver” was not in my vocabulary. When you hear “caregiver,” most people think of seniors being looked after and cared for by their adult children – who may even be seniors themselves. I come from an entirely different caregiver population – (though I’m a senior myself!)

My caregiving journey began in 1999. Little did I know that our youngest daughter, [who was] almost 16 at the time, was struggling with self-esteem and anxiety issues. An eating disorder was about to become a devastating bomb dropped on her and the rest of our family.

When she first got sick in high school, her friend came to tell me that she was throwing away her school lunch. Around the same time, she became a vegetarian, started making and requesting ‘funny foods,’ and began exhibiting strange kitchen behaviours. Her overall attitude also started to change. 

“Where do we go from here?” I remember asking myself.

Our first thought was to speak with her pediatrician. At the time, we were so naïve and didn’t know we were about to get caught in the whirlwind of an unknown illness. We had no idea where we were heading.

I still remember my husband frantically charging through downtown Toronto to the National Eating Disorder Information Centre (NEDIC) to gather names of therapists, doctors, dieticians, nutritionists – anyone we could call or reach out to for help. There was no Google at that time, and the internet was in its infancy.

At the beginning of our daughter’s illness, I waited anxiously to attend a weekly peer support group for mothers – a life-saving program. 

I vividly remember sitting in this group and watching the facilitator ask those in the room to share how sick their daughters were and for how long. Some said three years, others said five years, and some even said ten years.

“Yeah, right, we will be done with this in a year,” I remember thinking. Unfortunately, this was not my reality, and I became one of those mothers. 

We tried everything to help her, from tough love to unconditional love, from having her living at home to refusing her living at home. From a publically televised intervention, to her residence in safe houses, renting basements, incarceration, inpatient and outpatient programs – the list goes on. Being an Eating Disorder caregiver is no easy feat.

Never in our wildest dreams (or nightmares) did we think we would be taken down these dark roads with our daughter who had everything a kid could want. We were loving parents doing everything we possibly could within reason for her and her older siblings. We even uprooted our lives and moved houses in the hopes of making our lives’ better’ and giving her privacy in our basement.

In 2016, I took her to the E.R. to be rehydrated – over 20 times. I would drop her outside and let her call me when she was done. I was getting to the end of my rope.

During that time, my only respite was that I knew she was safe in the hospital. She was too sick to run out with people watching over her. I was ‘free’ for a few hours – imagine having to think like this.

To this day, our hearts sink whenever we receive texts or telephone messages from her and have had to create an alert system so our own stress levels are lessened.

One significant lifestyle change we have made, with her agreement, is placing locks on the fridge and freezer. The only groceries in the kitchen are spices and seasonings. The rest are locked away. My grandkids are accustomed to asking “for the key to get a snack.” These adaptations are still realities in our lives.

Having an Eating Disorder is not a choice. Some people believe Eating Disorders are just a rich, vain teenage girl’s sickness. Nothing could be further from the truth.

Eating Disorders affect all genders, racial, ethnic, and religious identities, sexual orientations, and socio-economic backgrounds.

No one can condense twenty years of a living nightmare into a short blog post. But it is enough to paint a dark picture of the life my family and I have had to live with, affecting us all both emotionally and financially.

There is good news, though. After 19 years, our daughter has finally started her ascent up the mountain of recovery. She is driving again after 12 years of not being allowed to; she’s gained weight and is content. It feels like we have our daughter back.

We are finally starting to feel that all of her strength, love, and will to lead a quality life suppresses the voices stemming from her mental illness.

Although the stress and worries of being a caregiver will never leave us alone, we have remade our lives as a couple and continue living and are committed to enjoying our lives (which we do!) I count my blessings every day.

About the Guest Blogger: Wendy Preskow is the President and Founder of the National Initiative for Eating Disorders (NIED).  NIED is a not-for-profit coalition of health care professionals, counsellors and parents with children suffering from Eating Disorders. NIED’s team aims to help bring about positive change in both the availability and quality of treatment of Eating Disorders in Canada.

The coronavirus pandemic has evoked a sense of living in an eerie, uncertain, and unpredictable dream. We all need to do our part to carry out public health recommendations to reduce the spread of COVID-19 (i.e., keeping a safe distance from others, practicing proper hand-washing and hygiene techniques, staying at home). But for those who struggle with an eating disorder, the isolation, stockpiling of food, empty grocery store shelves, along with a general sense of heightened stress and anxiety, can be a living nightmare. Indeed, eating disorders tend to develop insidiously in hiding, as a person becomes more isolated with their illness. Concerns about food scarcity and stockpiling food can create enough tension and anxiety to lead to binge and/or purge urges, while guilt about eating limited food may trigger restriction urges. For those in treatment with a prescribed meal plan, having limited access to their regular foods can create confusion, fear, and panic about what to eat. Disruption to our routines, including our food, eating, and activity routines, can threaten our sense of security. On top of all this, social media memes about weight gain and the ‘quarantine 15’, along with the plentiful messages about ‘staying fit at home,’ can bring upon intense body image distress and/or compulsive exercise urges. This combination can be a perfect storm for ED to rear its head.  

Although this can be a challenging time for those who struggle with an eating disorder, there are strategies to help ease, cope with, and tolerate the distress:

Maintain a (flexible) schedule and plan

Having a structure to our days can be hugely beneficial to our sense of security and stability. Maintaining regular meal and snack times can offer grounding anchor points throughout the day. Further, having a meal plan can reduce anxiety during this time when food-buying patterns are shifting. Building flexibility into that schedule and plan, however, can help to reduce the likelihood that rigidity and perfectionism flare, both of which may trigger eating disorder symptoms. For example, this might mean creating a meal plan with multiple options for meals and snacks, so that limited food available at the grocery store is less likely to create panic and distress. 

Connect with your physical self outside of exercise

Physical activity can be soothing and regulating. For those with compulsive exercise urges, however, connecting to our physical self in forms outside of exertive training might help to limit these urges. For example, stretching, deep breathing, or body-based guided meditations and mindfulness exercises can help to feel a greater connection to our body.  

Engage in tactile and sensory activities to cope with and manage eating disorder urges (e.g., crafting, drawing, playing an instrument, doing a puzzle).

Much of an eating disorder exists inside our internal worlds – doing something external by engaging our senses can help to shift our focus away from eating disorder thoughts and urges. 

Limit time on social media

Being inundated with overwhelming and conflicting messages on social media can contribute to heightened anxiety, depression, and unhelpful social comparison. Putting boundaries on scrolling through social media can help to prevent this spiral.

Seek connection and support

Although many in-person support groups have closed, online support groups may be available. Further, many clinicians are continuing to offer assistance through video and/or phone therapy sessions. The National Eating Disorder Information Centre (nedic.ca) runs a helpline and instant chat for those needing support. Hours are available on their website. Connecting in with loved ones and talking about our struggles can also help to soothe the distress associated with an eating disorder. Asking a loved one to help out with grocery shopping or meal prep may reduce the related stress, while also offering opportunities to feel connected to and supported by others.

And finally,

Be compassionate towards yourself

Eating disorders are notoriously harsh and critical. Gently approaching yourself with moments of self-compassion and kindness, acknowledging that this is a difficult time, and validating the struggle you are experiencing, can be a quietly powerful way to help weather this perfect storm. 

Clinicians at CFIR can support you in working with issues of weight and emotional eating.

Dr. Jean Kim, Ph.D., C.Psych. is a clinical psychologist at CFIR’s Toronto location. Over the past eight years, Dr. Kim has had the opportunity to work alongside people as they develop a greater understanding of themselves and their relationships. She has specific interests and training in working with people who struggle with disordered eating, weight, body image concerns, as well as those who are experiencing the challenges of integrating their cultural identity.