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Green Hills with Blue Sky

Ask Our Experts/ Video Blogs

This message board provides links to our videos and podcasts containing information about eating disorders from our experts.  


Setting Up Your Treatment Team- Dr. Emma McManus

Binge Eating Disorder- Dr. Emma McManus


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When do you know you are in the right type of treatment?  -Dr. Tony Paulson

This is a common question as patients and their loved ones struggle to find the best type and level of care. The goal of treatment is recovery so if you see improvement and movement toward recovery that would be an important consideration. Another thing to consider is whether the treatment is helping in your long term recovery. In other words are you learning things in treatment that will help you recover and stay recovered? The relapse rate for people suffering from eating disorders is nearly 50%. Why is this so high? Why do so many people after leaving treatment relapse? Part of the answer has to do with the level of family involvement in the patients treatment. Are the family members learning how to help their loved one sustain his or her recovery when she is no longer in treatment?
I tell patients and their families that the combination of family involvement and treatment that leads to abstinence from their eating disorders is the right level of care for them as long as they do not need acute medical care. If the combination of family involvement and treatment is not producing a change in their eating disorder behavior a change in the treatment is warranted and can include more intensive family involvement or higher levels of treatment.


Promoting Healthy Body Image  -Dr Emma McManus

The month of February is the month of celebrate or love your body weeks nationally across college campuses in this country. Every year I participate in these campus events and every year I am blown away by the support we get from college students about the promotion of self-love. We often bring “life sized barbie,” a mannequin, who is always a hit; despite her disturbing ability to even remain upright since her body portions are so distorted. This being said body hate remains prevalent in so many people in this country. Many of us diet, obsessively exercise and go to extreme measures to be thin or muscular and we still are not living body positive. Celebrating your body is a wonderful idea but it gets lost in translation. Why are so many of us promoting body positive language yet not living it?

That being said teaching your child to feel confident in their own skin is of epic importance. I don't think that a child can be too young to talk about self-love. Ideally, the target age would be 8 years old to begin taking preventive action in promoting healthy body image in children. Considering that more than half of 7 year old girls and one third of same aged boys think they should be thinner the window of time to make a difference is small.

Encouraging body positivity begins at home. It is influenced by peers and the media of course yet family has a large influence on a positive sense of self. Additionally here are a few other suggestions for parents to foster body positivity in their children.

Language is powerful: In order to foster body positive ideals one must practice body positive language in the home. Use body positive language toward others and especially yourself.

Food is fuel: talk to your kids about the purpose of food and how our bodies need the nutrients to be active and have healthy brain function.

Exercise is for well-being: discuss that physical activity is for mood stability and health versus to be thinner. Teach your kids that the outdoors has so many benefits and teach them to enjoy being in nature while exercising.

Practice body positivity: learn to love your own body without constantly critiquing it. Teaching kids to be proud of being strong and to appreciate their bodies for all they can do.

Healthy role models: focusing on extreme body types is not helpful. Teach your kids to have role models who possess more than just beauty. 


Chasing Prescribed Beauty  -Dr Emma McManus

As 2017 creeps up on us many people will make New Years resolutions to lose weight. Many promise themselves that they will do what it takes to lose the extra pounds they carried last year. Even those who are of healthy weight are dying to be thinner.  No matter which diet you choose in order to create a thinner you, the diet industry continues to feed its deep pockets. Paradoxically, the industry wealth continues to grow as do the waistlines of Americans. This has always struck me as a disturbing truth, especially since the pockets of the 6 billion dollar diet industry are deep and we as a society are not benefiting instead many of us are selling our souls to be thin.

The drive for thinness is not a new concept, yet it becomes a conduit  for many ailments including body dissatisfaction and potential for the development of a eating disorder. Eating disorders continue to increase in this country with a very early onset. Many studies indicate that girls as young as 8 years old are preoccupied with weight loss. Third grade is now the target age for prevention of the development of an eating disorder.

My New Years resolution is aimed at avoiding prescribed beauty and instead embracing being healthy and content in my own skin. I refuse to fall victim to the oppressive nature that the obsession with beauty induces. I encourage those of you reading this blog to strive to break the mold of female oppression and chasing the thin ideal in 2017.  I leave you with the following thought provoking quote:

Naomi Wolf:  The Beauty Myth (1991):  “A culture fixated on female thinness is not an obsession about female beauty, [it is] an obsession about female obedience. Indeed, what might happen if suddenly women were encouraged to be at home in their bodies? Where might their energy go if our clients stopped chasing the fantasy of thin?

When Does Healthy Eating Become Disordered Eating?  - Dr. Emma McManus

Healthy eating is getting a lot of attention lately in the treatment community. An obsession with healthy eating initially appears as simply engaging in healthy lifestyle changes. However, it is not unusual for healthy eating to quickly lend to a full blown eating disorder. 

When these healthy changes lead to severe restricting of the variation of food consumed this is referred to as "Ortho-rexia".This term describes a specific set of behaviors but it is not a recognized DSM-V diagnosis. This restrictive diet involves individuals who are overly focused on eating healthy foods.  With this type of eating disorder people take healthy eating to the extreme where they eliminate so many foods from their diet they begin suffering from malnutrition and serious health consequences. 

It is important to recognize that healthy eating as part of a healthy lifestyle is admirable; however, any extreme restriction is unhealthy for overall health. Health and wellness are emphasized in this country despite high levels of obesity. The following examples are unfortunately more common than most people are aware of in elementary-aged children. 

A 7 year old announces that she's become a vegetarian because she loves animals. Then she starts eating less and less of her food. When her parents bring her into treatment, she is emaciated but pinches a tiny amount of flesh between her thumb and forefinger to illustrate "how fat" she really is. She now developed a full blown eating disorder. 

More than 60% of elementary and middle school teachers report eating disorders behaviors in schools (National Association of Anorexia Nervosa and Associated Disorders, 2014).

These statistics stand alone in illuminating the slowing growing epidemic of growing disordered eating behaviors.

42% of kids in first through third grades wish they were thinner

81% of 10 year olds are afraid of becoming fat

51% of 9- and 10-year-old girls say they feel better about themselves when they are on a diet

These statistics speak to the potential internalization that growing numbers of children glean from societal pressures. Studies suggest that kids often perceive that it is not okay simply to be who you are. Instead suggesting that beauty is about restrictive eating and dieting in order to achieve an overly thin physique.

Unfortunately, unhealthy societal messages and pressures are inevitable making teens especially vulnerable during puberty. However, teaching teens how to respond to the pressures in healthy ways is a crucial preventative.

Attaining wellness and living a healthier lifestyle is about balance. If an individual is engaging in "orthorexic" behaviors, a form of obsession and restriction, they may have developed disordered eating behavior. Therefore, question is, “can an individual be too preoccupied with health and the quality of food potentially leading to an eating disorder. Prevention and reframing societal messages for healthy living for teens is an important preventive of eating disorders.


The Rollercoaster of Recovery  - Dr. Tony Paulson

The process of recovery sometimes seems cruel. At least initially the better you do the worse you feel. Its so hard for many people to fight through that initial stage because the more they distance themselves from ED the more anxious they feel. Eventually the anxiety subsides but how do you sit through the initial anxiety associated with recovery? I think an important piece of getting through it is to have someone supporting you through the process. Someone who will be sympathetic to your struggles but still be a barrier to you engaging in your eating disorder.


Binge Eating Exposed: Closing the Emotional Gap  -Dr. Emma McManus

Binge eating disorder is the most common eating disorder in the US. Binge eating disorder affects three times the number of people diagnosed with anorexia and bulimia combined. Believe it or not binge eating disorder is more common than breast cancer. It affects 2.8 million people. Women are more likely to experience the symptoms of binge eating disorder as compared to men. The onset typically begins in early 20’s for women and men in midlife. I am sure as you read this you know someone in your life who is battling with this difficult and painful diagnosis.

Binge eating disorder (BED) is an eating disorder that includes eating large quantities of food in a short period of time. The compensatory behaviors such as restricting caloric intake, excessive exercising and purging are not used. Due to eating large amounts of foods many individuals feel guilty and ashamed. Some try countless diets and others gain weight with secondary medical complications.

Binge eating is more than just over eating. The psychological underpinnings cut much deeper than just feeling out of control when eating or all day snacking. Typically, the individual does not actively decide to overeat as a way to cope unlike the individual with anorexia decides not to eat in order to achieve the thin ideal. They are not focused on chasing the thin ideal like those with individuals with anorexia or bulimia. Weight loss or weight gain is not always a concern, eating becomes an attempt to ease persistent emotional distress.  It is a misconception that all individuals are overweight who have binge eating disorder. In fact, many individual’s weight falls within healthy weight range. 



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