About Leslie

  • About Leslie E Murray MD, MPH

    Leslie E. Murray, MD, MPH is a Child and Adolescent Psychiatry Fellow at the University of Iowa.  Her interests include the treatment of men and minority populations, eating disorders advocacy and mental health care access and delivery. Read More...

June 27, 2009

Weight bias, discrimination, kids and the role of clinicians

These videos were are from Yale University's Rudd Center for Food Policy and Obesity. Given that these videos accurately depict interactions that often occur between obese patients and clinicians I have decided to post them.  As bias has been linked to binge eating, talking about bias is essential. 

Confronting clinicians who engage in this behavior is your right.  It lets the clinician know about their behavior, and empowers you as a patient.  Insist upon gowns that fit, comfortable waiting room furniture, scales that accommodate your size and that your blood is taken correctly with a proper sized cuff. After all, this is supposed to be a monitor of your health and medication is adjusted based on these numbers!

Pediatric obesity is a topic of great concern due to increasing prevalence.  Of note, bullying and teasing can have lifelong ramifications and effects on a child's self esteem, desire to learn and job prospects.  In the video, we learn that 3 year old children prefer not to have an overweight friend; that is clear sign of a weight obsessed society.  It is time now to think about what we are going to teach our children about weight, body image, and how to love themselves.  Hint:  it has nothing to do with paying them to lose weight.



 

Feel free to submit your stories and speak out against discrimination.  Don't attempt to mask your feelings with food.

Lastly, do not allow the airlines new policy of requiring the purchase of an extra seat affect job performance.  Getting passed over at the workplace is discrimination and it must be pursued.


To learn more, see the following references:

 http://yaleruddcenter.org

Puhl, R. M., Heuer, C. A. (2009). The Stigma of Obesity: A Review and Update. Obesity (Silver Spring), 17(5), 941-64.

Roehling MV. Weight-based discrimination in employment: psychological and legal aspects.  Personnel Psychol 1999;52:969–1017.

Harvey EL, Summerbell CD, Kirk SFL, Hill AJ.  Dietitians’ views of overweight and obese people and reported management practices. J Hum Nutr Diet 2002;15:331–347.

http://www.bodypositive.com/

http://kidshealth.org/parent/general/body/overweight_obesity.html

June 20, 2009

Good hair part II

CNN has taken up the issue of "good hair" as part of their Black in America series.  I've included a link to their website below. The CNN special series Black in America will air July 22-23, 2009. The myth of "angry black people", pressures to assimilate, pressures to conform to black societal standards and evolving definitions of beauty can all be felt, seen and described in the black hair experience.

http://www.cnn.com/SPECIALS/2009/black.in.america/

http://www.cnn.com/2009/LIVING/06/24/bia.black.hair/index.html

 

May 20, 2009

I may be confused, but I'm not sure...

Who are you?  Not the song by the Who, or the theme to CSI, but how would you describe yourself?

Sounds easy enough to the person asking, but occasionally to the person being asked, this can provoke a quite complicated response. "In what way?" "Around who, my friends or family?" "I'm not sure I understand."  But underlying this concept are multiple psychodynamic theories.

Consideration of psychodynamic theory and when most eating disorders have their onset (often teen years) has led to study of Erik Erikson's stages of development.  According to his theory, the typical challenges at this time would be completion of mastery of Industry vs. Inferiority and once mastered, Identity vs. Role Confusion.  To put in other words, the sense of being knowing you can succeed at something followed by discovering who you are, what you believe, and developing your own identity.

Or, learning to break from parents, or social groups and feeling that it is okay to do so.  Depending on personality styles, this may be hard to do, or even inconceivable.  Being able to say no to something may not be based on what you believe, but what you were taught to believe, or what you think someone may wish to hear. 

Others may still suffer that feeling that they were never quite good enough.  Passions may fly (or be absorbed) and some may wish to label you with poor self esteem or "inferiority complexes."  The eating disorder may have been your method of being "good" at something.  I challenge you to say "enough" and move on with your life and development as a person.

Role confusion may include anxieties about sexuality, religious preference, going to college or into the family business.  You may recognize it because you are doing things because others suggest them to you, not because they light a fire in your heart.  Being confused about who you are is a natural course of life, while anxiety provoking, happens to everyone.  Julia Roberts in "Runaway Bride" is a great example of Role confusion.  Her (unhappy, lost) character took on the characteristics of every person she was with, including how to eat her eggs, without ever knowing herself.  In the end, she had to just spend time, figuring out what she liked and what pleased her.

In Spanish, to ask for permission, one would say, Puedo _____ (fill in the blank).  This word is from the verb poder, which can be translated as may I, or can I, but most importantly as the power to.

Changing our language from I can, to I have the power to, strengthens our resolve and belief in our self and worth.  No longer the little engine that could, we become the Acela.

April 18, 2009

Dare to live your dreams -- Susan Boyle scores a point for self confidence


Susan Boyle wowed a doubtful crowd recently on Britain's got talent.  If you're one of the few people who hasn't seen it, take a look. Never been married, never been kissed.  First glances and people doubt her, as she does not fit the "image." People laugh at her hair, dress, age, makeup...that is, until she sings.  She then becomes proof that belief in one's dreams can defy all. 

Believe in yourself today (and everyday).  Dare to live your dreams.  Know that your own self approval matters.  You don't have to have gifted to enjoy doing something.  Say yes to yourself.  Outside approval is not always a valid test of talent, remember Jennifer Hudson didn't win American Idol (or get to the finals).  She did win an Oscar and Golden Globe and starred in several movies.  Please know your intrinsic worth does not come from beauty. As you grow more body confident, you will feel it and believe it.  Now go follow your dreams!

 
 

March 24, 2009

Fear, guilt and shame


Fear. Guilt. Shame.  The emotions are often driven by our deep rooted anxieties and self doubt.  We must challenge ourselves to mentally "turn down the volume" and re-regulate the role that they play in our lives.

For individuals with eating disorders, and for the population at large, much of our behavior is governed by these emotions.  It is only when we get out of balance that problems occur (yes, the everything in moderation talk). 

In speaking with individuals who don't "fit the mold" of the "typical" eating disordered patient, there still exists the fear of exposure to family, friends, and loved ones.  This fear, bolstered by shame for having the illness and/or guilt for having a " white woman's illness" is allowed to persist and strengthen.

By not speaking out, it becomes more difficult to obtain treatment and end the cycle. It also delays the necessary research to gain further knowledge about eating disorders.  Most importantly, we cannot accurately assess the prevalence, incidence, at risk populations, and devise new treatment for these disorders.

Continue reading "Fear, guilt and shame" »

February 16, 2009

Pay no attention to the man behind the curtain...

So goes the line from the Wizard of Oz.

Far too often, we find ourselves looking for that magic that will cure us of our ills, only to find we had the strength inside all along.  A fable, you say?  Only works in the movies? I wish to challenge your thinking.

Let's stipulate...there are no shortcuts to recovery (okay, take a moment to sigh, and be upset, now compose yourself, because there is good stuff coming up). 

Yet somehow it doesn't stop you from looking for anything or anyone who can promise results fast.  To take away the thoughts of self loathing, or urges that seem hard to control, and desires to do everything you are not supposed to do. 

You sit and ruminate and wish for the Wizard in order to be able to say, "I'd like you to get rid of my eating disorder."  Thing is, you are actually wishing on someone(thing) that is fake, and will never provide your needs, and will let you down every time.

Well, what if he did say, "You wish is granted."  Now what?  What are you going to do with the rest of your life?  Start facing the things that have unknowingly been putting off or have been too difficult to talk about? 

Scary notion for some.  This is when we start to understand the role of the eating disorder.   A grand distraction, perhaps even a cocoon that helped you feel safe.  A curtain, if you will, that stands between you and the life you were meant to have. 

Like the Wizard who in the end chose to come from behind the curtain and admit his shortcomings of lacking power, you too can do the same.  Then with vigor, he chose to follow his lifelong dreams and leave the shadow of his past.

Come out and join the world.  You too can leave the past behind.  Step out from behind the curtain.

January 25, 2009

Blacks and Body Image-- I love my hair!

With today's images, I was floored when I came across this book...

 


Before even beginning to comment about the title of the book, I must comment about the lovely drawing.  This child clearly has African American features and appears happy!  Fabulous!

Having black hair separates girls from many activities that others take for granted.  Unless the hair is "permed," (as in chemically straightened, not chemically curled) getting it wet is a severe no-no.  So activities like sports and swimming pose a hazard because it makes it more difficult to comb the hair, and young girls are discouraged from and less likely to engage in activities for fear of "sweating out their hair." 

Hair is often worn in braids as not to cause tangles, and this is a style that will last a number of days.  In recent commentary about the daughters of our new inaugurated President, some lamented that his daughters looked better without braids.  Perhaps they are speaking from an eurocentric point of view and describing what they are accustomed to seeing, however, from an afrocentric point of view, braids are the norm.  They do not represent a militant stance, and adding beads to the braids was quite popular for decoration as depicted above.  

 Good hair

(http://festival.sundance.org/2009/film_events/films/good_hair )

Recently at the Sundance Film Festival, Chris Rock unveiled his documentary, "Good Hair."  He states his new documentary, was spurred by his daughter Lola's question why she doesn't have "good hair." This took him on a journey through salons and businesses to attempt to find an answer.  In the process, he spoke to people in salons/barbershops, celebrities, and learned how black hair affects self esteem, the pocketbook, relationships and about the bustling hair industry, leaving him with the belief that what is most important is inside than on top of his daughter's head. 

Perhaps it is not a coincidence that the first woman millionaire was Madame C.J. Walker who developed a line of beauty and hair products for black women.

Continue reading "Blacks and Body Image-- I love my hair!" »

January 11, 2009

Promises, Promises

A major milestone in the life of those with food and body image struggles has recently passed. 

The first Monday of the first week of the new year was January 5, 2009.  As Mondays for many weeks serve as the start day for many diets, this was the Superbowl day of the dieting world.

A landmark day for many millions, it fills the deep pockets of the diet industry. They know and are counting on the New Year's resolutions which undoubtedly include diet and exercise goals.  So entrenched are these goals, that they are made automatically, often without formal recognition.

I can't help but asking...after all the pomp of the ball dropping on times square, when the diet commercials start playing so often on television, if given a multiple choice test you could correctly match the diet program with the celebrity, new gyms are joined, and fridges are stocked with food that promises to thin while you sleep...

Was there time in all of this to serious consider what you really need (versus want) right now? 

Continue reading "Promises, Promises" »

January 01, 2009

People's Sexiest Man of the Year

I suppose Congratulations are due to Hugh Jackman for being chosen as the "Sexiest Man of the Year."  In addition to raising his salary per appearance and film, he has participated in Hollywood's beauty pageant of the stars. 

A quick visit to the site reveals what is wanted of today's man...business savvy, a love of family, and a body that is desired by the masses.  Sexy is heterosexuality...which of course likely draws more women to buy more magazines.  Beauty is also a full head of hair (the thicker the better), with lots of photos of men on outings with their children regardless of their marital status, or the status of their relationship.

Disturbingly, there is a section, where the reader can guess the person after being shown only their chest.  More surprising, is that it is possible to do so!  Perhaps it is due to the overexposure by the media.

This unfortunately is not a trend limited to People Magazine.  Recently the President-Elect was vacationing in Hawaii and photos of him were taken without wearing a shirt and distributed widely across the internet.  His medical records were also quoted for his fitness and compared to his opponent and used as a strategy in the election process.  Whispers of Camelot precede him in the halls. 

I support the recognition of someone for physical feats, not the worship. There will never be a part of yourself that you can change to cause you (or others) to like you more.  If others cannot accept you as is, they may never accept you in your new skin. 

Begin to confront the demons inside that plague you, and tell you that if you don't measure up to "societal standards".  If you can begin to question why you've been feeling that you must look a certain way, you are ready for therapy, and ready to begin to heal.

December 20, 2008

Blacks and Body Image--The Jet "Beauty of the Week"

Jet Magazine is a weekly periodical published by Johnson Publications, the same publishers of Ebony Magazine.

Each week, a young lady vies for the opportunity to be selected as the "Jet Beauty of the Week."  Qualifications, you may ask?  Taken from the their website's FAQ (with deletion of submission address):

How do I become a Jet Beauty of the Week?
Submit two current photographs of yourself, preferably in a two-piece bathing suit, taken against a plain background with few distractions. Please make sure all photos indicate the name and address on the back.

In order to be considered you must be at least 18 years of age. Acceptance of the photographs submitted is based on the decision of the Editorial Review Board. You will be contacted, by mail, as to the board's decision. JET reserves the right to retain all photographs. Thanks for your interest and good luck.

 

The magazine's definition's of beauty is singular and sadly archaic.  While women have grown and developed new roles in society, the beauty of the week remains.  As I looked for information before writing this blog, I found others disgruntled with Jet's inability to change with the times.  

My issue involves not only shape/weight pressures on women, or that women must pose in a swimsuit, but that this provides a weekly reminder to young impressionable people (think college dorm rooms) that the only form of beauty is physical. 

Many young men who paste these pictures on their walls, and look forward to the arrival of the magazine each week.  It was a young man in college who pointed out to me that the Jet Beauty of the Week is consistently on page 43 of each issue.  

That picture will tell nothing of her inner beauty.  It will not tell if she has friends, is kind to people or elitist.  It will not tell how she treats her family.  If she has grace and poise.  Does she care about her community?  We cannot know her core values.

So often, people judge by looks, only to find that something that appears outwardly beautiful is actually an empty shell.  It cannot be said that the magazine is looking to counteract images of blacks in the media, by showing black women in all shapes and sizes because of their stated preference for women to be photographed wearing bikinis. 

Perhaps Jet should look for someone of substance to highlight each week.  A mover and shaker in the community.  There are so many young people who give their time to their community or excel in school and ask for nothing.  By doing this, hopefully it will show rewards for something other than physical attributes, and help refocus others.  It is time to take the focus off of the physical. 

Have someone submit a photo of themselves doing volunteer work (or any positive)while fully clothed.

Let these people be our new role models.  The feature would be open to all people and renamed the Jet Person of the Week.

 

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  • The posts and comments contained in The Gürze Books Eating Disorders Blogs do not necessarily represent the views, beliefs, or opinions of Gürze Books. The information contained here is meant to complement, not substitute for, professional medical and/or psychological services.

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