About Marcia and Nancy

Nancy Matsumoto

May 05, 2008

Where Does "I Feel Fat" Come From?

Dear Readers,

For those of you who have helped or are helping a loved one battle an eating disorder, one of the most puzzling aspects of these diseases can be the absolute conviction of your loved one that she or he is fat, when in fact they are starving to death, or even on the thin healthy side.

There are so many other behaviors associated with eating disorders that are equally inexplicable: Why does your child feel happier and safer the more his bones stick out, the more he courts cardiac or cerebral damage? Why does she crave the ritual of stuffing herself with junk food until she feels sick and passes out? How can she continue starving and purging when she knows eventually her bones will crumble like bread sticks and her teeth will rot and fall out?

Continue reading "Where Does "I Feel Fat" Come From?" »

April 20, 2008

Unlocking the Mysteries of Eating Disorders

Dear Readers,

I just finished a new book that many of you will want to know about, Unlocking the Mysteries of Eating Disorders: A Life-Saving Guide to Your Child’s Treatment and Recovery (McGraw Hill, 2008). It is written by David B. Herzog, M.D., a Harvard psychiatry professor and head of The Harris Center at Massachusetts General Hospital; Debra L. Franko, Ph.D., a Northeastern University psychology professor and Harris Center associate director, and Pat Cable, R.N., the Harris Center’s director of publications.

Marcia and I know Dr. Herzog to be one of the most compassionate and expert professionals in the eating disorders field. He and his colleagues have written an eminently sound guide. You hear the voices of lots of parents and their kids who are struggling with eating disorders, both boys and girls. I especially liked the section on setting up a treatment team for your child, which is broken down into important issues and questions that should be asked, as well as the section on the use of antidepressants in treating both bulimia and anorexia.

One common denominator the authors find among their patients is the feeling, “I’m not good enough.” They note that eating-disordered kids come from a wide variety of backgrounds: some report idyllic and happy childhoods, some have a history of trauma or abuse. “The paths that lead to ‘I’m not good enough,’ differ from one person to another,” they write.

A good piece of advice is to counsel your perfectionistic child  to strive for “excellence, not perfection.” The authors explain, “Excellence is achievable; perfection isn’t.”There is also a very helpful section on how to appeal a denial of coverage from your insurance company.

In short, this is a book well worth reading.

Take care,

Nancy

April 07, 2008

Fashion and Body Image: A Deadly Combination?

Dear Readers,

In our book, Marcia and I discuss the importance of media literacy, and educating your children on how to be a critical consumer of mass media. I was reminded of what can happen to those who haven’t been given this kind of education recently when I attended a very good public forum on body image and fashion in Cambridge, MA.

Titled “Redefining Perfection: Beauty, Fashion and Body Image,” the forum was sponsored by The Harris Center, formerly known as The Harvard Eating Disorders Center (which is headed, incidentally, by the excellent Dr. David Herzog, whose new book I will write about next). Speakers included Kirsten Haglun, Miss America 2008; Paige Adams-Geller, a former Miss California and founder of Paige Premium Denim, and Bradley Bayou, former creative director for Halston, who now dresses Oprah, Halle Berry and Deborah Messing, among others.

All three panelists have personal ties to the issue of eating disorders. Haglund and Adams-Geller are both former anorexics. Haglund has made eating disorders education her “platform,” or main topic as she criss-crosses the country speaking. Adams-Geller, once an anorexic model and USC student who survived days on end eating only rice cakes, transformed herself into a successful “fit” model for jeans, then parlayed her expertise in jeans fitting into her own $100 million company. Paige Premium Denim makes the importance of maintaining a healthy body weight and healthy body image an integral part of its message. Bayou woke up to the issue of eating disorders when his own daughter was diagnosed with bulimia four years ago when she was 25.

Bayou recounted how the saddest day of his life was when he learned of his daughter’s diagnosis, and recalled how, as a child, she had tried so hard to fit into his own line’s sample sizes an an effort to get his attention. Then he launched into an attack on the fashion industry, especially fashion editors, for failing to take responsibility for the negative message they are sending to young Americans. By only publishing pictures of anorexic-looking models, said Bayou, they are setting the standards  by which top designers, models, and modeling agents have to live.

Bayou also placed some blame on the CFDA (Council of Fashion Designers of America) for being “unwilling to stick its neck out” and legislate stricter rules against underweight models. Spain and Italy, Bayou noted, have both instituted such rules, and in those countries 30 percent of the models who worked the runways last year were too thin to work this year’s shows.

Adams-Geller talked about how it was nearly impossible to get normal sized models for her denim fashion shows. She prefers models who are around size six (still hardly an accurate reflection of the average American woman) but no modeling agent represents models bigger than size 0 or 2.

The forum was a good reminder that since the fashion industry, including the fashion magazines that create consumer demand, are not changing their ways, it’s still up to parents and educators to teach children that the female (and male) “glamour” figures they see in magazines, movies, on tv and in music videos do not reflect reality. Instead, let’s teach our kids to look elsewhere for role models: to scientists, writers, activists, musicians, educators, or artists, people who are celebrated for what they do, not how they look.

Take care,

Nancy

March 27, 2008

The Parent’s Guide to Eating Disorders Wins 2008 NAPPA Parenting Resource Competition!

Dear Readers,

Marcia and I have exciting news to share. Our book, The Parent’s Guide to Childhood Eating Disorders: Supporting Self-Esteem, Healthy Eating & Positive Body Image at Home, has just been awarded a National Parenting Publiciations Awards (NAPPA) Honors Award!

 

Continue reading "The Parent’s Guide to Eating Disorders Wins 2008 NAPPA Parenting Resource Competition!" »

March 26, 2008

Male waifs on the runway: be afraid

If this New York Times style story The Vanishing Point is to be believed, male fashion models have gone from being athletic-looking muscle men to hollow-cheeked, concave chested stick figures. The latest men’s runway shows in Paris and Milan were full of such young men, reports the NYT, shocking an industry that just over a year ago was telling itself that its female models have to get more real-sized.

Continue reading "Male waifs on the runway: be afraid" »

January 14, 2008

Eating Disorders are Illnesses Not Choices!!!

Even though this message is blazoned across The National Eating Disorders Association (NEDA) homepage, few people understand this very important fact. Too often, anorexics, (not to mention bulimics and binge eaters) are blamed for their own illnesses, and have to bear the unfair judgments of other people on top of the intense pain, loneliness and hopelessness that go with the disease.

Continue reading "Eating Disorders are Illnesses Not Choices!!!" »

January 11, 2008

Buddy Howard: Fighting the Food Police

Dear Reader

Just last week, during the course of my reporting, I met an inspiring man named Buddy Howard. Buddy's daughter Stephanie nearly died from anorexia at age 11, but with the help of the entire family, some great doctors at Johns Hopkins and Duke, and four years of hard work on Stephanie's part, she overcame her disorder.

Continue reading "Buddy Howard: Fighting the Food Police" »

December 18, 2007

Weightism lives, even on the campaign trail! Advice for a happier, healthier (but not necessarily thinner) society

Dear Readers,

Many of us have a hard time maintaining a healthy diet in a culture overflowing with sugary, processed and junk food on the one hand, and pathological fear of oveweight on the other.

The New York Times ran a front-page story (”Where the Votes Are, So Are All Those Calories”) on Nov. 23 about how presidential candidates are faced with an extreme form of this dilemma. Constant travel, brutal schedules and lack of control over what they eat add up to an unhealthy diet and, often, weight gain. As former Arkansas governor Mike Huckabee, who was obese until he shed 110 pounds several years ago, told the  Times, “If you’re really overweight, some people just look at you and immediately sort of write you off. They just assume you’re undisciplined.”

Continue reading "Weightism lives, even on the campaign trail! Advice for a happier, healthier (but not necessarily thinner) society" »

17th Annual Renfrew Center Foundation conference, my report

Dear Readers,

In November, I attended the 17th Annual Renfrew Center Foundation in Philadelphia. I had heard that this was one of the best eating disorders conferences out there, and was not disappointed. There were so many great speakers and topics that it was difficult to choose which sessions to attend. In the next several blogs, I'll be reporting bits and pieces of what I learned.

The title of the conference was "Feminist Perspectives and Beyond: Exploring Eating Disorders Recovery." Workshops included complex discussions on the role of genetics and cultural factors in the onset of an eating disorder; spirited discussions on the Maudsley method of treatment (in which parents take the lead role in refeeding their eating- disordered child, and which Marcia and I discuss extensively in The Parent's Guide to Eating Disorders), and the ever popular discussion of how and where the war on obesity intersects with the war on eating disorders.

In this blog, I'll just tell you a few things that struck me about the workshops that I attended. Later I'll blog in more detail. I heard a lot about the situation in which an eating-disordered child is trying to get well, but is hampered by a parent, either mom or dad, who also has an eating disorder. Sometimes this parent is terrified of trying to help her child recover because she has been unsuccessful in treating her own eating disorder. She doesn't know what portion sizes are normal, she doesn't know how to fix a balanced meal. One nutritionist asked, "What do you do when your trying to help your patient who is away at college and her mother calls her on the phone and says, "I had pickles for lunch!" Or the child who just can't recover while living with parents who prize thinness over all other qualities. Sometimes the parent will either consciously or unconsciously sabotage a child's recovery. One nutritionist brought up the situation where her college-aged patient was terrified of going home for break because she knew it would mean being around mom, and inevitably succumbing to the disordered-eating behaviors that ruled the home.

Another topic that I heard a lot about was the desperate need for more transitional, or step-down care for patients who are coming out of an inpatient facility. Their risk of relapse is so high at this point because the patient has been coaxed, often against her will, to restore normal body weight. Often these patients are sent home without knowing how to shop for food or stick to the food plan. Often parents are equally clueless. Without boundaries and guidelines, relapse follows.

Another message I was struck by was the plea by so many professionals to take the focus off weight and dieting and to put it onto to health. That means not obessing about pounds and BMI, but on eating and exercising to stay fit and healthy. The slogans "fat and fit" or "healthy at all sizes," were phrases I heard more than once.

I'll be blogging on these and other topics I learned about at the Renfrew Conference, so stay tuned!

Be well,

Nancy

November 07, 2007

Organized eating lessens anxiety, promotes organized work habits

In The Parent’s Guide to Eating Disorders, Marcia and I devote a whole chapter to “disordered eating,” behavior that isn’t severe enough to be called a full-blown eating disorder, but nevertheless can ruin a person’s life. We tell the story of one patient, Rosalind, who is in her mid-twenties and has been seriously dieting since the age of 13. Her weight loss has never been great enough for her to be classified as an anorexic, yet Rosalind suffers from lack of periods, one of the class symptoms of anorexia. Rosalind’s life has revolved around her eating disorder for the past 10 years. She’s thin, yet she has such a negative view of her own body that she refuses to date. She’s got a great new job at an ad agency, but it’s hard for Rosalind to make friends because she turns down any invitation that involves food. She looks totally put-together, her hair stylishly cut, dressed head-to-toe in the latest looks. Yet Rosalind feels anything but at ease. Her kitchen is a mess, and at any given moment, she is either dieting or living on junk food. Although her “binges” are small, she feels miserable when she eats four croissants for dinner. Occasionally she makes herself throw up or uses laxatives to purge.

What Rosalind is engaged in is “disordered eating,” a chaotic and haphazard pattern of food consumption that makes her feel out-of-control and anxious all the time. She worries about her weight. She worries that she’s eaten too much, or that she hasn’t eaten the right foods. Despite her outward polish, Rosalind’s life is in shambles.

What Marcia has found with her patients is that when a child or adult learns to eat regular meals and snacks in a patterned yet carefree way, these anxieties fade. (See Part Four: Healthy Eating Guide of our book for more information on learning and sticking to the Food Plan.) Adopting a pattern of regular meals and snacks not only lessens anxieties about food, eating and weight, it lessens all anxieties, allowing you to live a more organized life.

Just recently, Marcia received a call from her patient Christie’s mom, who reported that her daughter’s grades have never been better. Mom is sure that Christie, a junior at a small Vermont high school, feels better and is more energetic because of the regular eating patterns she has recently adopted with the help of the Food Plan. Both mom and Christie are amazed at how, miraculously, when Christie’s eating became more organized, the rest of her life became less chaotic and more manageable as well.

This close connection is especially visible with children, for whom disorganized eating can affect the quality of their lives, their health, and, as Christie’s example shows, even their school work. I was reminded of the link between chaotic eating and chaotic living recently when I spoke to my friend Deborah Kawashima (www.creativeOrganizer.com), a Los Angeles-based personal organizer. Deborah told me, “Eating healthy requires organization, and being organized is a skill that anyone can learn. For parents, or whoever is shopping for food, being organized with your food means making a healthy shopping list (for ideas, see Part Four, Chapter 14 of our book), so that when you shop, you are shopping for those specific items, not impulsively buying whatever looks yummy at the moment. This way, you have healthy foods available at home or on the go.”

Deborah explained that when hunger strikes, kids – and adults – tend to grab whatever is at hand. All too often, what happens to be at hand is junk food. “As part of your kids’ homework routine,” she suggested, “schedule snack time right before they do their homework. This will give them energy and is a nice transition from school to homework time. I create a ‘Snack Area’ for my clients in the kitchen (on a kid-level shelf or in a basket) where kids can easily choose a healthy snack when they are hungry. I include a place for plastic cups and plates for even the youngest child to reach. It’s just as easy for them to get into the routine of eating an apple or cheese stick as it is to grab a bag of chips.”

For her own family, Deborah said, “Healthy eating can still be fun. I made up a menu, like in a restaurant, for my kids to choose their snacks. They use their decision-making skills (most disorganization is the avoidance of making a decision) and they see that eating healthy can include a wide variety of foods. When their friends come over, they love to ‘choose’ what to eat from the menu, then go to the snack area and help themselves. Eating becomes a conscious choice instead of  impulsive ‘grab and eat’ behavior. Deborah pointed out that making conscious, healthy eating choices instead of giving in to impulsive eating works to help teens and adults eat better, as well. Since she is a professional organizer and these things come naturally to her, Deborah also pointed out that organizing your pantry will make changing your eating patterns easier. “It makes you really see what choices you are making and what you can change,” she explained. Another tip: “Being organized with your food means having a place for everything, so you can find what you need when you want it.”

What Deborah and I realized was that our areas of interest overlap. “Organizing your food and eating routines are part of being an organized family,” Deborah said. “There is definitely a connection between organized eating and being organized with homework routines!”

Be well, Nancy

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