Cassey: Hi! Please introduce yourself and your professional background briefly!
My name is Shannon Lagasse and I’m a holistic health coach and recovered anorexic. Using knowledge from my personal studies, experience, and my schooling at the Institute for Integrative Nutrition, I help emotional eaters and eating disorder clients heal their relationship with food.
Hi, I am Mary Hartley, a registered dietitian from New York City with an online practice. Over the years, I have worked with thousands of people around issues of weight, food, self-care, and medical problems. My “online office” is at Organized Wisdom.
Cassey: What is your definition of an eating disorder?
Shannon: To me, an eating disorder is having an unhealthy relationship with your body and with food. It’s the use of food for expression instead of for nourishment and sustenance.
Mary: Many people have aberrant eating patterns that place them at nutritional risk, but to actually be called an “eating disorder” (i.e. anorexia nervosa), these diagnostic criteria must be met:
- Body weight is less than or equal to < 85% of expected weight
- Amenorrhea (in girls and in women after menarche) for three consecutive months
- There is an intense fear of gaining weight
- There is undue emphasis on body shape or weight
For bulimia nervosa, the diagnostic criteria are:
- Recurrent binge eating (at least two times per week for three months duration)
- Recurrent, inappropriate, compulsive behavior to prevent weight gain such as self-induced vomiting, abuse of laxatives, diuretics or other medications, or excessive exercise
- Persistent over concern with body shape and/or weight
- Absence of anorexia nervosa
Cassey: What is your definition of a body image disorder?
Shannon: A body image disorder is a lack of self-love. It can be characterized by picking apart the body, making self-deprecating comments, and low self-esteem. When you look in the mirror, instead of seeing the beautiful and perfect person you are, you see someone you’re ashamed of being.
Mary: Body image is the way someone feels about his or her appearance. It is usually linked to self-esteem. If body image issues are stealing the joy in life, it’s important to change your mindset. Understand how hurtful comments from the past influence you today. Do not compare yourself to Photoshopped images of women in the media. Surround yourself with loving people and focus on your attributes and the good things you do. Listen for your own negative comments and tell yourself to stop! But if you can’t build your self-esteem on your own, then get help from a licensed therapist.
Cassey: What are the signs of a developing Eating Disorder or Body Image Disorder?
Shannon: Let’s start with eating disorders: They’re not always easy to notice, at first. Typically there is a point where someone with ED will isolate themselves out of fear and shame. Anorexics do not want others finding out that they’re not eating, bulimics want to hide their purging, and binge eaters want to keep their bingeing a secret. Some anorexics get very picky about what they eat, more so than they were before. Bulimics may spend more time in the bathroom or at the gym. Binge eaters might express a feeling of being out of control.
Body image disorders often lead to eating disorders. People with a body image disorder have a tendency to be hard on themselves. They nitpick their appearance and only seem to see what’s “wrong” with them.
Mary: Anyone who is inclined towards depression, anxiety, perfectionism, and impulsivity, AND who buys into the social pressures to be thin, will be at risk. Signs of a bigger problem include:
- Aversion to eating, such as skipping meals, taking minute portions, narrowing the range of acceptable foods, peculiar patterns of handling food, bizarre food rituals, finding reasons to avoid eating, avoiding family meals and events where food is present; noticeable weight loss; an intense fear of weight gain.
- Excessive exercise; an overly harsh exercise schedule; prolonged exercising despite fatigue and weakness.
- Obsessing over thinness and thin people; spending a lot of time in front of mirrors and on the scale; obsessing over everything that is wrong with their bodies.
- Social withdrawal, moodiness; difficulty concentrating; secretiveness.
Cassey: At what point does someone’s love for diet and exercise become an obsession or addiction that requires outside attention?
Shannon: When a diet becomes too restrictive and when missing out on a workout feels like the end of the world. I remember feeling horribly about myself if I didn’t work out at least 2 hours a day.
Mary: Eating disorders are marked by extremes. When a person’s “love for diet and exercise,” precludes eating and enjoying a variety of wholesome foods in the amount needed to maintain a healthy weight, then that’s a problem. And when someone’s exercise program is so intense that it leads to injuries, illnesses, exhaustion, and irritability, then that’s a problem too. If a person cannot reverse these problems through his/her own efforts, then professional attention is needed.