How I Observe Yom Kippur in Recovery

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By: Florence Taglight

If you wouldn’t tell someone in recovery from alcoholism to ‘just have one glass’ don’t tell me to ‘’just fast for one day’’ 

Festivities, holidays and celebrations can be extremely hard for those in recovery from an Eating Disorder. Think about it – most festivities revolve around food, whether it is Christmas, Thanksgiving, Passover, Ramadan or Halloween. Alike how Eating Disorders are NOT simply about the food; it is not the only obstacle during holidays, large dinners, parties, anxiety provoking situations with friends and family who may not always understand your struggles can cause internal chaos and pain.

Rosh Hashanah is the Jewish New Year and falls on the 1st day of the Jewish calendar month Tishrei. It marks the beginning of Teshuvah – a 10-day period of repentance where we ask for forgiveness for wrongs done in the year past and attempt to amend our behaviour. On the tenth day we are ‘’to afflict our souls’’ and fast for almost 26 hours.

I have not taken part in the ‘fasting’ for three years, and I will not be participating this year or the next. This can cause controversy and agravate many, but nonetheless I choose to respect my decision, my health and my body without needing to provide reason to any remark.

When I was in treatment for Anorexia, I met a 40 year old women who was also recovering from Alcoholism, she told a story on how someone once told her to ‘’just have one drink’’ at her sisters wedding to join in the festivities. For those of you recovering or who know someone in recovery from Alcoholism you know that ‘just one drink’ is not possible; for someone who has been substance free for 1, 10 or even 20 years, you would not suggest ‘’just one pill to calm down’’. In this same one please do not suggest I fast ‘’just for one day’’ or even ‘’one meal’’.

My friend told me that at her sisters wedding she was expected to have a drink to join in the festivities, implying that by not having a glass of champagne she was not celebrating. Ridiculous right? But for those unsupported, or alike her new to sobriety this can be enough to alert the voices in our minds that we have practiced ignoring, cause them to flare up like an infection and in turn cause ‘us’ to give in to our deadly disorders.

I refuse to take in others who believe I am not ‘’joining’’ in on Yom Kippur, the celebration of my religious new year. Over the past ten days I have thought about my year, my wrongdoings and asked for forgiveness. But I am not concluding it with a day of atonement, Does this mean I am lesser off than those who do? Am I LESS forgiven, or LESS free of my sins? NO.

The truth is for me, by not fasting, I am more forgiven, and more free of my sins.

For me by not fasting, I am courageous, daring and brave.

By respecting and then discounting the people who judge me for feeding my body, soul and mind I am once again honouring myself and beginning my New Year how I will try to embrace the whole year, by loving myself and waking up every day to courageously battle my own internal fight.

Even though I am Jewish and this is particularly about Yom Kippur.  I still join in the celebration over Christmas and on other holidays too. I still struggle with the large groups of people, the buffets (a scary place for many new to recovery –a deadly tarantula to arachnophobes) and the socialising. However with time, practice and a supportive family I have managed to overcome these situations and my anxiety lessens year on year. But some are not so fortunate to have these people around them. Much like an eating disorder or addiction, they suffer in silence. So if you know a friend or family member has struggled in past offer support, offer guidance, and offer non-judgmental compassion.

Physical, Biological and Psychological Effects of Food Restriction and Chronic Dieting

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By: Megan J. Driscoll LPC, RD, CD

We all can agree that the dieting industry in the United States is a forever booming and profitable industry (to be exact, an alarming 60 billion dollars annually according to Washington Monthly) however we also know that dieting does not produce long term results and is also a significant risk factor in the development of an eating disorder. “Getting healthier and losing some weight” are often a main reason for going on a diet. However, what is often less talked about and even ignored are the harmful physical, biological and psychological effects of dieting or food restriction.


Physical (to name a few) –

  • Use of muscle tissue for energy (why would we want to decrease our muscle if we are dieting to be “healthier?”)
  • Reduced metabolic rate
  • Cold intolerance (I am from Wisconsin, why would anyone want to have this?)
  • Constipation and delayed gastric emptying (meaning food stays in your GI system longer, resulting in discomfort and bloating – constipation is literally the worst, we all know it.)
  • Cardiac arrhythmias
  • Edema & other skin changes – these changes may actually influence our negative body image even more
  • Osteoporosis


Biological –

  • Increases your appetite by reducing the amount of leptin you produce (leptin is our fullness or “satiety” hormone and is released to tell you to stop eating and increase your metabolic rate to start burning the calories you just ate – why would we want to mess with this?)
  • Lowers your core body temperature
  • Reduces your effectiveness at recognizing hunger and fullness cues


Psychological –

  • Induces powerful urges to binge on food (think about survival)
  • More specifically, powerful cravings for energy dense foods such as ice cream, chips, chocolate (sugar is the quickest way for our body to get energy in a deprived state). Remember the brain does not function without carbohydrates
  • Food obsession and preoccupation – why would we want to spend our lives only thinking about food when there are so many more important things to think about, like our goals, dreams and vacations we want to go on?
  • Depression
  • Anxiety
  • Social isolation
  • Apathy
  • Fatigue
  • Irritability
  • Poor concentration (our brain’s neurotransmitter’s rely on fat to make the myelin sheath which essentially helps them talk to one another and perform)
  • Mood swings
  • Drop in levels of serotonin
  • Binging causes the release of “feel good” chemicals like serotonin and endorphins so it begins to act like a self-soothing/stress relief mechanism to cope with the stress of dieting. Therefore, the body begins to crave the binge behavior to simply feel better.
  • Last but NOT LEAST, when we “fail” at our diet because our body is trying to save us, it induces feelings of shame, guilt, failure and that we did something “wrong”


Overall, “getting healthier and losing some weight” is not as simple as “eat less calories” and see the number on the scale go down. We know many factors influence our health and weight such as our age, genetics, medical and other underlying conditions, and dieting/weight history. What if instead of promoting dieting and scale-dependent self-esteem, what if we begin practicing body acceptance and intuitive eating? Life is too short to only order salads.


Source: Health at Every Size by Linda Bacon & Keyes Starvation Study

About the Author: Megan J. Driscoll LPC, RD, CD is a registered dietitian and psychotherapist. Megan Driscoll specializes in research based weight management, chronic disease prevention and health promotion using a health at every size and non-diet approach. Megan Driscoll graduated from the University of Wisconsin-Madison in 2008 with undergraduate degrees in Dietetics and Psychology. Megan completed her Dietetic Internship at Mount Mary College in Wauwatosa, Wisconsin. Megan then went on to complete her Master’s degree in Educational Psychology, with an emphasis on community counseling, at the University of Wisconsin-Milwaukee in 2011. She currently works as a registered dietitian and program psychotherapist at Aurora Psychiatric Hospital on the inpatient and partial hospital eating disorder unit. She is also the primary dietitian for their Eating Disorder Lorton Outpatient Clinic and provides outpatient nutrition counseling through Affiliated Wellness Group in Glendale and Delafield, WI. She lives with her husband, their 3-year-old son, Henry and their big dog, Riley. She enjoys shopping, reading and being outside in her free time!

But Darling Please – A Poem

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By: Izii Jane Taylor

Oh beautiful girl

The devil in your mind

Has taken you away

Reminding you of each bite, you didn’t eat yesterday


The days have become meaningless

One tiresome, ongoing, groundhog day.

That may be their rock bottom, but darling..

Yours may not look the same

The external may be different to the one beside you

…But inside, the feelings and thoughts are all one game


Oh beautiful girl

The damage this disease brings

It’s not your fault my darling

I don’t blame you that you don’t see

Because when you are in it

It’s all consuming,

Everyone else is lying

Except that screaming voice inside your head

Telling you would be better off dead.


But the thing is..

….You have dissappeared

Your mind is not present

..And your body is fading..

But darling the thing is…

….This may go on for months or even years.


The sad part is

Some won’t take you seriously

They fail to see

Its not just the body, the weight, the numbers

Its the mind, the behaviors, the thoughts..that not everybody see’s

But darling, please. Not everyone will understand, and nor do they have to.


And this crossroad remains

With only two directions





Some don’t make it

Some survive

Others are unaware

Others don’t care

…But many do thrive, when they are given a hand to hold, a footprint to follow and a step to take towards life.


Recovery, what the hell was that

wasn’t something I wanted..


…I wasn’t thin enough

…I wasn’t ill enough

My life, my company. Together all the time, stood there right beside, destroying my mind. It was the abuser that I could not leave. But ‘I’m Fine’.


But I failed to see, the hurt the pain, the fear….and utter helplessness of my family around me.

..they had to watch their own creation, fall apart.

Stealing tiny pieces of their heart

I didn’t understand, I pushed them away,

My games couldn’t be saved for another day


That was the moment of feeling complete helplessness. As you faded..

The life sucked right out of you

…another grueling night


But darling, I won’t wish that you sleep tight

Because you have the power, in every hour

To fight

And darling you have so much potential

Please don’t leave it to late


One day, I hope you will find

The danger of staying tightly closed

Is more painful, more scary

Than the danger it may take to bloom.


I know you won’t believe me when I say

The world would be worse off, without you there each day.

It’s hard to hear anything beyond that mind but..

….Tell the little child inside

She’s not alone, she doesn’t have to hide.


There is no guarantee that this will ever be easy

It’s a process, a journey


If not now for you, then try for me, for him, for her..

…There may be bad days…

But before it was months or years.


And for those who believe there is no-one who cares..

..or there is no point..

it’s hard to find the words

Many of us know those intense, crippling feelings, that always seem to be there.

But I promise, I will always care


…Please, I pray, give yourself a chance. I’ll be here, that part of life is better to leave behind

There are so many ways that you can shine


And try to be a little less harsh to yourself my darling, for we are all imperfect.

In this whirlwind of beautiful pain.


Scatter your blossom

Let your heart run free


..And sprinkle the air with the uniqueness of you

About the Author: I’m Izii Jane Taylor. I first came into recovery from anorexia when i was 17. I went through three rehabilitations and they helped saved my life. I am studying addiction psychology at university and I really hope to help those struggling with addiction of any kind to find their voice to fight. I hope to give back the help I have received. Everyone with mental health struggles have beautiful souls. Sometimes we all just need a little help to see a glimmer of light, and a splash of hope and love. For someone to say I understand, you are not alone, you matter. For someone to love you until you can love yourself (and of course after that too!) Looking back my greatest achievement is continuing to live when I wanted to die. I think this is everyone’s greatest achievement. Just facing one more day. One more moment Putting one foot infront of the other and deciding for that second to stay.

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Letting Myself Be a Part of Body Positive, Even When I Don’t Feel Great About My Body

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By: Melena Steffes

Seeing body positive posts pouring in over the internet has had its positives, but at first it gave me some unreasonable expectations of myself during recovery. You can’t go from loathing your appearance to loving it overnight. It’s hard to make that transition in one thought process, in one snap decision. But I wanted it to be that quick of a change. I didn’t fully understand everything at first, but I believed that in order to be a part of a body positive culture, it meant I had to love my body all of the time. Doing that while in eating disorder recovery just isn’t that easy. It can’t be one of those “snap decisions”.

Seeing people in their underwear or swimsuits posting these long Instagram captions of how they found acceptance did motivate me, and it was also a reminder that I too have been in that spot, but at times it just seemed discouraging. Logging into other social media platforms like Tumblr and Facebook had similar effects on me too. Seeing before and after pictures wasn’t always something that made me smile. If my body wasn’t like theirs, I felt like maybe I wasn’t able to be part of that culture of body-love just yet and that I needed to ‘wait’ until I fit some sort of criteria. But loving yourself doesn’t have entry requirements, it’s an invitation and it’s always there for you, welcoming you.

Reading how people found this new love for their bodies was like a breath of fresh air, but since I was still trying to find it myself, I felt behind. I thought I just couldn’t do recovery ‘right’, I felt like I would always only be halfway in recovery, and halfway in eating disorder land.

But, I was wrong. I need to allow myself to accept my body, whether I believe I deserve it or feel a bit behind, etc. I’ve come to find that being ‘body positive’ doesn’t mean that I have to love my body 100% of the time. Rather, that I promise to work with it- not against it, and to always try my best to accept myself in whatever form I’m in.

There’s a quote I love that I repeat to myself often:

“Accepting this body did not mean convincing myself that it was beautiful, it meant giving myself permission to exist regardless.”

– Trista Mateer

The size of my thighs or the width of my hips doesn’t get to determine how much fun I have at the party, or how often I use my smile. I am not wrong for having this body. I am allowed to eat the rest of the ice cream and wear my favorite high waisted shorts instead of hiding away in my leggings and baggy sweatshirt. And while I still may struggle with this, and some days it feels further away from me, trying to love and accept myself is always more worthwhile than any time dwelling on ways I ‘need’ to change myself.

I don’t need to love my body every second of the day, but that doesn’t then give me permission to withhold things from it that it deserves, being nutrition, or going out with friends. My body doesn’t need to be punished for simply existing and neither does yours. If you’re looking for permission to find body positivity or self-love, this is it. You have all the permission in the world to accept yourself in the form you’re in.

MelenaAbout the Author:Melena Steffes is 21 years old, studying journalism with a minor in psychology at the University of Wisconsin- Milwaukee. She is passionate about mental health advocacy and eating disorder awareness and therefore writes majority of her pieces around those topics. Being in recovery herself, she has been personally impacted by the power of words from some of her favorite authors. She wants to give back to the recovery community herself through writing. She believes that Project HEAL is an organization that has a profound impact, and strong mission which is one of many reasons why she wants to be involved and volunteer. As of 2017 she is also one of Project HEAL’s blog managers. If she’s not writing, you can catch her playing fetch with her new kitten or drinking coffee at a nearby coffee shop.

The In-Between

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By: Krystal Cook

I’ve found myself in a difficult place lately. A place I’ve come to reference as the In-Between. No one talks much about this place, but I have a hard time believing I’m the only one who has found themselves here. I’m in-between the old me and the future me. The sick me and the whole me. The addicted, disordered me and the real me.

You see, I dropped out of life at 13 when I began starving myself, self-harming, and living with depression. I retreated into a giant shell that was my armor for over 12 years. I dropped out of school, out of relationships, out of my family, and out of growing up. I didn’t know how to handle the pain, the chaos and all the feelings in the world around me so I did everything in my power to stop feeling anything. If you know me at all you know that when I get passionate about something I get very, very passionate about that thing. I give everything 110%. I feel everything to the extreme. This would be great if the world only dealt out love, joy and happiness, but we all know that is not the case. So I decided that even the intense love and joy I felt at times were not worth the intense pain, rejection, and sadness I also felt.

Fast forward through a dozen years of therapy, treatment centers, recovery attempts and relapses…and here I am today with over a year of true recovery behind me, and only traces of the sick me that surface in my brain every once in a while. Don’t get me wrong, to be where I am is a miracle and I am so grateful to be out of the dark hole I crawled into so long ago. I am no longer obsessed with food, my weight or the scale. I don’t have to fight the urge to hurt myself anymore, and I get out of bed most days so thankful for my life. But at the same time I often feel like I woke up out of a dream and I am that 13 year old girl in a 27 year old body. I am married, self-employed and by all outward appearances handling myself pretty well as an adult. I’ve gotten really good at the “I’m fine” persona who has all her ducks in a row and is “just living and enjoying life!” But under the surface I find myself in low grade panic mode in many situations. Especially when it comes to relationships and interacting with other people.

As an introvert to begin with, and one who never learned how to make healthy relationships in my formative years, I find myself retreating into a different shell of isolation. So while I am not struggling with the behaviors of my sick self, I am also not what I would consider a whole self either. I even find myself struggling in my marriage because I was a different person three years ago when I said “I do” to the man who had won my heart and who (I thought) knew the best and worst about me. The truth is, I still put the “I’m fine” wall up with him more often than not. He says it is like pulling teeth to get me to open up and be honest about how I really feel. In many ways I feel like we’ve had to start completely over again in getting to know each other, and I know that is a process that will continue for the rest of our lives. But it is hard, frustrating, and has left me feeling confused and misunderstood many times.

I say all this to say that recovery from any addiction, disorder or mental illness is so much harder and more complex than I think people realize or want to admit. Just because the behaviors change or stop does not mean the work is done. Just because life is a million times better than it was with the addiction (I absolutely promise you it is!!) does not mean it is easy. Just because you are out of treatment and can call yourself recovered or in recovery, does not mean you no longer need help. When your entire identity was wrapped up in this thing for over a decade you emerge without a sense of who you are and where you belong now. And if you are not careful you will gravitate to defining yourself by mere labels and what your current role in life is (wife, mother, sister, friend, career woman, etc). You can feel like a ship without a rudder suddenly trying to navigate life, and all the emotions you stuffed down for years come at you like a hurricane. It can be incredibly overwhelming and it explains why relapse happens so often.

I realize the blessing in this is that I know where I am. I see that I am not where I want to stay, that I have so much more growing to do. I tell people I want to live a life of authenticity and yet I watch myself put up a front more often than not. I long for real connection that goes beyond the surface and yet I keep people at arm’s length. I tend to use my ‘introvertedness’ (if that’s not a word it is now) as another shell to hide under. I’ve spent enough years of my life feeling stuck and out of control. I’m ready to move on and move forward. I want to do the hard things (ok, I don’t really want to but I know I need to) and reach out and truly connect with others. I want to find out what it’s like to be whole me.

Brene Brown defines whole hearted living this way, “Whole hearted living is about engaging in our lives from a place of worthiness. It means cultivating the courage, compassion and connection to wake up in the morning and think, no matter what gets done and how much is left undone, I am enough. It’s going to bed at night thinking, yes I am imperfect and vulnerable and sometimes afraid but that doesn’t change the truth that I am worthy of love and belonging.” I think this is such a good place to start. Addicts have so much shame to fight through even after they break free from the behaviors. Shame that the past ever happened, and fear that it might repeat itself in the future. That shame keeps us from believing we are worthy. And only until we believe that truth and begin to live out of it will we start to fully live and move out of the In-Between. So this is just to say, I’ll be working on that and here is a good list to start with if you are too.

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What Your Therapist Wants You to Know

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By: Dr. Michelle Mannia, PsyD, HSPP

Asking for help in recovery is difficult. Some people hide their struggles from friends and family or hesitate to meet with a therapist because of anxiety or shame. Fears about being judged, not being understood, or not gaining anything useful can prevent people from getting valuable guidance with managing disordered thoughts and behaviors. Therapists serve many different roles and can provide support and direction to help manage challenges at any stage of recovery. As a psychologist specializing in the treatment of eating disorders, I have encountered many fears, concerns, and beliefs that people have about therapists.

So here are 5 things that your therapist wants you to know about eating disorder recovery:

We believe you can recover. We are working with you because we know you can make positive changes and have a more fulfilling life. Even when it’s hard for you to believe, trust us that recovery is possible. We are not angry when you have a setback in recovery. Lapses are a normal part of recovery. We view them as opportunities to learn about yourself and become stronger. What you do after a setback is important, and we want to help you get back on track. Honesty is important. Shame and secrecy can be barriers to making progress in recovery. It is easier to help address your concerns and struggles when we know what they are. It’s okay if you’re not sure you want to recover. Making changes is difficult! We are happy to help you better understand your ambivalence and figure out what to do next. You don’t have to be motivated all of the time. Recovery is worth it. We know that recovery is hard and that the things we ask you to do may be difficult or painful. But the chance to live a fulfilling life free from your eating disorder is worth the effort. Recommit to recovery each day and each meal, and you will not regret it.

About the Author: Michelle Mannia, PsyD, HSPP is a clinical psychologist specializing in the treatment of eating disorders in South Bend, Indiana. For more information, visit

17 Years Counting Calories is Enough

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By: Erica Johnstone

I just turned 30, and I have counted calories for over half of my life, as far back as I can remember. My anorexia started at age 12, and by 13 I knew the calorie counts of nearly everything I ate, and if I didn’t, I didn’t eat it or I calculated all the components, erring on the side of overvaluing them. In the past few months, I have accomplished a major victory over my anorexia: I have not been counting calories. I never thought this would happen. After years and years of inculcating my mind with calorie counts and the idea of an acceptable daily total that could not be surpassed under any circumstance, I was resigned to the fact that this would be part of my life forever. I have been at a healthy weight for the past few years and in solid recovery for the past 6 years, but I still counted calories, agonized over parties with dessert that did not fit into my daily calculation, and exercised on a rigid schedule six days per week. I was, as everyone else would tell me, “so disciplined.” Let me tell you, this disciplined rigidity is not something to aspire to. It is not inspirational or motivating. It sucks the energy, joy, and spontaneity out of your life. It is more akin to living under an internal dictatorship. You cannot disobey. You complete all reps, limit calories, calculate for the day ahead and the next day and the day after that. You must develop a plan every time a workout is 1 minute too short. You must eliminate something to compensate for this failure. And that is what it really is about – a sense of failure and unworthiness. You must drive yourself to the ground and deprive yourself so that you can earn the happiness in your life.

I felt that I would always be partially recovered. I would be healthy enough, and I would manage well enough, ironically feeling that I was never good enough. I was inordinately happier than I had ever been, so I would settle for that. I am married to an incredibly loving, supportive husband who brings me enormous joy. I am completing my master’s in counseling and will be starting work in an eating disorder treatment center in the coming months. However, I knew that a part of me wanted more freedom from my eating disordered thoughts, and yet another part, the eating disordered one, was scared, telling me “No, don’t go farther. Look what you have already done, how big you have gotten.” It was an eternal battle I would fight forever. During my last period of restriction, last March, my dietitian had me write down the pros and cons of restricting. I had done this before, but this time it was very impactful. Prior to it, I thought there were more pros than cons because in the moment restricting made me feel better. It made me me feel like I had earned the right to live because I had successfully deprived myself. And yet there were so many cons: I was not free, I felt bad for those I was disappointing around me, I had less energy, I was hungry and exhausted from calculating and calculating day after day. I wanted to be truly free. I also knew that I was entering the field as a clinician soon, and I needed to be fully recovered to do so. I wanted to be able to have a baby and be a healthy role model. As I started experimenting with intuitive eating after many previous attempts, I finally got some satisfaction from the freedom, from defying the ED voice. Whereas before I had always thought of how hard recovery from anorexia is because you feel partially bad about it all the time. It seems different from recovery from drugs or alcohol where you can feel accomplished each day sober. With anorexia, a part of you feels horrible because of what you are doing. The eating disorder tells you that you are disgusting and indulgent, and it makes you think you will never be able to tolerate, much less accept, the body you are growing into.

However, I started to think I could be ok with it. I could be ok with this body because it is going to be what it is going to be. I think the biggest contributor has been a subtle shift in trusting my body. Though I have been told that my body will figure out what food it needs, it is incredibly terrifying to believe that, as someone who has feared her body, and particularly changes in it, for her whole life. I was scared that I would never stop eating and never stop growing. However, I am learning that my body tells me when it is full. It tells me what it wants to eat. It does not want to eat endlessly. It also does not want dessert all the time. It craves many different foods. It is not against me. It is me. Making peace with this is so incredibly relieving. It is a sense of freedom, a great weight off your shoulders. It is strange to be 30 years old, to be what I consider now a “real” adult chronologically, and yet I am relearning the most basic of all skills that babies learn. I am learning how to eat again. As challenging as it may be, the taste of freedom is worth it.

About the Author: My name is Erica Johnstone, and I am a psychology researcher and graduate student in counseling. I live in Folsom, CA with my incredibly supportive husband Tyler and our dog Oso. I am starting an internship this Fall at an eating disorder treatment center and will be graduating next June as an MFT intern hoping to work as a therapist specializing in eating disorders.

About Bulimia

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By: Melissa Gerson, LCSW

Alex starts her day with the intention to “be good.” As she navigates through her day, burdened by negative body thoughts, she feels down but hopeful that she will eat “clean” and with control. By mid-afternoon she’s starving and preoccupied with thoughts about food. When a co-worker puts out a tray of desserts for everyone to partake, Alex tries to resist but then can’t get the treats out of her mind. So she has one. Then another.   She’s on autopilot, out-of-body.   After too many cookies to count she’s despondent, miserable, stuffed.   She purges in the office bathroom since the full feeling is intolerable… and of course, the threat of absorbing all the calories is equally terrifying. Alex is resolved to make this her last binge/purge.   She’s “back on track.” But before you know, a food “mistake” or unexpected temptation gets in the way and the rest is history.

The pattern I just described is the classic bulimic cycle. There is restriction, deprivation, rules about what is on or off limits… Then a temptation, giving in, a food “mistake…” The binge means freedom from the exhausting control – at least for a short while. But then remorse, self-hatred. The purge is supposed to “undo” the binge but at the same time, without realizing it, the purge forgives the binge, actually opening the door for more binges in the future.

Most individuals with bulimia, will relate to some element – if not every element – of this cycle.*   The problem is that intuitively, it seems like more control and restraint are needed. The reality is that the exact opposite is true: over-control, deprivation, rigid rules are to blame. Because of this misguided effort to increase control, many who struggle with bulimia try and try again to end the cyclical pattern but find themselves frustrated in the process – and left with more shame, self-loathing, isolation.

What you should know about bulimia:

  1. Frequent purging – either by self-induced vomiting or laxatives – can lead to dangerous medical complications. The most common concern relates to cardiac health since minerals essential for proper cardiac function like sodium, magnesium, phosphorous get depleted through fluid loss. The only way to know if you have imbalance of these minerals is through a blood test. Your health status can change quickly so frequent labs are essential if purging is happening regularly. You could absolutely be at risk for a serious cardiac event but physically, feel no indication that anything is wrong.
  2. It is so important to consider a behavioral therapy like CBT-E, a treatment designed – and proven – to treat bulimia nervosa. CBT-E is so successful because of its laser focus on the factors that are keeping the cycle going – things like chronic dieting or restriction, rigid food rules (i.e. good and bad foods)… and also factors like intense focus on weight/shape, harsh comparisons to others and body checking like frequent weighing or body checking (mirror, pinching etc).
  3. CBT-E focuses on guiding you to a pattern of regular, consistent and flexible eating – an eating style that tends to reduce one’s vulnerability to binge eating and purging.   The treatment works to change your relationship with food (and thus your control!) by integrating:
    1. Flexibility: encouraging an approach to eating that allows for last minute changes, social eating, managing with the food available to you.
    2. Variety: balanced, satisfying meals. Moving away from having “off limit” foods since those tend to be the very things people consume in excess later.
    3. Adequacy: under-eating, delaying eating for long periods makes you more vulnerable to over-eating. If you’re starving, it’s harder to stay in control.
    4. Awareness: being present, aware of what is happening in the moment is key to maintaining control over eating behavior.
    5. Planning: you mustn’t under-estimate the power of being prepared. For many who struggle with BN, decisions on the fly lead to trouble. We want to move away from impulsive decision-making.
  4. Treatment must also address your current coping strategies since binge eating and purging for many are actually methods for relieving stress, numbing out, escaping….   To recover, you will likely need to establish alternative methods of coping – skills and strategies so you can care for yourself and manage feelings without defaulting to food-related behaviors.

Bulimia: The Bottom Line

There are many factors that contribute to the development of bulimia – biological/genetic, cultural/social, emotional…. But often what caused the problem in the first place is less important to focus on that the factors that are keeping the problem going now.

Bulimia is highly treatable. With the right intervention, people are able to make significant changes very early on in treatment. It is so important to seek help if you’re stuck in a destructive cycle with your eating.

* Please note that every individual is different. The pattern described in this post is among the more common presentations but there are many who have a very different “clinical picture.” Regardless, it’s essential to understand your pattern so that you can target the factors that are keeping it going.

About the Author: Melissa Gerson, LCSW is the Founder and Clinical Director of Columbus Park, Manhattan’s leading outpatient center for the treatment of eating disorders. As a comprehensive outpatient resource for individuals of all ages, they offer individual therapy, targeted groups, daily supported meals and an Intensive Outpatient Program (IOP). Columbus Park uses the most effective, evidence-based treatments like Enhanced CBT and Dialectical Behavior Therapy (DBT) to treat binge eating, emotional eating, bulimia, anorexia and other food or weight-related struggles. They track patient outcomes closely so they can speak concretely about their success in guiding our patients to recovery.

Recovering with Buddha

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By: Cait O

I have gone through many spiritual cycles in this life. I was born into an Irish Catholic family (which is where I probably received my training in guilt and shame). Before I went away to college, I began reading Buddhist scripture. 

What I remember most profoundly about my first encounter with Buddhist text is the story of pretas, or hungry ghosts. These are believed to be the souls of people who have suffered tragic death in the physical life.

I didn’t realize it quite yet then, but at seven years old I experienced the loss of this lifetime as I know it. My parents split up, and as in most cases of divorce, the court decided which parent got to spend which days with me. Each parent moved on with their lives. In the meantime, I surrendered to the false belief that nothing I could ever need or want was important. I would always be starving to feel significant. I became a hungry ghost. Invisible. Needy. Afraid. In-between.

Most peoples’ first experience with Buddhism is the concept of karma. The literal translation of karma in sanskrit is ‘action.‘  In this westernized, co-opted culture of instant gratification, I have observed that people often perceive karma to be the retribution or punishment we receive from the universe as a form of atonement for our mistakes, selfishness, and wrongdoing.

This is, in my opinion, a very shortsighted view.

I have begun to view karma the way I view recovery and my own body. What I put in, I also receive. The law of cause and effect is our karma. It is neither good nor bad, it just is. We receive it as we see it.

Receiving happens only as long as I am open. This idea of karma is more gentle. It does not see actions as good or bad, it just sees them for what they are. They tilt the proverbial scales accordingly–it is our perception of the outcome that convinces us that anything is “good” or “bad.” 

Karma is merely the sum of our actions, and mindfulness of the times we give or withhold compassion in this life.

In my recovery, I have had to do the same thing. I no longer see foods as “good” or “bad”; they are what they are, and I decide how and when and how much to put them into my body. If I binge, I feel uncomfortably full. This leads to suffering; physical, mental, and spiritual–sending me down a shame spiral, possibly to other behaviors. If I skip out on food and ignore my hunger, it leads to suffering–I am hungry, I get irritable, obsessive, and I am unable to act out of kindness. I withhold compassion from myself.

In recovery, I am more mindful of the how, when, what, and how much I use to nourish my body. And most importantly, I no longer withhold compassion from myself or others.

So when somebody sat down next to me the other day as I was eating and said, “Ooh, pizza, huh? Pizza is bad. I can’t do the carbs.”

I raged on the inside. Forgetting that this person is suffering, just like I have, from their own perception of food, body and self. I wanted to judge them, stay angry with them, put distance between myself and their ignorance.

But then I remembered that withholding compassion from this person is a guaranteed way to increase my own suffering, or samsara. Just the same way that withholding compassion from myself for nearly 15 years increased my suffering greatly. Believing that I was not enough was the reason that I committed to several disordered behaviors across the spectrum, rather than looking to recovery as a solution

I realized that there was nothing wrong with this meal in front of me. It was delicious, I planned it, decided on it, committed to it and enjoyed it. I quickly reminded myself that this person has no knowledge of my eating disorder. Then I let it go.

Being from Long Island, the road rage capital of the world, anyone in my immediate surroundings would probably ask themselves, “how???? I would have at least cursed her out or mentally flipped her off.”

The hardest lesson I have learned in recovery is the ‘letting go’ part. In Buddhism, this is known as ‘nekhamma’, or non-attachment. I developed my eating disorder out of a codependent need to control people and things, or at the very least, give myself the illusion that I was doing so. There was a hole in my family-of-origin story that I filled with bingeing, which quickly became the pressure to be perfect in every aspect of life.

Oscillating between binge eating and exercise purging based on other peoples’ expectations of me is how I facilitated my own suffering, abused my body and have carried a broken spirit around for far too long.

I have since had to consciously and thoroughly drop all the expectations, beliefs, emotions that are not my own. I did this in the pursuit of an easier, softer life, and it’s given me a new peace to settle into. My recovery is one gift that I took for granted until I realized that I couldn’t come to expect it unless I put in the work, unless I let go of resentment and hurt and anger, and started building bridges to people who’s experiences looked different than mine; rather than building walls of judgment, difference and fear to keep them out.

Recovery, to me, has come to mean being willing and open to sitting with my biggest fears, and feeling the joy of conquering them through meditation, compassion, service to others, kindness and work. I am no longer a hungry ghost because I have started to heal, make myself visible, live a life that’s authentic. And whether it’s through Buddha, program, treatment, love or family–you can, too. 

“Every human being is the author of [their] own health or disease.” 


What ‘To the Bone’ Got Right From Someone in Eating Disorder Recovery

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By: Danielle Lowe

I’ve been excited about seeing “To the Bone” since the news broke that there would be a true-to-life movie about a woman with an eating disorder. I’m in eating disorder recovery myself, and there aren’t really any recent films about eating disorders, just a few documentaries. I knew Lily Collins would be playing Ellen, a young woman with anorexia, and while I was excited, I was still a bit concerned. The media is known for only representing the “white/young/anorexic” story, and I wondered why they chose to portray this already engrained narrative.

However, after reading that it was based on director Marti Noxon’s story, it made sense. She was young, white and had anorexia, and while that is the narrative people already know, I understood why she wanted to make a film loosely based on her own experience.

However, I don’t know if the average Netflix viewer will read up on the movie as much as I did. Maybe they’ll just think it’s about another girl starving herself and scroll past. But in my opinion, it did end up being more than that. In fact, in many ways, I was pleasantly surprised.

Here’s what the movie got right:

1. It shows “recovery” often takes more than one try.

The movie does a wonderful job showing complex parts of the eating disorder and treatment process an average person has likely never seen before, like how sometimes treatment can take multiple attempts — something that is common to many people with eating disorders. Many people think a person with an eating disorder goes to treatment and comes out “fixed.” However, the reality is, many people are not ready when they first seek treatment, and it often takes multiple tries and years of work to get the momentum going.

Typically, when we see eating disorders represented in 30-minute sitcoms, the story arc goes like this: a girl looks in the mirror and suddenly dislikes what she sees, and she starts using unhealthy behaviors to lose weight. But then, by the end of the episode, the issue is seemingly resolved, and she has come to some nicely wrapped revelation about her self-worth and body image and it is never mentioned again.

Even when the person has gotten on the recovery road, there are so many things that come up. Years after my last time using behaviors, I still have disordered thoughts about food and urges to use behaviors. The difference is now I don’t act on them. How I would have loved if my eating disorder was something I could have fixed in a week with the help of a couple pep-talks.

2. It highlights eating disorder behaviors besides restriction.

The other issue that “To the Bone” gets right is that it highlights other behaviors common to eating disorders besides restricting, which is the most common behavior people know. But there are so many people with eating disorders who don’t restrict at all. There are many other common eating disorder behaviors — such as cutting food into small pieces, grouping foods, eating very slowly or very quickly — that should be taken just as seriously as restricting. However, “To the Bone” highlights behaviors common to bulimia and binge eating disorder, along with lesser “textbook” behaviors.

3. It highlights the real issues that surround an eating disorder, such as complex family dynamics.

The movie makes huge leaps and bounds just by showing the familial stress that can trigger Ellen’s eating disorder. They even show multiple family discussions and arguments around the disorder. It becomes clear quickly that her mom doesn’t want Ellen to live with her, so she sends her off to her non-present father and step-mom.

Her sister also delivers an extremely emotional and realistic speech in a family therapy session, where she cries and tells her how the eating disorder affects her, too. These feelings of desperation and helplessness in the support system are true to many people’s recovery stories. It tells parents and families, “It’s OK. See? This family didn’t know what to do either. You are doing your best and rocking it.” And I love that.

I was also pleased to see there was no focus on anyone in the the house encouraging unrealistic beauty standards, as many narratives do to simplify the reasoning behind an eating disorder. This will go long ways in smashing the misconceptions people have of eating disorders.

4. It highlights the role the internet can play in eating disorders.

Another element I personally connected to, and something I thought accurately represented having an eating disorder in the 21st century, is when Ellen creates triggering artwork depicting her eating disorder and posts it on Tumblr. The internet can provide such wonderful communities for healing, like The Mighty, but often is a place where those in the throws of their eating disorder can find the wrong kind of connection. Ellen’s artwork has clearly made her well-known and liked in that community, and you can see how this has an affect on her identity.

5. It emphasizes that no one can “save you” but yourself. 

I was nervous when I saw that there was a potential romantic interest (Alex) in the trailer, but it ended up being my favorite plot line in the movie. It could have been another “girl falls in love with boy, boy ‘saves’ her, girl wants to get better for him” story, but that’s entirely not the case. There is an element of romance and maybe that’s what most people will see, but I saw so much more in their relationship. More than a love interest, Alex represents hope in the house. Something that Ellen seemingly didn’t have before. Though he is in the same setting the others are in, he’s motivated to recover and encourages the others, too.

6. The movies shows hope does exist in those early stages of recovery.

When I went to treatment, I thought it would just be a bunch of sad people sitting around all day waiting to leave. Oh, how I was stunned when there were people really, truly recovering there. When I got there, I was shocked and immediately intrigued. How did they get there? How did they do it? I was there because I recognized the huge space my eating disorder was taking up in my life, but I had no clue what I was actually going to do about it. I just knew it had to stop. I was fascinated, and a small part of me started to want the freedom from food other’s were beginning to have. Right in front of my eyes, I was seeing it was possible. Seeing someone “do it” can be a powerful force in recovery.

My favorite scene was when Ellen says to Alex, “How do you do it? How do you eat?” It’s the first spark of curiosity, and even hope, that Ellen has about recovery — and it’s beautiful. Everybody wants freedom from their eating disorder, but there is so much fear that goes along with letting go. I saw this as her acknowledging the part of her that knows this can’t be her life. I hope everyone has a moment like that, and a person to share it with.

All that being said, it was by no means a perfect movie. So to people wondering, is this going to be triggering and unhelpful? My answer: it depends. As seen in the trailer, there were mentions of weights, calorie counts, bones and behaviors. However, these elements weren’t nearly as prevalent in the actual film as the trailer led me to believe they would be.

However, when I was new to recovery, I would have been triggered by any mention of weight or calories — and a door would have been quickly opened for eating disorder thoughts and behaviors. As I’ve gotten further in my recovery and fully integrated back into the “real” world, where weight and calorie counts are often mentioned, I have learned to reframe or talk back to the thoughts that tell me these should be important pieces in my life again. This has taken a lot of work, and I would be lying if I didn’t cringe a bit when they mentioned numbers. If you are new to recovery, or even just feeling on shaky ground with recovery in general, I suggest maybe staying back from this movie until you’re feeling more steady. It’s just not worth the risk. If you feel at all hesitant about watching the movie, I would advise discussing the manner with your treatment team and making sure you’re getting support.

And for Netflix viewers, I hope you understand that eating disorders are not one person, one thing, one reason, one race or one age, but a global issue. There are many people out there like Ellen, and many people not at all like Ellen, that also have life-threatening disorders. I hope this is the first of many films highlighting one of the many experiences a person could have with an eating disorder. Who knows, maybe you’ll make the next one about your experience.

To end, we all have that voice, the one that tells us to engage in our eating disorder, to harm ourselves, that we’re bad at our job, that we’re a bad parent, that we’re a bad student, or that this is a bad life. And to that I say:

“You know what to do.”

“Fuck off, voice!”

About the Author: Danielle Lowe is a 20 year old LA native studying music therapy at the University of Miami. Aside from her passion for writing and playing music, she has also found a passion in eating disorder advocacy after she struggled with her own. Now over two years strong in recovery, Danielle is the Project HEAL blog manager along with the president of the Project HEAL Miami chapter. She is also currently an intern for The Mighty’s mental health section. IMG_7500