FAQ Friday: Are Weight Transformation Images Liberating or Triggering?

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by Dr. Colleen Reichmann, Licensed Clinical Psychologist 


“Are the weight transformation images a good thing or are they negative for the recovery community?”


woman-smartphone-girl-technology-2-650x437This is an important topic, because of the recent swift growth of the online pro-recovery and body positive community. The notorious “Transformation Tuesday” pictures that have historically reeked of diet culture (i.e. images of individuals pre and post-weight loss) have been commandeered by our beautiful community.

If you search #transformationtuesday on social media today, you will still find a slew of weight-loss before and after pictures. However, dotted among these pictures will be the occasional weight-gain picture– typically an individual pre and post-weight restoration during recovery from an eating disorder.

Recently another hashtag started trending – one that is more specific to the recovery community- #gainingweightiscool. A search of this hashtag will almost exclusively yield these before and after weight restoration pictures of individuals in recovery from eating disorders.

Additionally, some of the most loved body positive and recovery accounts routinely post these transformation pictures. These accounts are widely followed, and hence have the potential to deeply impact the community as a whole.

So while I am typically against black and white responses, I do tend to believe there are more negatives to these transformational images than positives. Let me explain:


The Negatives

These images focus on just that – images.
They put a face to eating disorders. This encourages us to do what we are all subconsciously primed to do anyway – focus on someone’s appearance as a gauge to estimate how sick they are or once were. The vast majority of individuals suffering from eating disorders are not underweight-indeed many individuals with anorexia may not ever appear drastically underweight. Hence the dangerous myth that eating disorders are all about weight loss is not something that we want to perpetuate via social media.

Additionally, more simply, they encourage us to focus on the outside. We are all SO used to focusing on the outside anyway, and recovery from an eating disorder usually involves a fight to recognize that worth stems from the inside. So putting focus on visual depictions of the illness seems like a step backwards.

They ramp up competitive eating disorder voices.
This is a no-brainer. These pictures are triggering for many individuals struggling with or in recovery from an eating disorder. Though the message may be that #gainingweightiscool, the stark visual image of sickness leaves the door open for the eating disorder voices, saying things like, “I’m not sick enough,” or “I never got sick enough,” to creep, ever so sneakily, back in.

An important note is that some well-known body positive activists will post disclaimers on their transformation pictures to address this very point. For example, some will post pictures featuring the pre-weight restoration and post-weight restoration with a notation at the bottom to the tune of: *YOU DO NOT HAVE TO LOOK LIKE I DID FOR YOUR STRUGGLE TO BE VALID. EATING DISORDERS COME IN ALL SHAPES AND SIZES*

Disclaimers like these might, however, have the drawback of speaking to rational thought, and the “I’m not sick enough” thinking is anything but rational. Rather, it’s ED thinking. For some, this notation may not be enough to break through the thoughts that come along with the triggering images once they begin. The “I’m not sick enough” thoughts can still be pervasive even after one has been well-educated about the fact those suffering come in all shapes and sizes.

They perpetuate societal misunderstanding.
Society (and sometimes doctors, insurance companies, etc.) already seems to have a tough enough time grasping the fact that eating disorders have no face. ED’s affect people of all different genders, sexual orientations, ethnicities, ages, and YES- body types. They Do. Not. Discriminate. And yet, the vast, vast majority of articles and educational pieces for the mass media are written about one type of eating disordered individual – the young Caucasian female with Anorexia Nervosa. Articles for the commercialized media are more often than not accompanied by images of emaciation.

Why? Because this sells. Anorexia is easily sensationalized in the media because of our current societal obsession with the thin ideal.

Those of us involved in recovery awareness and activism cannot necessarily help what a women’s magazine chooses to focus on. But we can help what our social media community chooses to promote. By posting these transformation pictures, we are adding to the societal idea (as well as the eating disordered thought) that anorexia is Everybody’s Favorite Eating Disorder, and that people who are not underweight are not sick. In doing so, we are also perpetuating the tendency to overlook those suffering from other forms of this illness like Binge Eating Disorder, Bulimia Nervosa, Other-Specified Feeding and Eating Disorder (OSFED), and Avoidant and Restrictive Food Intake Disorder (ARFID).

The Positives

They fight stigma.
It cannot be denied that these transformation pictures buck the trend-among a slew of weight-loss idealization pictures, it can be so refreshing to see someone celebrating weight gain! It is a great reminder that weight loss is not always the goal, and that “healthy” can mean different things for different people.

They allow people to own their stories.
The pictures can be liberating to post. Our society sends an overwhelming message that mental illness is something to hide or be ashamed of. These pictures are an attention-grabbing, incredibly courageous way of saying, “Hey! I went through something. I’m STILL going through it. And you know what? I’m not ashamed. I’m a brave warrior and I’m fighting every day.”

Also, sometimes when one goes through something as trying and difficult as an eating disorder, there is a pull to show people just how much suffering occurred. A pull to shout, “Hey! I went through hell and back, see?” After staying silent and numb for so long, (as people tend to when suffering from their eating disorder), sometimes there is that irresistible pull to break free, tell one’s story, and in turn, set it free. There is absolutely nothing wrong with this.

And furthermore, not everyone considers their social media account to be part of a social justice movement. Some people simply want to document their journey, and posting their pictures is 100% their right in doing so (although sometimes the pictures depicting severe emaciation do get reported and removed by Instagram).

They start a conversation.
If the pictures are public (and even if they aren’t) they start a conversation. They start a conversation among strangers, family and friends. They force people to confront their own biases about weight gain and health. The pictures are a visual declaration that weight gain can be positive, beautiful, and life-saving. They are a pictorial screw-you to the diet culture script- the idea that weight loss is ALWAYS the goal and that skinnier is ALWAYS healthier no matter what. These pictures have the potential to open people’s eyes and minds to the idea that all bodies are good bodies, and that health can fit every size.


There are both positives and negatives to these transformation pictures, but my final thought would be to proceed with caution. You never know who could be triggered by the image.

Your journey is yours to own, so of course it is within your right to post your photos and empower yourself and your recovery. I would simply suggest that you be deeply thoughtful about what your reason is for posting the pictures before doing so. Consider not putting too much emphasis on them, and instead focusing on your inner strength, your mind, your newfound ability to deal with tough emotions, and your fresh starts in relationships.

Eating disorder recovery involves so, so much more than the outside.

And, as a final note to the well-known body positive accounts: please use the images sparingly. You are all doing such amazing, impactful work. Your message is SO important, and you have the potential to influence so many. So while your journey may have involved weight gain, there are an infinite amount of other variables involved that make you YOU. Be sure to shine a STRONG light on those as well.



About the Author:

As seen on a Sussex Directories Inc site


Dr. Colleen Reichmann is a licensed clinical psychologist, practicing in Virginia Beach. She works in a group practice, and is a staff psychologist at the College of William and Mary. She is an eating disorders and women’s issues specialist She is an advocate for feminism, body positivity, health at every size, and FULL recovery. Connect with her on Instagram, Facebook, or send her an email.








*The views expressed in this posting are based on this writer’s professional knowledge, training, and experience in accord with current and relevant psychological literature and practice. These views do not indicate that a professional relationship has been established with any recipients. Readers should consult with their primary medical professionals for specific feedback about any and all questions.





The Unmeasurables of an Eating Disorder

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by Jennifer L. Gaudiani, MD, CEDS, Founder & Medical Director of the Gaudiani Clinic

Illness cannot always be measured, and neither can wellness. This is one of the great medical challenges facing those with eating disorders, where often the act of measuring becomes the obsessive focus of life: how many calories/miles/pounds/steps?

Unfortunately, the Western medical system—of which I am a proud member, even while realizing its limitations—further puts the focus on measurables. In our strained system, patients can get triaged into “ok” vs. “sick” based on numbers that may have little to do with their overall suffering. No one would question that certain measurable values carry clear and present danger: an abnormal potassium level, sodium level, bicarbonate level, measure of kidney or liver function, or a very low body weight.

However, the vast majority of patients with eating disorders live within the torment of the ED voice, carrying out its demands to varying degrees in eating disorder behaviors, and never have a medical measurable that validates their illness.

No number that clearly tells their medical practitioner, “This person needs more support, a higher level of care, a greater degree of attention, a family meeting, more compassion.”

It’s a tragedy. Because the ED voice is already saying, “You’re not sick. You’re fine. You’re not worthy of treatment. You have to get to ‘x’ to be really ill/accomplish our goals.” The fact that those with eating disorders are some of the smartest, hardest working, most driven people imaginable means that often they are in fact achieving and performing at high levels that to most would be incompatible with a life-threatening illness. Then medical invalidation further supports the ED voice, and people continue to suffer and be pulled further and further away from their values.

What are some of these unmeasurables I’m talking about?

Normal electrolytes

Sodium, potassium, and bicarbonate are almost always normal in pure restriction, no matter how intense. While often abnormal due to purging, electrolytes can all be completely normal, even when someone is purging a lot. Why? I have no idea. My theory is that the body has learned over time to accommodate purging behaviors and keep itself stable. (The body is an extraordinary, remarkable entity…thanks body for hanging in there despite bad treatment.)

Stable weight despite intense ED behaviors, or a “normal-appearing” body weight despite recent weight loss

In an overly weight-focused society (don’t even get me started), weight can be one of the factors that clinicians/programs/insurance focus on to an extent that really highlights the severity of weight bias in our culture. I can’t tell you how many patients have experienced dangerously unconcerned medical care because their body looks “normal” or is of a higher weight, even if they’ve lost a catastrophic amount of weight recently due to medical or eating disorder cause. The patients whose bodies don’t “look” malnourished are often ignored by the medical system. This is a grave mistake, and it misses not only medical complications that need evaluation and treatment, but also the whole human who is clearly suffering and ill and needs more help.  

Irritable bowel syndrome/pain syndromes/dysautonomia

Many patients with eating disorders are also prone to somatic manifestations of emotional suffering. That means emotions are made physical in the body. On more highly stressful days, someone could experience more intense than usual symptoms of nausea, bloating, diarrhea or constipation, back pain, lightheadedness, passing out, gastroparesis (slowed stomach emptying), and more. Issues like Positional Orthostatic Tachycardia Syndrome (POTS) are prevalent in those with eating disorders, and worsen as nutrition and self-care worsen. Guess what? None of these things show up on a lab panel or a CAT scan. The response of the medical system is usually to say, “You’re fine.” The eating disorder has a field day with that one, even as the soul wilts a little more. Or perhaps worse, “It’s all in your head.” That compounds the ever-present guilt, as the person thinks that somehow if they just wanted to be less sick, they’d have less pain. Baloney! These are all complicated medical problems with workups and solutions that are beyond the scope of this blog. However, the right thing to do is deeply validate the suffering and focus on whole-person wellness to try and reduce symptoms.


In sum, many aspects of illness are unmeasurable. This is particularly true with eating disorders. If you have an eating disorder, at any body shape or size, you’re not ok.

Don’t compare yourself with your sickest day ever. Compare yourself with the you who embodies your values daily, who treats you kindly and compassionately, the one who uses food as fuel and enjoyment, without torment. The distance between eating disordered you and that you can’t be measured by any medical test…but it’s real.

Keep working toward recovery. It’s worth it.



About the Author:

ckgaudianiclinic-094-copy-300x300Dr. Jennifer LGaudiani is the Founder and Medical Director of the Gaudiani Clinic, a unique outpatient medical clinic for adolescents and adults with eating disorders. She is one of very few internal medicine physicians in the country who hold the Certified Eating Disorder Specialist credential from the International Association of Eating Disorder Professionals. Check out the Gaudiani clinic on Facebook and Twitter.








FAQ Fridays- Are the Friends I Make in Treatment Good for Me?

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Frequently Asked Questions Friday


This weeks question is:

Are my friendships with the people I met in treatment good for me?


This is a tough one. I personally do not believe that there is one right answer to this question. I think that it depends on 1. The nature of your friendships, 2. Where you are in your own recovery, 3. Where the other individuals are in their recoveries, and 4. Your personality and friendship dynamics. Did you expect me, the psychologist, to say, “No. These friendships are not good for you. End of story”? Well I cannot, in good faith, say that. And perhaps I diverge from many of my colleagues in my belief on this matter, but I do not consider this to be a black and white issue. I think that there are several themes that apply to friendships formed in treatment, so I will attempt to give this complicated question the multifaceted answer that it deserves:


It’s no secret that eating disorders are competitive illnesses. In fact, for a great deal of sufferers, treatment can be made more tricky because the eating disorder becomes triggered to be the “best” when surrounded by others who are also ill. This is why a number of treatment centers have policies ruling against socialization after discharge. However, having an eating disorder can also be incredibly isolating. It can be a welcome change to have a friend who just gets it.


But when you both have an eating disorder, and you are both trying to recover, things can easily get dicey. Eating disorders are tricky illnesses. You can want recovery in your heart of hearts, and still feel a twinge of jealousy when you see someone else acting on behaviors. You can be working towards weight restoration with all of your might and still find yourself perusing how to cut calories. It’s difficult enough to manage your own symptoms and tease out if the eating disorder is in control at the moment. Now throw another person in exactly the same boat into the mix. You both want recovery. You both understand the torturous nature of this confusing illness. And you are both dealing with working through the ED thoughts and stopping the behaviors. On one hand, it’s beautiful to feel that type of camaraderie. (In a world where most seem to be shouting “Just eat!” what a breathe of fresh air to sit across from someone shaking just as much when they pick up the sandwich.) On the other hand, you are now vulnerable to a particularly strong type of trigger- the relapse of a friend.


Anybody who has been through this can tell you- it’s incredibly difficult to watch a friend go through a relapse. It’s easy for the eating disorder to sneak in during this time and set off those competitive feelings. It’s equally as easy to take it personally. (i.e. How could she do this when we are in this together? Doesn’t she know what this does to me?) Additionally, there is the danger of feeling the responsibility to save her. You might feel the pull to begin to pour all of your time and energy into helping her. The danger here? You begin to neglect your own recovery, and, again, the door is left ajar for the eating disorder to flare up.


So what is the solution? Should you, as those aforementioned treatment centers suggest, cut off all relationships with fellow patients after being discharged? Or should you throw caution to the wind and venture on towards the sister/brotherhood of recovery warriors? The truth is, only you can answer what is the right solution for you. I know some people who have felt that they need to keep themselves at arm’s length from fellow patients. These individuals have shared that they sought an identity outside of the eating disorder, and noted that they wanted to surround themselves with the healthiest people possible. One friend told me that she felt it necessary to immerse herself in “normal eater world,” so that she could attempt to emulate her friends who have had historically healthy relationships with food and weight. Another individual told me that she was tired of conversations surrounding triggers and fear foods, and indicated that she felt the need to cut off these relationships if she truly wanted to recover for good. I have also heard the opposite-people who feel that their relationships with their fellow warriors were vital to recovery. Some will hold that the bonds that are created when people go through treatment together are unlike any other. There is sense to this- there will never be another time when you are more raw and vulnerable, so these relationships do have the potential to be very deep. In fact, our fearless Project HEAL leaders have shared that they met in treatment, and that their relationship was indeed important to their recovery processes.


So, as I initially stated, similar to most everything about recovery, the answer to the question of whether or not relationships between two people in recovery are healthy is not black and white. I believe the answer is- there is no absolute answer. Just like any friendship- some may flourish and some may become toxic. Certainly, many may find a sense of acceptance and peace in these relationships. Others may feel that it is best to keep a clear boundary between friends and fellow patients. No matter how you feel, it is important to be honest with yourself and others about what is helpful to you during the recovery process. No two journeys to recovery are identical, which means you must pay close attention to what is helpful to you. Listen to your inner voice when it comes to friendships with fellow recovery warriors. It may be that you need to return to you original circle of friends after treatment, and keep fellow patients at arms length to protect your own recovery. Or perhaps these friendships will be better suited for you later on in recovery-when you are feeling strong and have a deep sense of what triggers you and what helps you to cope. At that point, you may just find that these friendships can truly be like no other-just ask our Project Heal co-founders! Whatever the case, you and your recovery must come first, so pay close attention to your inner wisdom. It’s there, I promise.










Colleen Reichmann is a licensed clinical psychologist, specializing in the treatment of individuals with eating disorders, body image issues, self-esteem issues, and women’s issues. She lives in Virginia Beach with her husband, goldendoodle and sheepadoodle.

Let’s connect!

Email questions to: blog@theprojectheal.org

Instragam @drcolleenreichmann

Facebook Page: Dr. Colleen Reichmann

*The views expressed in this posting are based on this writer’s professional knowledge, training, and experience in accord with current and relevant psychological literature and practice. These views do not indicate that a professional relationship has been established with any recipients. Readers should consult with their primary medical professionals for specific feedback about any and all questions.

Frequently Asked Questions Friday

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Frequently Asked Questions Friday


This weeks question is:

How does treatment differ for males?


This is a great question, and one that does not receive enough attention or discourse. Males are and have been left out of the eating disorder discussion for far too long. As a society, and sometimes even as health professionals, we tend to hold the mistaken belief that males do not struggle with body image, or that they cannot develop unhealthy relationships with food. This is simply not true. The percentage of males that report struggling with eating disorders has been on the rise for years, but my argument is that our current understanding of percentages and numbers is likely very inaccurate, due to underreporting. There is still that strong societal belief that eating disorders are “female illnesses,” which leads a lot of male sufferers to feel shameful and stay silent about their pain.


One important factor to note is that many males develop their eating disorder along their journey to become “fit” versus simply thin. Our society currently holds a different fitness ideal for males than for females. “Fit” for men may imply more of a high muscle-low fat ratio. Currently, the pressure for males to achieve this body-to be “cut”-is astounding. However, this body type is not natural or attainable for the majority of the male population. The term “muscle dysmorphia” has been coined to describe this preoccupation with less fat and greater muscle definition. Hence males can begin to fall prey to the very same behaviors that females do. This shift can be tricky to identify at first, due to the fact that the original intention was not necessarily weight-focused. However, for many of these male eating disordered sufferers, their focus gets lost and the relentless pursuit of thinness takes over. The sport or activity that was once enjoyed then becomes an obsession.


Similarly, males tend to struggle more with legal performance-enhancing supplements — things like whey protein, creatine, and L-carnitine. Studies have shown that the use and abuse of such supplements is on the rise, and up to 22% of males stated that they had replaced meals with said supplements in the quest for a lean frame and large muscles. This behavior is dangerous, eating disordered, and rooted in low self-esteem- however it goes largely unnoticed by the majority of our society. In fact, the use and abuse of supplements seems to be considered somewhat normalized behavior at this point. This is quite problematic because these supplements have been linked to the development of eating disorders, and normalizing their abuse contributes to the trend of ignoring male disordered eating behaviors.


It is also important to note that, just as the thin ideal does not contribute to all eating disorders among women, current male fitness trends do not factor into all male eating disorders either. Many males report experiencing the very same influences as females- bullying, a drive for perfection, a quest to disappear, a desire for control, a need for numbness, a history of trauma-when conceptualizing their eating disorders in treatment. Therapy and treatment must include room for males to explore this part of their eating disorder, instead of simply focusing on body dissatisfaction with a focus on fitness trends.


At the inpatient or outpatient level, male-only groups tend to be helpful. This is because males have concerns regarding social issues, family dynamics, and body image that are vastly different than those of females. Male-only groups are helpful in that they allow males to specifically discuss and lend support around the stigmatization factor to one another. This is not to say that mixed-gender groups cannot be helpful as well. In the end, everyone is suffering with an illness that falls under the same umbrella, so support and camaraderie in general is a healing experience.


Research also suggests that a focus on gender dynamics overall in the treatment for males with eating disorders is important. Individual and societal perceptions of masculinity likely affect one’s experience of disordered eating, and must be explored. Masculinity has been correlated with more negative attitudes toward obtaining mental health help, and may contribute to the reason that males make fewer attempts at seeking help. Hence a therapist may identify this as something to explore further.


Other parts of treatment are comparable across genders. For example, treatment outcomes are similar. The basic principle of treatment (i.e. weight restoration, disrupting maladaptive behaviors, challenging thoughts related to weight and shape) also remain the same. For a more detailed analysis of this, I would suggest looking into the article “Males and Eating Disorders: Gender-Based Therapy for Eating Disorder Recovery,” found in Professional Psychology: Research and Practice, by Greenburg and Schoen.


I believe that if we continue to raise awareness and educate others about the fact that males can and very much do get eating disorders, the intervention and treatment for males will improve drastically. Currently, there are still far fewer treatment center options for males than there are for females. But as awareness continues to spread, more and more centers are beginning to not only accept males, but also provide specific tailored treatment or “male tracks.” This is encouraging progress. There is also NAMAD- The National Association for Males with Eating Disorders, which provides resources, inspiration, support, and articles for males



Conclusively, we still have a long way to go in terms of our awareness and inclusion of males in the eating disorder conversation. But the conversation has begun, and this alone is great progress. Lets keep it going!











Colleen Reichmann is a licensed clinical psychologist, specializing in the treatment of individuals with eating disorders, body image issues, self-esteem issues, and women’s issues. She lives in Virginia Beach with her husband, goldendoodle and (brand new!) sheepadoodle.

Let’s connect!

Email questions to: blog@theprojectheal.org

Instragam @drcolleenreichmann

Facebook Page: Dr. Colleen Reichmann

*The views expressed in this posting are based on this writer’s professional knowledge, training, and experience in accord with current and relevant psychological literature and practice. These views do not indicate that a professional relationship has been established with any recipients. Readers should consult with their primary medical professionals for specific feedback about any and all questions.



The Media Contributes To Eating Disorders But Does Not Cause Them

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Written by Project HEAL Southeast Pennsylvania chapter, Suzanne Brier.

Eating disorders are physical and mental illnesses that are frequently spoken of yet are still simultaneously dismissed and misconstrued. While the causes of an eating disorder are complex, explanations that are offered are too consistently simplified and often presented as if the disorder results from a single variable. More often than not, I will hear well intentioned individuals minimize the severity of an eating disorder by making it to be simply about poor body image and the media’s effects. The reality is that eating disorders are not simply caused by internalization of the thin ideal or poor self esteem. There are many potential factors that can put an individual at risk of this form of illness. While these factors can contribute to the problem, there is much more that needs to be considered and understood. Through my own observations, conversations with sufferers, and review of published scientific articles, the media, in fact, has much less power on how an individual perceives their body than we believe. Body dissatisfaction is far more affected by one’s perception of peer values and actions. Discussions about the importance of losing weight and striving to look a certain way in order to accumulate value in their eyes are much more likely to impact the likelihood of developing the disorder than a magazine or movie. While the media does not have as significant of an effect on the formation of beliefs, the media can have a powerful effect by confirming what a person at risk for an eating disorder has already internalized though other life experiences.

In eliminating other possibilities for development of an eating disorder, we silence the voices of individuals who struggle with this particular mental illness and in doing so perpetuate stigma. As indicated above, the answer to the question of what causes an eating disorder is complex and varies from individual to individual. Not only do causes vary, but like coping with any hardship, how people feel while struggling with an eating disorder will differ. Eating disorders can be motivated by a desire to want to control one’s body because they feel an immense lack of control. It can be motivated by a desire to have a body type that will make you feel you deserve love. Other motives include an attempt to regulate emotions, to avoid appearing attractive to keep others away, especially after a trauma, and to feel worthy by getting praised for your body particularly when nothing else about you makes you believe that you have that worth.

Eating disorders, just like all other mental disorders, are complicated and affected by an interaction of social, psychological, cultural, and biological factors. Among mental disorders, eating disorders are difficult to overcome and come with no known quick fixes. Yet, there is always hope and people do recover. I have witnessed this personally when my best friend sought help for the first time and confided in me as well as those she cared for. It was the seemingly miniscule, but critically important step loved ones made when saying, “I am ready to try recovery.” I believe that we can do better in understanding the nature of eating disorders and avoid making assumptions of what causes the disorder that is by no means one size fits all. This can be how we begin to more effectively provide empathy individually to those who struggle and learn how to better exhibit compassion to those we love deeply and are suffering. In continuing the conversation with new found awareness of various causes, we can work towards erasing stigma and allow for sufferers to share their stories without the shame.

Open Letter to the Online Recovery Community

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To All of My Online Recovery Warriors-

Can I just start out by saying you guys are incredible? Seriously. When I was recovering from my eating disorder, this type of recovery kinship simply did not exist. From what I can recall, during that time period, the world-wide-web appeared to be dominated by pro-ana culture. The internet was a place for people with eating disorders to give each other tips on how to become sicker, and to feel safe from judgment when doing so. Instagram wasn’t a thing yet, and I had never even heard of the term “prorecovery” until well after I recovered.


Since that time, it seems like we have seriously taken back the internet. It’s amazing. Not since Alcoholics Anonymous has there been such a powerful, self-run, self-monitored community of like-minded individuals committed to a singular cause of bettering themselves and overcoming a specific mental illness. From Facebook support groups, to instagram recovery accounts, to blogs where individuals dispense recovery tips, we have really come into our own.


But just like AA, we have our issues. The online community isn’t regulated which, in and of itself, invites a slew of potential problems. And while, more often than not, I am uplifted and inspired by how well we do supporting ourselves and one another regardless of monitoring, there are a few nagging issues that keep popping up for me. Read on, and tell me if you agree warriors:


  1. Instagram bios- Specifically, listing number of inpatient stays in bios. This, to me, is unnecessary at best, and harmful at worst. I understand that, having been through hell and back, there is sometimes a pull to shout, “I’ve been though hell and back! I am worthy!” This is human. The problem is, it feeds the eating disorder mindset of “sick enough.” In a community of individuals who are trying to recover, lets just put our cards on the table and say that we all actively struggle not to engage in comparison with one another. Right? Right. But our ED voice tells us to do so daily. So when your number of inpatient stays is higher than her number of inpatient stays, her ED voice may just get a little bit stronger for that moment. And hey, I get that we are not in a trigger-less world. It is not our job to make sure that everyone around us feels free from triggers all the time. But if you are making the choice to actively engage in a community of individuals who are striving towards recovery, why not make an attempt to scream “I am worthy” louder than ED screams you are not, EVEN in the bio?



  1. Bios again!- Specifically, listing lowest weight, highest weight, current, weight, goal weight, you get the picture. Grrrr numbers. Come on now. See above. I’ve learned a long time ago that numbers are never helpful to the discussion of recovery and eating disorders. When ya’ll put that in your bios you are directly participating in eating disorder sensationalism. Even if you don’t mean to. You contribute to societal ignorance and misconception that eating disorders have to do with being underweight, AND, you charge up other people’s competitive ED voices. And your own, without realizing it. Because who are you really trying to prove something to by putting your lowest weight in there? In the end, when you really stop and think about it, it’s probably just your eating disorder.


  1. Food pictures. I LOVE food pictures. Love them. And contrary to a lot of other people’s opinions, I love the food pictures that look gorgeous. Why not make your pancakes look like art girl? If that helps you in your recovery then more power to ya. I just think that sometimes it is important for us to take a step back from the food pics and make sure that we are communicating/noticing all the other aspects of our lives. Recovery is about food. Definitely. But it is about so much more than that. And if you spend your time arranging your food and then taking picture after picture of it and then posting them all you might not get to share those other cool parts of yourself with the online community. So keep on keeping on with the food pics. But every once in while write a blog post about your favorite hobby. Or post a make-up free #fearlesslyme selfie. Recovery is about living life again, which can be expanded into so many directions-the possibilities are endless!



  1. Hashtags-I’ll make this short and sweet. We need to be more responsible with the hashtags. Hashtags are a way to be found. They are a way to make yourself vulnerable, but they are also a way for the vulnerable to find. Please PLEASE stop posting things that are intentionally triggering and hashtagging them with #edwarrior, #prorecovery, #bopo, #everybodyisbeautiful, etc. It’s toxic and counterproductive.


  1. Reaching out – So the online community is a supportive forum. I get that. I get that people want to post things that they are dealing with and reach out for support. I think that it can be a great recovery tool! My only advice would be to use caution. Instagam, Facebook, or even your blog can be great, but they are not you, in a room, alone with your best friend or therapist. As I previously stated, these are self-regulated, as in you are not sending an SOS out into a group of professionals. Hence, especially if the forum that you are using is completely public, you may not always receive the most healthy or kind feedback. When you are feeling your most down, or vulnerable, I would say to use caution and make sure to ask yourself- do I post about it, or is this a “call a friend/therapist/family member” moment?



So there you have it online warriors! We are a force to be reckoned with, that’s for sure. Despite the issues listed above, I feel an immense amount of pride towards the online prorecovery community, and everything that we are doing together, everyday. But what are your thoughts? Do you agree or disagree? Are there issues that I didn’t list that you have noticed? Comment! Your thoughts matter!




C, PHEAL Blog Manager

Prorecovery Enthusiast

Why the Jeans Struggle is (Still) Real (And Why This Gives Me Hope)

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Ask me what my top ten likes and dislikes are. Go on. Ask me. If you did, I might tell you all about my love for coffee, memoirs, bangs, and dogs. I might tell you about my distaste for traffic and slapstick comedy. I know I would tell you about jeans. Yup. Jeans.

This seemingly innocent article of clothing has crested the top of my “dislike” list for years and years. Why? I’m not so sure that there is a simple answer. But let me try to explain:

I struggled with an eating disorder for over ten years of my life. When I think about my late teen and early adult years, my most stark memories are not falling in love, getting into college, or landing that great job. Rather, I recall me-obsessively calorie counting, me-running in rain/snow/excessive heat, me-losing friends as I slipped more and more into my own little world- you get the picture. My eating disorder happened gradually and then all at once. What started out as a simple diet slowly but surely became an all-consuming illness, one that would take me years to disentangle myself from. And while much treatment has brought me to the realization that this was about a lot more than weight, poor body image was and continued to be a decidedly strong symptom of my illness for quite some time.

Flash forward to present day. I am recovered. I am a wife. I am a friend to many. I am an advocate for those who struggle with eating disorders. I am a psychologist. Meaning I not only pulled myself out of my own personal hell and demise, but I kicked ED’s ass long enough and hard enough for me to feel comfortable pursuing a career empowering others to do the same. And while I do not disclose my history of an eating disorder to all of my patients, the times that I choose to, I inevitably get asked the same question: Are you completely recovered and how did you do it?

I feel comfortable answering that yes, I am completely recovered, because I can be authentic and genuine when saying so. I am and have been behavior free, I accept my emotions, and the thoughts that once dominated every second of my day now come so infrequently that I can spot them a mile away. This is what full recovery means for me.

In terms of body image, I have worked long and hard to accept and cherish my body. Now does that mean that I LOVE everything that I see in the mirror every day? No. I’m human, and I was born and raised in a society that celebrates the thin ideal and promotes diet culture aggressively. Enter-Jeans.

Jeans are my Achilles Heel. Try as I may, I despise shopping for them. They just never feel like they were created with my body-type in mind. They are always too tight or too loose. I always find myself irritated when shopping for them, muttering to myself like a cantankerous old man- “Why are there so many damn washes? What even are jeggings? High waisted or low? How the hell should I know?”

This happened recently, and it got me to thinking- why do these stubborn feelings persist about this stupid article of clothing when I left my eating disorder in the dust long ago? After much contemplation- this is what I came up with:

I’M HUMAN! A recovered human, yes. But also a highly sensitive, introspective, and perfectionistic human. These are some of the personality attributes that made me vulnerable to the development of an ED in the first place. These things don’t just go away. I just learn how to work them. Years of progress in recovery allowed me to understand how to make my personality work for me, rather than against me. Like I previously stated, to me, full recovery doesn’t necessarily mean that you never have a disordered thought. It just means that they have no power over you anymore. A fully-recovered individual becomes a ninja at challenging and deflecting those thoughts. Yet even ninjas have Achilles Heels.

So rather than let this terrify me or make me question myself, I celebrate the fact that I still have a bit of work to do. Why? Because it is a great opportunity to catch myself getting a little too sure, or compliant. My jeans light-bulb moment allows me to continue to work on my own progress. I hope the day never comes when I decide I have done enough self-reflection and stop striving for more progress. Because there is always room for more. And the more progress that I make, the more personal mountains that I move, the more I can help to empower others to do the same. How great is it that I have such a clear understanding of what still gets under my skin?

So jeans, consider yourself my next Everest. I am comin for ya.




Third Wheelin’ It With ED

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Scene opens to women sitting in restaurant with a man


Man: What are you going to order?


Woman: looks up from the menu with palpable alarm I’m not sure. There- I don’t see anything that I am in the mood for.


Man Come on, why don’t you get the chicken? You were just saying how you were in the mood for it the other day.


Woman: looks away I’m not in the mood for it anymore. (thinks to herself ‘Cant he back off already? Geez’) Maybe I’ll just get the salad.


Man: Come one. You haven’t had enough protein today. begins to look mildly irritated


Waiter: Are you two ready to orde-


Woman: No! So sorry but we just need a few more minutes.


Woman: to man in a harsh whisper I’m sorry but there isn’t anything on here with protein that I’m into.


Man: Stop letting your eating disorder win. Get what you want. Come on, we can share it if you want.


Woman: UGH Please don’t play therapist with me. I’m not even hungry anymore. Come on lets just leave.


Waiter: Ok, ready to order now you two?


Woman and man glare at each other in heavy, heated silence




Relationships are complicated. Throw an eating disorder in there and it really gets complicated. While the above-mentioned scene no longer occurs with anything close to that amount of panic or intensity, this is a more than accurate play-by-play of most meals out that I had with my husband when we were dating, and the eating disorder was in full swing. As you can see, it was a difficult time for both of us.


The thing about being in a relationship with someone who has an eating disorder is that, despite the sufferer’s best intentions and efforts, you are not a dyad. The eating disorder is always there, the annoying third wheel that seems to pop up everywhere from dates, to family gatherings, to the bedroom. When my husband and I were dating, I will admit that my ED ruined more days than not. I was constantly preoccupied and obsessed with food, weight, and physical activity. In short, I was not a great partner. I didn’t have the ability to be at that time. If I am being honest, my eating disorder was probably more my partner than he was. I loved him. I don’t really buy that saying that you cant love someone until you love yourself because I did. I loved him more than anything. I think the saying would be more accurately worded if it said “You cannot properly show someone that you love them until you love yourself.” Because at that time, while I swear I loved him with all of my heart, when it came down to the wire I put my eating disorder first every.single.time. And I hated myself for doing so. I just didn’t feel that I had any control over it. Every time he asked me out to dinner I had to choose between turning him down and feeling guilty about that, or going and feeling guilty about the food. In reality the wrath of my ED voice was 1000 times worse than the guilt that I could ever have about anything else.


Luckily, with much time and treatment, I got well. It was a conscious choice, over and over again, every single day. And he stuck with me. I still have trouble understanding how he endured this, and why he decided to put faith in my ability to recover and become a real person again in our relationship, but he did. And here we are, years later, married, happy, and a true dyad. ED no longer has a place in our home.


The emotional toll that my ED took on my husband both during the phase when I was actively disordered, as well as when I was going through recovery, was huge. Eating disorders are incredibly insidious and all-encompassing. Though I tried my hardest to play the magician, to keep a front of being perfectly fine and perky on the outside, while falling apart on the inside, it just didn’t work this way. The ED had tentacles, and I had no idea at the time how much the effects radiated out and rippled into those around me. I was consumed by ED, so I couldn’t and didn’t see the pain that others were experiencing. During the hardest times, I was drowning, and, because he cared enough about me to stick around, I was pulling him down with me. But don’t take my word for it. Best if you can hear it from him:


*I like calling it ED. I was so happy when the therapist explained it this way to me because it showed me that I wasn’t crazy. She was totally different when ED was in control. I don’t want to call her a monster or anything, but when ED was around, she seriously become a different, hardened person- she became cold, calculating, and distant. She did bad things, like steal money from me for laxatives. At the worst of it she seemed to almost consciously change her outside appearance to reflect her inside experience- she wore huge black shirts with tights and, of course, her body changed and became completely foreign to me. Gone was the beautiful, athletic, fun-loving brunette. Here instead, was this frighteningly angular cold little person who rarely smiled. I think that was the worst of it actually- the way her smile changed. It became a “not-smile.” She smiled without her eyes. Now you should know, my wife is beautiful. She is smart as hell, and she cares more about people than anyone that I have ever met in my life. She is compassionate, funny, ridiculously sarcastic, and her smile lights up my day. Her eyes crinkle at the edges when she does and I swear that smile could pull me out of a coma. But like I said, when her eating disorder took over, her entire personality changed. She was a shell. Very sad, very angry, and very lost.


But you know what? I stuck around. I went to interventions for her with her family. I held her hands while she cried and cried before going to treatment. I attended the therapy sessions and I learned about the meal plans. I encouraged her to eat (You take a bite I take a bite). The whole thing was a test of my patience, and I learned more about what I was capable of at that time than I have at any other point in my life because it was the most difficult thing that I ever experienced. When she wasn’t eating, I was obsessed with getting her to eat. I begged. I got angry. We fought constantly. There were periods of feeling hopeless. “You look nice” was triggering, but not saying anything at all seemed to be triggering too. Sometimes it just felt like my hands were tied. Some days I felt like I had to recover with her. The hard thing was that when she got out of treatment, she had been through months of intensive therapy, whereas I hadn’t had any. So I kind of had to play catch up. But in the end it was all worth it, because slowly, day by day, week by week, I got my girlfriend back. And being the support for her through that has only made us stronger. Storms and trees with roots and all that, you know? *


So for the partner of someone struggling- Remind yourself that there is a light at the end of the tunnel. It can be an exhausting experience, but don’t give up on your person. Their eating disorder likely has them convinced that they are not worth fighting for, so keep that in mind when you find yourself falling into the trap of feeling like your partner is intentionally trying to be difficult. Make sure that you take time for your own personal self-care. Remind your partner constantly that you wont give up if they do not. Strive to be a pillar of support as they work towards recovery, because if you do, their chances of being able to recover completely will be even stronger. And always remember- ED tires of consistent effort, vulnerability, and support from others, so keep up the fight! Recovery will happen, and with it will come healing for both of you.

Not Sick Enough

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“Can I ask you something? Would you ever consider going inpatient?” My therapist implored me, her eyes heavy with concern. Truthfully I had been spacing out until that moment, but the term “inpatient” pulled me out of my head quickly. “No way. I’m not sick enough for that.”


This just about sums up the endless cycle between myself and various family members, friends, dietitians and therapists for longer than I would like to admit. They approached the topic of a higher level of care- I brushed off the concern, laughed even, and told them I was not nearly sick enough. And they subsequentially found themselves speaking directly to my eating disorder and not me.


If you can relate, if you ever find yourself thinking “I’m not sick enough” take comfort in the fact that you are not alone in this thought. I can honestly say that I have never met anyone who has suffered from an eating disorder, including myself (see above) that has not had this thought at one point or another. But next time you find yourself thinking this, remember: this thought itself suggests that you are, in fact, “sick enough,” because this is an unhealthy thought to have. People who are well do not tend to wish to be ill.


According to the DSM-5, the most telling diagnostic factor for an eating disorder is a negative impact on social, emotional or physical functioning. This updated diagnostic classification system takes into account that an eating disorder will present itself in a unique way- a specific constellation of symptoms, behaviors, emotions, and thoughts that cause distress and dysfunction in different arenas of one’s life. Hence there is no actual operational definition for “sick enough.” It is an ED thought and one that stems directly back to the biological and chemical roots of the disorder itself. For example, research conducted among ED samples demonstrates that there is an altered response to pain, emotion intensity, hunger and satiety, and assessment of body shape/body image. This suggests that part of the brain that senses pain related to physical and psychological experiences does not function properly (which may, in part, account for the “numbing effect that many people with eating disorders report). Hence an individual suffering from an eating disorder may be physically or psychologically compromised, but their brain does not sense this. As a result, patients can actually be quite ill but their brain (and specifically the eating disorder part of their brain chemistry) is still feeding them thoughts of “not sick enough.”

To put it plainly-You will never be sick enough, because there is no sick enough. The sick enough that the eating disorder is promising you is a disappearing goal post, a mirage. I’ve had frank conversations with the very people who my eating disorder used to compare me against- the people that I thought fit my idea of “sick enough”-and guess what? They all reiterated some version of the very same thought- “I just never saw myself as sick enough.”

This is why, when the “not sick enough” thought comes to mind, it is important to consciously process and acknowledge the fact that this is your eating disorder speaking. If you want recovery, you must challenge this thought immediately. Ask yourself, “What does sick enough mean? And why do I want to be sick? What will I get out of being sick enough? What will I achieve from being the most sick?” Challenge your eating disorder voice on this every.single.time. Do not let your ED voice bully you into thinking that being sick = happiness.


So: A quick reminder that your eating disorder is a real and valid experience even if…

  • You have never been underweight
  • You have never been inpatient
  • You are weight-restored
  • Your labs look fine
  • You have never been on an NG tube/never drank ensure/never been near death
  • You’ve been told you don’t “look like” you have an ED
  • You’ve never been to a therapist
  • You don’t have a strikingly alarming “rock bottom story” about your ED
  • You don’t restrict food groups/count calories
  • You don’t feel triggered by the media or diet culture
  • Your friends or family don’t know
  • Your friends or family don’t believe you
  • You like to eat certain things/look forward to meals
  • You don’t have fear foods
  • You don’t fear foods that others seem to
  • You don’t use the behaviors that people most commonly speak about when they discuss EDs
  • You don’t exercise
  • Your recovery is going smoothly
  • Your journey/gender/ethnicity/identity does not match the most common portrayal of eating disorders in the media or the memoirs

Summarily- ban/obliterate/kick out “not sick enough.” Argue relentlessly with your ED when the thought comes to mind. As a past therapist told me “Let go of the idea of not being sick enough. You are sick. You are also enough. The relationship ends there.”



The Dirt on Clean Eating

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Is it just me or is our culture sending a bit of a confusing message lately? On the one hand, the body positive movement is gaining momentum every day. On the other hand, the societal message that we must “eat clean” has never been more pervasive. This creates a rather puzzling cultural dynamic. And nowhere is the message louder than on social media. Food bloggers have sprung up in record numbers lately. One need only take to instagram to see five million pictures of acai bowls and chia pudding. An interesting twist? A not-insignificant number of these bloggers have publicly spoken about past struggles with disordered eating. The pictures tend to be gorgeous, but what is the message towards recovery here? I find it somewhat puzzling when people label their pictures with #edrecovery, directly followed by #cleaneating. Now I am certainly not a dietician, but I am a psychologist who has worked in several inpatient eating disorder treatment centers. From everything that I have seen and learned, recovery and “clean eating” typically cannot coexist peacefully.


Because what is clean eating exactly? A quick google search of the term yields a plethora of definitions:


“At its simplest, clean eating is about eating whole foods, or “real” foods — those that are un- or minimally processed, refined, and handled, making them as close to their natural form as possible.” (fitnesscenter.com)


“Clean eating back to the natural health food movement of the 1960s, which shunned processed foods for the sake of moral and societal values (rather than health and nutrition issues)” (cookinglight.com)


“It is not a diet; it’s a lifestyle approach to food and its preparation, leading to an improved life. It means choosing organic whenever possible, drinking lots of water, and avoiding anything high in sugar and anything fried.” (cleaneatingmag.com)


“Clean eating includes structuring your diet to get proper nutrition, help manage diseases, avoid developing diseases in the first place, lose weight, remove toxins, and just feel better.” (dummies.com)


Seriously? How is it possible that something so talked about can have no agreed upon definition? One thing is for sure- those definitions do not sound particularly conducive to recovering from a disorder that involves a focus on manipulating food intake and weight. In fact, the definitions above suggest that clean eating appears to very much skirt the line between diet and disorder. Indeed, the term Orthorexia has been coined to describe an eating disorder that involves an obsessive pursuit of pure and clean eating, to the detriment of one’s happiness, functioning, and at times, health.


So what is a recovery warrior to do? I would strongly argue that clean eating is not something to pursue when in recovery, ESPECIALLY early recovery. Perhaps individuals who are not prone to eating disorders can “eat clean” and get away with it, but when you are in recovery, their diet is your eating disorder. It’s an important mantra to keep in mind, given the aforementioned cultural wave. So when you feel the pull to begin engaging in chatter about wholesome and pure ingredients, repeat to self :“Their diet is my eating disorder.” And make no mistake, clean eating does fit under the umbrella of diet. Recovery, true recovery, involves letting go of dietary restrictions and rules. The idea is to break the rules that ED created for you. Clean eating is restrictive. It simply is. And trying to eat clean may just be leaving the door open for ED to slowly weasel back in and morph those rules into being more and more restrictive and problematic.


So the dirt on clean eating? My vote is stay away warriors. Recovery means eating for nourishment, eating what makes you feel good, and eating in a way that helps your emotional and mental well-being. That can involve both sweets and salads. Freedom from rules and obsession is the goal, and getting back to living your life is the reward. And life should be fun, imperfect, and messy. Not clean.