Eating Disorders/Disordered Eating

A Personal Note from Rebecca:

Happy Holidays! As many of you know, Rebecca Bitzer MS RD and Associates has been working hard over the past several months to bring you even better services.  Over the summer and early this autumn, each of our Registered Dietitians (RD) has completed extensive continuing education in her primary area of interest.  Each client will be matched with the RD who has the passion and the cutting edge information to be able to provide you the best intervention possible and delivered in the most caring manner.  For more information about each RD and her practice, please visit our website and see the “Meet our Dietitians” link.
 
With this in mind, I have specialized as well and will focus on my passion.  I have just launched a NEW comprehensive program called “Empowered Eating” designed to provide freedom from food struggles and hope for people struggling with eating disorders and their loved ones.  For more information on these programs, visit my new website and blog at www.empoweredeatingblog.com.
 
In addition, we have a NEW newsletter where we will be including a seasonal recipe, an inspirational quote and upcoming events. We hope to inspire you with positive messages, inspiring information, and practical suggestions to help you learn ways to improve your health, make healthy, informed decisions and practice exquisite self-care.  Included in this newsletter, we hope to inspire you to practice some of the principles of Empowered Eating including: love your food, love yourself, and heal your life.  Enjoy.

You can sign up for the newsletter here!

For even more updates, like us on Facebook and follow us on Twitter.

By: Rebecca Bitzer, RD, LD

When I first started this blog, I decided that I wanted my section to focus on exquisite self care. Since then, I have become more clear on what is exquisite self-care. Merriam-Webster’s on-line definition of exquisite is the following:

1 : carefully selected : choice
2 archaic : accurate
3 a : marked by flawless craftsmanship or by beautiful, ingenious, delicate, or elaborate execution b : marked by nice discrimination, deep sensitivity, or subtle understanding c : accomplished, perfected
4 a : pleasing through beauty, fitness, or perfection b : acute, intense c : having uncommon or esoteric appeal

Although all of the above  seem to fit, the idea of exquisite self-care to me seems to encompass being able to identify your individual needs and finding ways to meet them by “filling up” your own vessel  and have enough to nourish others also.  This seems like a tricky thing to do, unless you carefully select things that foster nourishment of one’s body, mind, and soul.

Another interesting way to think about nourishing your body is to think about nourishing all of your senses.  In addition to nourishing your sense of taste by eating, how can you nourish your sense of smell, touch, hearing, sight, etc?  The photo above reminds me of ways that my dogs meet my needs of touch, hearing, sight and help me to slow down and enjoy my day.

For me, I must slow down long enough to really listen to myself to find out what charges my batteries or what drains me.  Some things that drain me, are important to do, so I must remember to nourish myself with things that replenish my energy.  I know when I am tired, stressed, and over-extending, I am not much value to myself and those around me.  However, when I am rested, well-nourished, finding time for satisfying work and play; I like myself much more and I seem to attract even more wonderful nourishing things in my life.

A carefully selected choice, it can start with a simple decision before you get out of bed in the morning to be grateful for the day and to commit to doing one positive thing for yourself each day.  This can be as simple as deciding to take the time to eat breakfast in the morning or making sure to get to bed at a reasonable time at night or any combination of other “carefully selected” choices throughout the day.

I believe that it is necessary to slow down and take the time to be thoughtful in terms of which actions would help you live your life with more peace, more creativity, more health, more satisfaction, more direction, more sense of accomplishment, more fun, or more whatever may be missing from your life.  You may wonder why I am writing about this as a “NUTRITIONIST” but I think if not me, than who?  As a nutritionist, I see that so many people’s lives are “out of balance” and that for whatever reason, most people need support and encouragement to make better choices in terms of  self-care.

Self-care in my mind involves anything that makes you a healthier person.  Who can argue that getting enough sleep, eating healthier foods and physical activity at regular intervals will not help you feel better?  Who does not benefit from some form of movement, fun, or adventure?  Food and feelings are very closely tied for some and for others there may be a big disconnect between food and feelings, but wherever you fall on this spectrum,  I believe that is important to pay attention to all the ways that you nourish your mind, body and spirit.

I challenge you to come up with big ways and small ways to nourish yourself.  I encourage you to share these with us on the comment section and I want to also say that I will be introducing additional opportunities for you to try new experiences which might encourage you to add tools to your tool box of ways to nourish yourself.   The choices and opportunities for self-care are vast and I encourage you to challenge yourself to commit and follow through with at least one positive choice or one example of exquisite self-care each day.

Please join us for our Eating Disorder Support Group in our Columbia office with Registered Dietitian Rebecca Bitzer and Kait Fortunato, and Therapist Courtney DiLallo, LCMFT.

 All Eating Disorder/Disordered Eating sufferers welcome: Anorexia, Bulimia, Binge Eating, and Emotional Eating.

 The first group will meet Thursday, November 3^rd from 1-2 pm and continue to meet every week after that. Family members are welcome!

The group will be located at our Columbia Office:

 9881 Broken Land Parkway, Suite 105, Columbia MD 21046

 Directions can be found on our website. 

Topics Include

• Exquisite self care
• Relapse prevention
• What is normal eating?
• Media’s influence on ED
• Cognitive Behavioral Therapy Tools

 Please contact admin@rbitzer.com or cadilallo@gmail.com for more information.

 We are very passionate about helping our clients recover and we look forward to working with you.

 Please visit www.empoweredeatingblog.com for more information about Eating Disorder treatment and to sign up for the class.

Is your relationship with food impacting your everyday life? Do you struggle to find a healthy eating balance? The Empowered Eating movement is a powerful nutrition intervention that can save your life led by Rebecca Bitzer, an experienced Eating Disorder Nutrition Therapist. This is the ideal program for those who are serious about their commitment to recovery from disordered eating or an eating disorder. These programs are individualized based on need but include a combination of the following services. I want you to feel empowered to make healthy food decisions and feel good about yourself. Together, we can identify challenges and provide creative, helpful solutions to establish habits that will allow you to find freedom from your disorder for good. I can provide the accurate nutrition knowledge you need and the support you deserve.  Empowered Eating allows you to love yourself, love your food, and heal your life.

Check out the website for more information about the 3 programs and ways to get help.

EmpoweredEatingBlog.com

Programs

Blog

By: Amy Bortnick

The most common eating disorder in America plagues 5 million American women and 3 million American men has been recently discovered and termed binge eating disorder. The book “Crave” by Cynthia M. Bulik explores this complex disorder in which people feel powerless to fight food cravings and overeat to the point of guilt, regret and embarrassment.  “Crave” travels deep into the reality of binge eating disorder, and provides essential and clinically proven strategies for overcoming the disorder. Dr. Bulik breaks the environmental, scientific, and psychological research behind binge eating disorder into an easy to read tool that aims to restore a sense of wellbeing and provide personal empowerment in those suffering from the disorder.  The novel challenges those suffering to understand themselves, identify, isolate, and eventually manage their self-defeating behavior. Crave is not only a tool and must read for those suffering from binge eating but also a source of education for anyone seeking an understanding of this complicated disorder impacting so many Americans. If you struggle with binging, stress eating, or emotional eating, this book may help you overcome your disordered eating patterns.

At Rebecca Bitzer and Associates we work on forming a positive relationship with food and not restricting the foods you love. Make an appointment toay to learn how to enjoy food and move further away from disordered eating.

By: Amy Bortnick

I once found myself in a conversation with a woman about why I choose to be a nutrition science major. I never forgot the conversation because it was a unique one. I remember her saying to me, “but if you major in nutrition science you will always have to think about food.”  At the time I thought that was strange because to me food something everybody thought of and I was just uniquely fascinated by the role it played in one’s health, wellness, and strength and thus decided to study those things as a nutrition science student. However, it dawned on me later that like a victim recovering from an addictive relationship wants to escape thoughts of a drug a person abusing food wants to escape thinking about it but cannot. The problem is while some people may feel victim to food as if it were a drug, food is something we need to survive thus the relationship you have with food is intertwined with the relationship you have with yourself. Like any healthy relationship the one you have with food needs balance. I see the woman’s  argument now, being constantly preoccupied with food is exhausting it’s like that unfortunate friend whose dating a jerk and can’t stop talking about him because the relationship is always bothering her. Being preoccupied with an unhealthy relationship creates shame, guilt and negative energy. But avoiding thoughts about food altogether is dangerous and ultimately is not possible. Having a positive relationship with food is a critical component in the quality of life. To some people this relationship comes naturally for others it takes constant balance. Being mindful of food and aware of what you eat in each moment can help nurture your relationship with food, this is the concept of mindful eating.  Mindfulness promotes balance, choice, wisdom and acceptance of what is. It involves being present in the moment with the food you eat. For, more information, strategies  and resources on mindful eating check out The Center for Mindful Eating.

By: Laura Drenkow

“Art therapy allows us to express and experience thoughts and feelings when words fail. It is a tool that can help provide access to those hidden feelings that often contain the key to our struggles.” -Amanda Bechtel

 I had the opportunity to sit down and talk with our new art therapist, Amanda Bechtel, who sees clients in our Greenbelt office on Fridays.  Amanda received her Master’s degree in art therapy from Mount Mary College in Wisconsin.  She currently works at Sheppard Pratt in a group setting, but is also branching out to private practices to do individualized therapy.  Her specialty is assisting patients who have eating disorders by teaching them to express their feelings through art.  Amanda teaches her patients to be completely free and expressive; they do not need to have any artistic ability to create a masterpiece.  The goal of her art therapy is to allow her patients to connect with their feelings.  She provides a wide range of materials and mediums, some of which can be associated with a certain type of mood. 

I did an exercise with her by testing out different types of materials such as pencils, water color paints, and markers.  It was interesting to pay attention to how smooth and free it felt to use a paintbrush; however, it felt more constrained to use a pencil because it was easier to control the outcome of the artwork.  I learned from Amanda that it is good to allow individuals who feel the need to control many aspects of their life to have them express their feelings through painting rather than another material such as drawing.  This can help them realize that it is okay have some freedom with their actions.  Also, I learned that certain colors can be associated with moods.  An individual who is feeling angry or stressful may choose to use red while an individual who is feeling happy or carefree may choose to use yellow. 

Amanda does several interesting projects with her clients; two of my favorites were creating altered books and doing a body trace.  An altered book is created by utilizing an old book and making a collage or series of pictures over the pages of the book.  It is similar to a diary, but of only pictures.  A body trace is when she traces the body of her patient on a large piece of white paper.  First, however, the patient draws how they depict their own body.  Then when Amanda traces their real body, they can see the difference between their perception of their body and their actual body.  People with a distorted body image see themselves to be larger than they really are.  This is a good way to display reality. 

I learned from Amanda that people can be very creative, though they may struggle with expressing their feelings. It is not an easy thing to try and explain how you are feeling to someone or to yourself, but art therapy to me seems less intimidating than talk therapy.  For some people, it is just easier to express feelings by drawing a picture than trying to explain it in words; sometimes words cannot adequately explain how one feels.  Someone may not even realize that they are feeling a certain emotion until they begin to do an art project so it allows them to connect with their emotions.  They may not be sure what is going on internally, but they can create a picture and be able to describe it. 

This is Amanda’s goal: helping individuals with disordered eating habits to become aware of feelings and learn to express them in healthy ways.  To learn more about Amanda’s art therapy, please visit her website. Talk to your dietitian about setting up an appointment with Amanda or you can reach Amanda directly at 202-455-5894!

BY: Amy Bortnick

“Prejudice is a great time saver. You can form opinions without having to get the facts.”-EB White

I’m spending the week at the beach with my Grandma. She is a woman of 89 with the health and wit of 60 year old. I have a special relationship with Grandma and love spending time with her. I don’t hang out with her out of the goodness of my heart but I do it because she’s fun, I love her, and I connect with her. However, we don’t always connect.  It wouldn’t be completely correct to say he’s stuck in her ways but more accurate to say she speaks without fully thinking sometimes.

I’m about to tell you about how her prejudice comments really let me down but first I want to tell you a little bit about her so you don’t get the wrong Idea about my Grandma’s character. Around the time I was born my Aunt, my grandma’s daughter was engaged to get married, she already had a few engagement parties and the wedding date was set.  My grandmother and grandfather volunteered to pay for the wedding as they are always willing to do anything to make their family happy.  The party was set to be at Holiday  Inn on Rockville Pike, the meals, food, and entertainment were paid for and set. A mere two weeks before the wedding my aunt realized she was a making a mistake and couldn’t marry the man she was engaged to. When my grandma called the Holiday Inn to get her money back the hotel manger told her she couldn’t get her money back. My bold and big-hearted grandma said that’s alright the party will go and I’ll call the food bank and invite 200 homeless people. Now, the Holiday Inn did reimburse my grandma but she donated much of everything else that we could no longer be used for the wedding to charity.  And she fully intended to invite the homeless to wedding-less event!

Now that you have a little of an idea of who my Grandma is I want to get down to the reason I am writing this. My Grandma has always been a source of encouragement and inspiration for me. So when I came to spend the week at the beach with her I was very excited to tell her all about running the Baltimore marathon and raising money for BEDA. Of course my grandma offered to donate before she even knew what BEDA was and was very happy I was running for charity. When I began to explain to her about BEDA, and show her my fundraising video, she thought it was great and offered suggestions about fundraising. I was happy and felt my grandma and I once again connected.

…read more on Binge Eating Disorder: a Misunderstood Disease

By: Amy Bortnick

Running is something you do alone or I like to think my ipod and I do alone.  You can argue it’s somewhat of a selfish sport, many people do it for reasons that will benefit them; to get in shape, to relieve stress,  or to reach a personal goal. I’m the to first to admit I run for myself, it gives me peace and strength that helps me to deal with everything else going on in my life.  Last year when I ran the Marine Corp Marathon I did it for me! I spent long hours running, cross training, and strength training so that at the end of 18 weeks of training I could cross a finish line and say I did it, I ran 26.2 miles. It gave me a sense of pride and satisfaction. Don’t get me wrong the personal journey was extremely rewarding and I believe it’s always important to do things for yourself. Besides when your happy you’re more likely to make other people happy .

But…this time around I want to run for something bigger then myself, I want to do something that will make a difference in other people’s lives. I think the idea to run for charity and particularly BEDA (Binge Eating Disorder Association) clicked one day at a staff meeting when my boss was explaining that success comes you learn to connect the different parts of your life so you can make the most out of all your time and effort. Now, those weren’t her exact words maybe not even close but that’s what I took from it and more specifically, I took “Hey Amy maybe you should make use of all those hours you spend running”.

I decided to connect the passion developing from learning about eating disorders  first hand at RBA  and through my experience giving body image an eating disorder workshops at UMD  with my love for running and my desire to help people! The more the process for fundraising and marathon training continues the more of a connection I see in what I’m doing. What I mean is that training for a marathon takes strength, determination, self efficacy, and as I allotted to above self love. Similarly, those recovering from an eating disorder need to be strong, to learn to love themselves, and to believe in themselves. I believe in BEDA because I had the opportunity to meet the co-founder Chevese Turner, an inspirational woman recovering from BED and among other things I recognized the drive, devotion, and passion needed to make change. To learn more about BEDA and help me reach my fundraising goal please visit my Fundraising Page any little bit helps! If nothing else go watch the Youtube movie I made.

In honor of Eating Disorder Awareness Week (February 20-26), we wanted to feature guest blogger, Andrew Walen LCSW-C. Andrew Walen is the founder of The Body Image Therapy Center, specializing in the treatment of eating disorders, weight management and bariatric surgery patients. Along with psychotherapy for all ages, they offer free support groups, psych testing, and wellness coaching. To learn more visit http://thebodyimagecenter.com.

There are three issues to weight gain:

1. biochemistry
2. underlying emotional issues
3. relationship to food itself

I’d like to talk about the second issues, particularly as it relates to self-esteem.

What is self-esteem? Self-esteem is the combination of self-efficacy and self-respect. Self-efficacy is the belief that you can handle whatever life throws at you and that you have something to offer the world. Self-respect is the confidence that you deserve to be happy and that others don’t have to fail for you to succeed. How many of you believe you can handle whatever life throws at you? What about losing weight with healthy diet and exercise? How honest are you about your ability then to handle whatever life throws at you? What about the idea that you deserve to be happy? This answer is often NO for morbidly obese women because of past history of sexual assault. The rate of sexual assault of women in the US is about six percent, but due to under-reporting it is assumed the rate is more like 20 percent. In a 2006 study by Oppong et al, it was found that about a third of morbidly obese women preparing for bariatric surgery had a history of sexual abuse. But again due to the likelihood of underreporting (many participants left that question blank), it is assumed the rate is much higher. We already know that women will often put on weight to become less attractive to their abuser. That safety can become a deterrent to losing weight not just out of fear, but also out of a sense of not deserving happiness – a loss of self-respect.

The most common cause of low self-esteem is destructive criticism. If you have spent a lifetime hearing “you don’t deserve it,” “don’t be silly,” “you’ll never amount to anything,” or other comments like this it can become a personal belief about your worth. You start to formulate what we call core beliefs about yourself, the world around you, and your future.

The underlying emotion behind low self-esteem is fear. The more you’ve been criticized, the more you’re afraid of being criticized. Imagine being a dog and you just peed on the carpet for the umpteenth time and your owner has no idea how to train you. What concern might fill your canine brain? They’re going to beat me! My nose is going in that, I just know it! I better get out of here! The effect is a very nervous dog. There’s no nurturance or reward for doing a positive thing.

So how do you improve your self-esteem? You don’t improve your self-esteem by working harder or trying to be more perfect. That never fills the void of poor self-esteem. You improve your self-esteem by letting go of the fears that undermine your self-esteem. That takes work to see what those fears are, where they came from, and what thoughts you have about yourself, the world and your future. You may find that your thoughts are a bit whacky, and need some fine tuning. That’s where a good support network comes in, as well as a good therapist.