Sunday, January 28, 2018

Yes, You Can Wear Make-Up in Recovery

One of the questions I'm often asked has to do with how "pure" one's recovery must be. Part of eating disorder recovery involves a paradigm shift from attacking one's body to body neutrality or acceptance. For some, perhaps the more black-and-white thinkers of the bunch, this means that anything we might want to do to enhance our appearance isn't aligned with recovery.


There's nothing categorically anti-recovery about focusing on, and enhancing, your appearance. Whether it's wearing make-up, getting your hair styled, or buying new clothes, many appearance-related behaviors don't threaten the spirit of recovery.

Some, on the other hand, do. When trying to decide whether a particular beauty service or process is in line with the values of recovery, you might want to ask yourself these two important questions:

1) Does the behavior cause me harm?
2) Can I do without the behavior?

In general, if the answers are "no" and "yes," this is a behavior that is a choice and has no negative consequences. With that in mind, if it's something you want to do, why not do it?

If a particular appearance-related behavior you're considering does cause harm (physical, emotional, financial, etc.), then you might want to think twice. Cosmetic surgery, for instance, might cause physical pain (and come with certain risks) and can create a dependence on additional procedures over time, though certainly not always. Your morning skincare regimen might not cause any physical harm, but it might drain precious resources (time, money, energy), important factors to consider when making your decision.

The second question helps you establish how important the behavior is to you and how much of a choice engaging in it is, versus a need or compulsion. For those who are graying, for instance, and choose to color their hair, could you imagine yourself going without your regular root touch-ups? If so, it seems the behavior (dyeing your hair) doesn't have much power of you, which might provide support for continuing to do it.

Think about other examples: straightening your hair, using cream to reduce skin discoloration, microblading, shaving your legs, getting regular manicures, using injectable fillers. Ask yourself the two questions above to get more of an understanding of any consequences of this behavior and your relationship to it. Many things we do to improve how we look (or how we feel about how we look) can jibe with eating disorder recovery, while some, you'll see, cannot. But still, it's important not to judge the urge (or even the acting on the urge) - in others or ourselves - to engage in any beauty-enhancing procedure, no matter how harmful or compulsive. We've all been socialized to value the beauty ideal.

And yes, you can wear make-up in recovery.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at

Thursday, December 14, 2017

5 Keys to Coping with the Holidays

Despite its festivities, the holiday season can present a number of challenges for those
in eating disorder recovery. For some, family time can be stressful. Food is often abundant
and not on a regular schedule. In many cases, individuals leave the comforts of their homes
and routines in order to celebrate with others. Those with co-occurring illness, such as
alcohol/substance use disorders, depression, anxiety, or trauma may face additional
challenges during this time.

Toward the goal of relapse prevention, a little planning can go a long way. As the holiday
season approaches, consider these five “S”s that can help reduce the likelihood of
symptoms escalating or re-emerging:

Going into the holidays, take a personal inventory. How have you been doing? What has
been challenging for you recently? What have you learned from past events? What types
of triggers do you anticipate going into the holidays this year?

Planning is the enemy of relapse. While it might be impossible to predict every potential
scenario, strategizing certain situations can go a long way. For instance, if you’re attending
a holiday gathering, discuss with one of your treatment professionals how you’ll approach
food before, during, and after this event. How will you respond if someone comments on
what you’re eating or your weight? If you’re sober, assume someone will offer you a drink;
have a response ready to go. Have some topics in mind to discuss if the conversation turns
sour (e.g., when the inevitable New Year’s diet talk ensues).

Think about who your supports are and reach out before the holidays approach to see if
they’re on board to provide you help if needed. Your interpersonal arsenal might include
specific family members, friends, treating professionals, peers from treatment, or others
who have identified themselves as healthy supports. Ask your supports if they’ll be
available to talk/message at designated times. See if you can check in before and after
specific events that you anticipate to be particularly challenging, a practice referred to
as “bookending.”

Knowing that the holidays can create additional stress necessitates a ramping up of your
standard self-care routine. What can you do that calms you/centers you in preparation
for this time? Now is the time to be particularly gentle with yourself. During a stressful
situation, are there specific tools you can use to help you through? Do you have an
escape strategy ready to go? If something triggers you, and you’re at an event, can you
step outside and get some fresh air or contact one of your supports? Are there any
pleasurable activities you can get on your calendar following your holiday commitments?


Recognize that, despite your best efforts, setbacks can happen. How you respond to
potential setbacks can influence their duration and severity. Recovery is a process of
learning from experience, maintaining motivation and commitment, and cultivating

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at

Sunday, October 29, 2017

Can You Add Joy to Your Workout Routine?

How often do you find joy when you're exercising?

If your answer is "never" or "rarely," it's probably time to reevaluate.

Physical activity need not be a miserable experience. It shouldn't be punitive, compensatory, or self-attacking. While a workout might be challenging or difficult at times, it should never be painful, motivated by fear, or sustained by self-hate.

I encountered the above quote at a gym several months ago. "Pain is temporary. Quitting lasts forever." I'm not sure who said it, but it's wrong. "Quitting" has taken on a negative connotation in our culture, when in fact, ending a workout because it hurts or doesn't feel right can be exactly the self-care that is necessary to sustain a healthy relationship with exercise. For many, pain isn't temporary. If you over-train or cross a threshold of discomfort during activity, you can do irreparable damage that threatens your physical and mental health.

If we enjoy something, we're more likely to continue doing it. That's Behavioral Psychology 101. Can you find the joy in your workout routine?

Recently, while teaching a spinning class at a local university, I spontaneously cued joy. We had just completed one sprint of a two-sprint song. As we were approaching the second sprint, I asked the class if they could do the second sprint "better." Now, typically, "better" in a spinning class means faster or harder or anything that demonstrates greater effort. But in defining "better" for this class, I also asked them, "This time, can you sprint more mindfully? This time, can you sprint more joyfully?" I was surprised by the response. As soon as I said "joyfully," I witnessed a room full of smiles. As much as we attend workout classes to sweat and work hard, we're also looking for joy. And that sprint was more joyful. It was fast and hard, but playful, too. It was better.

Where can you add joy in your exercise routine? Can you craft a playlist that makes you happy? Can you skip instead of run? Maybe get off the elliptical and dance? The more joy we find through movement, the more likely we are to continue engaging in physical activity. Joyful exercise is not an oxymoron. Find a way to make movement fun for you.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at

Monday, August 21, 2017

5 Things that Have to No Place in Eating Disorder Recovery

Recovery is a bumpy road, and there are often unexpected twists and turns, even with significant support. It's important during this process - and I might argue always and even for those without eating disorder histories -  to avoid cultural trends that can exacerbate symptoms or interfere with full recovery. The following are several examples that I have seen obstruct the recovery process:

1) Waist trainers: You don't need to "train" your waist. Recovery is about training your mind to be more body neutral - or even accepting - than it is about trying to manipulate any body part.

2) Macros, keto meal plans, Paleo, and more: If you are following a certain meal plan that excludes or significantly limits certain foods in favor of others that are judged to be "healthier" or better for weight-control, then you are continuing to do your eating disorder in disguise. Eating in recovery is flexible and varied and allows access to all foods, particularly those that diets tend to shirk.

3) Cleanses/detoxes: These are weight-loss gimmicks that can lead to relapse. Your body naturally detoxes on its own, and cleanses and detoxes are unnecessarily restrictive and can lead to sustained restriction or backfire in the form of binge eating.

4) Food scales: If you're weighing your food, you're not relating to food in a natural and transferable way. This inflexible approach won't get your far in your recovery journey, as it retains the rigidity of the eating disorder mindset and prevents exposure to more adjustable eating patterns, such as spontaneous snacks or restaurant meals.

5) Fitness trackers: Recovery should focus on intuitive movement, rather than exercise that is numbers-based or focused on burning calories. Especially in early recovery, counting anything (and then making behavioral decisions based on these numbers) ignites the eating disorder brain and can trigger relapse. Fitness trackers place too much emphasis on numbers, robbing us of our natural desire to move our bodies in flexible and creative ways.

Can you think of any others to add to this list?

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at

Monday, July 17, 2017

Don't Judge a Body by Its Cover

When President Trump remarked to French First Lady Brigitte Macron last week, "You're in such great shape," I immediately had a series of questions. For instance, when and where did she compete the presidential (no pun intended) fitness test that he must have observed? Was he most impressed with her strength or endurance, her flexibility or speed? Were there any other assessments he used to gauge her fitness level?

Because clearly, he woudn't have commented, "She's in such good physical shape" just by looking at her, would he? Surely, our president knows that being "in shape" is not attached to a certain look - or shape or size. It's not about structure or form at all. It's about the ability to perform various physical tasks at certain levels and about the body's physiological response to performing these tasks. We might want to assess data points such as her maximal oxygen consumption during exercise and the rate at which her heart rate returns to baseline post-activity.

One's weight or size is easily independent of one's fitness level. There are plenty of thin people who have zero physical training and plenty of fat people who run marathons and hoist heavy things above their heads. What we typically think of as physical indicators of fitness (e.g., a toned body, obvious musculature) are correlational at best. Many individuals are "blessed" with thin or muscular genes without ever needing to hit the gym.

Now, if Madame Macron is, in fact, no stranger to Velib, can lift even half of her body weight repeatedly, or knows a thing or two about downward dog, we might say she's in good shape. But, without this information, her being "in such great shape" is pure conjecture.

What Trump really meant to say was, "You're so thin" before he called her "beautiful." Wasn't it? That's all that he observed. And what he could have done, as a statement to women worldwide, was learn a little bit about her beforehand so he could comment on something more meaningful than her body or simply mention how pleased he was to meet her.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at

Friday, June 16, 2017

What Thin Privilege Really Looks Like

Individuals of all sizes may struggle with accepting their bodies; however, it is only those who live in fat bodies who also confront weight stigma. If you have a thin body - despite how much you might dislike it - you live with thin privilege. Want to know what thin privilege looks like?

In a restaurant, you order what you want, unafraid that others will judge or stare if you don't pick the "healthy choice."

You work out at the gym or go for a walk or run outside without fear that others will mock you.

You walk into a doctor's office and don't have to worry that the chairs in the waiting room won't support you.

When you go in to see the doctor, your provider doesn't suggest that losing weight is the answer to all that ails you.

If your doctor orders an imaging test, you don't have to drive an extra hour to a facility that has a machine that will support your body.

When you board an airplane, people don't stare and grimace, afraid you'll be seated next to them.

You can go to a shopping mall and know that most of the stores will carry something in your size. You can ask for a larger size without the sales associate saying, "We might have some in the basement", if they have it at all.

Your dentist doesn't ask you if you have a problem with desserts when you don't even care for sweets.

You can easily maneuver in and out of a pedicure chair.

When online dating, deciding how much of your body to show in your pictures doesn't torment you.

People don't casually - and frequently - suggest you join a gym.

Your coworkers don't automatically assume you want to buy into the office weight-loss challenge.

Family members don't ask you, "Are you sure you want that?" when you reach for seconds.

If you are thin and these examples resonate with you, know that know matter how much you might fight with your body, you don't live in a culture that echoes and amplifies your internal dialogue. Be aware of your privilege and use your voice to help challenge cultural weight bias.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at

Thursday, May 11, 2017

Physical Activity in Recovery

Recently, a reader contacted me to weigh in on physical activity among those with compulsive exercising and/or disordered-eating tendencies. I figured my thoughts might be useful to others:

1) Usually, if someone can't do something without it becoming obsessive/addictive, it's time to stop it for a while and regroup.

2) Those in recovery who begin or resume an exercise program will need to increase their intake to fuel their bodies. Dietitians can help with this.

3) I've found that some people have to cut out exercise as they know it and define things in a different way - i.e., choosing something that hasn't been triggering before. Often, an activity (e.g., a yoga class) that is different AND has set parameter involved can help. Some of my patients can't exercise on their own but can stick to a predetermined number of classes/week (and respect the time limits of these classes). 

4) Accountability is useful. Honest reporting to a therapist - setting intentions and then figuring out what worked and what didn't - is a valuable tool. Checking in with a therapist, or a friend/family member, before/after a workout can help (in the addictions world, it's called "book-ending").

5) If all this fails, and every single effort turns into compulsive or disordered exercise, then I'd say it's more unhealthy to exercise than not and recommend abstaining, at least until something else is in place (e.g., medication, a significant course of therapy, etc.) Exercising to the point of injury or illness  - or in a manner which threatens treatment gains - is disordered, and if it can't be done in a healthier way, it needs to be tabled in the name of health/recovery.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at