- 26 July 2016
- Internal Medicine Blog
It is never too early to start thinking about optimizing your health for a future pregnancy. Whether you are currently trying to conceive or still years away from babies, knowing this important information will help guide your path to pregnancy.
- Talk With Your Doctor About Preconception CareDuring an office visit, we can discuss the topics presented here, but also tailor a preconception-plan especially for you. It is important that existing medical conditions (such as depression, anxiety, high blood pressure, diabetes and asthma) be well controlled before pregnancy. All prescription and over the counter medications should be discussed with your doctor as some could be unsafe during pregnancy. At this visit, we could also screen for sexually transmitted diseases and be sure you are up to date with vaccinations, especially rubella and varicella. Finally, a review of any genetic illnesses or abnormalities present in a family should be done and referral to a genetic counselor made, if necessary.
- Healthy Diet
When planning for pregnancy you are “eating for two”, but in quality, not quantity. It is important that you maintain a diet high in fruits, vegetables, lean proteins and whole grain carbohydrates. Avoid simple sugars and high fat foods. Though fish can be an important source of healthy Omega 3s, when planning for pregnancy we must be careful of the type and quantity of fish consumed. Steer clear of tilefish, king mackerel, shark, and swordfish as they are known to contain high levels of mercury. Limit tuna to 6 oz per week and salmon to 12 ounces per week. Do not consume raw seafood or meats and be sure all hot dogs and lunch meats are heated to steaming before eating. Having calcium and Vitamin D in your diet is important, but be sure all dairy products are pasteurized. Finally, keep caffeine to 300mg per day or less, which comes to about 2 cups per day.
- Avoid Toxins
When planning pregnancy it is important to avoid tobacco, nicotine, recreational/illegal drugs and alcohol. It is also best to avoid certain chemicals including those in paint thinners, paints, and insect and weed killers. Individuals with pets in the home should refrain from changing cat litter or cleaning cages from rodents.
- Prenatal Vitamin
All women contemplating pregnancy should start a prenatal vitamin containing 400-800mcg of folic acid once daily at least 3 months prior to trying to conceive.
- Achieve a Healthy Weight
Make exercise a priority BEFORE getting pregnant. Plan to work up to 30min of exercise 5 times a week for optimal results. Exercise is encouraged once you are pregnant as well. It helps to keep weight gains during pregnancy in an acceptable range. Talk with your doctor to see if the types of exercise you are doing are appropriate for pregnancy.
- Learn to Relax
Knowing how to handle the everyday stresses of life is important at all times of life, but never more so than when pregnant. Trying to conceive, pregnancy and early motherhood are all very stressful times in a woman’s life and we need the tools to keep that stress under control. Having family support, a trusted friend or a therapist can be helpful. In addition, yoga, mindfulness meditation and progressive relaxation can help those stressful times feel more manageable.
- Detoxify Your Enviornment
This is the perfect time to think about changing out highly chemical and toxic products in your home for more natural ones.
- Get Your Partner Involved As Well
Male partners contribute half of the baby’s genetic material. A man’s sperm can be damaged by alcohol, drugs, tobacco, caffeine and toxins. Making sure his health is optimized is extremely important. Female partners need to be a strong support for a pregnant mom and set the tone for a healthy family, so making sure everyone is in the best health possible is a priority. Partners should visit their own doctors for a check-up as well.
- 26 July 2016
- Emotional Well-Being Blog
By: Courtney Liggera, Psy. D.
If you've ever blushed from embarrassment, “glowed” from happiness, or experienced an “angry” breakout of your skin, you know that your skin can mirror what you are feeling within. Emotional issues, stress, and other psychological factors can activate or worsen certain skin conditions.
Just as psychological and emotional stress can lead to skin conditions, the reverse can also be true. In fact, people with skin problems are at higher risk of developing psychological problems, and these problems can linger even after the skin gets better.
Skin conditions can reduce one's quality of life, in terms of unfair judgments on one's appearance, or pressure to look “normal” or to comply with social standards. As a result, people with a skin condition may:
● experience decreased sense of body image,
● have lower self-esteem,
● avoid situations where skin is exposed,
● feel anxious about people judging them,
● withdraw from social interactions,
● have sexual and relationship issues,
● feel shame and/or disgust about their appearance.
While we can't necessarily control how our emotional state manifests itself in our skin, we can control how our skin problems impact our emotional state.
So what can you do to maintain a positive and healthy view of yourself when suffering from skin problems? Here are some ways to feel good about who you are regardless of how your skin looks:
● Appreciate all that your body as a whole can do. Every day your body carries you closer to your dreams. Celebrate all of the amazing things your body does for you – laughing, breathing, dreaming, running, dancing, etc.
● Keep a top-10 list of things you like about yourself -- things that aren’t related to your skin condition or what you look like. Read your list often. Add to it as you become aware of more things to like about yourself.
● Remind yourself that “true beauty” is not skin-deep. When you feel good about yourself and who you are, you carry yourself with a sense of confidence, self-acceptance, and openness that makes you beautiful regardless of whether you have perfect skin. Beauty is a state of mind, not a state of your body.
● Look at yourself as a whole person. When you see yourself in a mirror or in your mind, choose not to focus on specific parts of your skin. See yourself as you want others to see you -- as a whole person.
● Surround yourself with positive people. It is easier to feel good about yourself when you are around others who are supportive and who recognize the importance of liking yourself just as you naturally are.
● Shut down any negative thoughts that tell you your skin is not “right” or that you are a “flawed” person, and overpower those feelings with positivity. The next time you start to tear yourself down, build yourself back up with a few quick affirmations that work for you.
● Do something nice for yourself -- something that lets your body know you appreciate it. Take a bubble bath, make time for a nap, find a peaceful place outside to relax.
The most important thing to recognize is that you are not powerless to minimize the overall effect that skin problems have on your daily life. Give some of these techniques a shot - your mind is a powerful thing!
- 26 July 2016
- Nutrition Blog
By: Marissa Martino, RD
Type 2 diabetes has been on the rise for the last decade, with a whopping 1.4 million Americans diagnosed each year. This accounts for adults and children. The most disheartening concept about this statistic is that type 2 diabetes, unlike type 1, is actually controllable and even preventable. Diabetes is when your body can’t regulate blood glucose- or sugar- properly, causing all sorts of harmful and long term effects. Type 2 is the form of diabetes that develops from insulin resistance. Insulin is the hormone that allows the sugar from the food that we eat into our cells, which is then converted into usable energy. If we eat too many foods high in carbohydrates and simple sugars, our blood sugar skyrockets. Insulin is then released in an attempt to lower and regulate our blood sugar. This feedback mechanism causes blood sugar to be lowered, which is the “crashing” feeling we get about 45 minutes after a sugary snack such as a muffin or donut. This rollercoaster effect of constant high and low blood glucose wreaks havoc on the body, and eventually leads to insulin resistance. Our cells become less sensitive to insulin, causing an influx of glucose in the bloodstream. Uncontrolled high blood sugar over time causes the blood to become sticky and viscous. This leads to damaged blood vessels and nerves which affects eye sight, hearing, lack of feeling in hands and feet, chronic inflammation and dehydration.
After being diagnosed with type 2 diabetes, the goal is to regulate blood sugar levels with diet before resorting to medication and insulin injections. The difficult part about this is, most of us are already comfortable with a certain type of lifestyle- which is usually filled with some unhealthy habits. And habits, as we all know, are not so simple to break. Our lives are hectic and busy, with the majority of the country constantly eating on the run. When we think about what foods are “convenient”, almost all of those options are carb based. Bagels, granola bars, soft pretzels and even food items we deem healthy, such as yogurt or smoothies can be culprits.
A large part of diabetes education is first understanding the vast amount of hidden carbohydrates entangled in our food system. Once we learn how to look at a food label and understand about how many grams of carbs we should be eating per sitting, it’s becomes less challenging to adhere to a diabetic friendly lifestyle.
An attainable goal is to stay under 200 grams of carbs a day. We should aim for no more than 30 grams for a snack, and average between 30-60 grams at meal time. The “diabetic exchange list” is a convenient source that lists all popular food items and the total carb count. A simple rule of thumb is to remember that 15 grams of carbs is roughly 1 slice of bread, 1/3 cup cooked rice or pasta, or 1 cup of fruit.
One of the most important guidelines to stabilize blood sugar, is to make sure that protein, fiber, or a healthy fat sources are combined with any carb. This is because fiber, protein and fat are slower digesting nutrients, meaning they will delay the rate carb digestion, preventing the high spike in blood sugar. It has also been shown that saving the carb portion of a snack or meal for last can also help slow down the rate of absorption. For example, if your snack is a handful of almonds and an apple, eat the almonds first and then the apple. The simple sugars from the apple will be more slowly digested thanks to the fiber, protein and healthy fats from the almonds.
By making sure that there is always fiber, protein and or healthy fat every time we eat, we are ensuring that blood glucose levels are stabilized. Even if it is a “complex carb” still try to add a protein. If you like oatmeal in the morning, add a hardboiled egg or a handful of walnuts. Also, rather than the sugar packed instant oatmeal, use plain or steel cut oats and add a drizzle of local honey or fresh berries. If you like a yogurt as a snack, make sure it doesn’t have more than 15 grams of sugar! (My favorite brands are Siggi’s, Chobani Simply 100 or Oikos Triple Zero).
Exercise is also a very important and useful tool in lowering and stabilizing glucose levels. The cells present in muscle are actually very sensitive to insulin, so the more muscle mass we have, the more our bodies will respond to insulin.
Changing habits takes time, focus and dedication. Registered dietitians can guide and support you to a healthier lifestyle, helping you to make achievable and sustainable adjustments.
- 30 June 2016
- Internal Medicine Blog
Viral hepatitis is a term referring to any of several infections that attack your liver and cause damage to its’ cellular structure. The viruses we usually refer to when discussing viral hepatitis are: Hepatitis A, B, C, Delta and E. There are, however, other viruses that cause liver inflammation and, reversely, these five viruses can also cause damage and symptoms outside of the liver.
Viral hepatitis typically presents as an acute infection – there are some cases that are ‘subclinical’ meaning patients do not even have obvious symptoms and may go through an infection without ever knowing they had it! More commonly, however, patients present with symptoms including: fatigue, loss of appetite, nausea, vomiting, and jaundice (yellowing of the skin due to buildup of bilirubin – a pigment that your liver removes from the bloodstream when it is functioning properly). Very rarely, severe cases can even progress to liver failure, brain disease and may be fatal.
Many cases of acute hepatitis resolve within days, weeks or months. However, sometimes acute hepatitis can progress into chronic infection (this only happens with types B, C and Delta). Most often (85% of adult cases) this happens with Hepatitis C. In fact, infection with Hepatitis C can very often present only subclinically with patients experiencing only some fatigue and indigestion. Of course, the concern with these asymptomatic patients is that they may be spreading the infection without being aware of it.
The Delta virus is actually a co-infection that is only present along with Hepatitis B virus. Its presence is usually an indicator of more severe or chronic hepatitis B infection. It spreads through contact with infected blood (through injection or sexual contact)
Hepatitis A is spread primarily through infected food, water or close physical contact with another infected person. It is most common in areas with poor sanitation, such as developing countries or amongst injection drug users. This infection only presents as an acute illness and does not progress to chronic infection.
Hepatitis E is similar to A in that it does not progress to chronic infection and is typically spread through contaminated water, although you can also get this infection by eating contaminated animal products or transfusion of infected blood. This infection is most common in Asia. This infection is most dangerous for pregnant women – the virus can cross the placenta and infect the fetus. Due to immune system changes during pregnancy, pregnant women are more at risk to have severe consequences such as liver failure. Infection in the 3rd trimester can be fatal.
Hepatitis B is transmitted through infected blood or bodily fluid contact – this means both sexual and percutaneous transmission is possible. In some developing countries, dentists with inadequate sterilization equipment can be a source of infection. In general, since hepatitis B can live outside of the body for up to 7 days, any kind of intervention can potentially introduce the virus. This form of viral hepatitis can also develop into a chronic infection; an estimated 240 million people worldwide have chronic hepatitis B. Children under 6 years of age are most likely to develop chronic hepatitis B if they are infected.
Hepatitis C is a blood borne infection – you can only get it through unscreened blood transfusion, unsafe injection practices or unsterilized medical equipment. It can also travel through the placenta of an infected mother and cause infection in her baby. This form of hepatitis can be considered the most dangerous since it can often go undetected for decades as a chronic, asymptomatic infection.
Can hepatitis be cured?
We now have the medications available to clear most patients of their viral hepatitis. Most of the viral infections require only supportive therapy – making sure patients are hydrated and other symptoms – such as nausea and vomiting are reduced. Anti-viral therapies have been shown to be helpful for severe or chronic cases of Hepatitis B. We also now have treatment targeted at Hepatitis C that has made this infection curable as well.
Of course, with severe forms of hepatitis, patients have to be well enough to respond to available medications and fully recover. Some patients will also have irreversible damage from the infection, such as liver failure. Therefore, the best thing is to never become infected in the first place!
What can I do?
First and foremost you should know your status. Get tested for hepatitis B and C to ensure that you are not an asymptomatic carrier of this infection – knowing your status is the best way to protect your partners and future children.
If you are travelling out of the country, schedule a travel visit to find out if your travels will be through an area where Hepatitis A and E are common – this will alert you to be mindful of sanitation shortcomings, make sure you do not eat undercooked food or water that has not been sterilized.
If you are an injection drug user, please use safe practices by not sharing needles. You should also be mindful in any place that uses needles – if you are getting tattoos or piercing, make sure your provider uses proper sanitation techniques.
Healthcare workers are a special risk category for hepatitis infection since they are in contact with patients all the time. For this reason, make sure you are always using proper protection equipment (masks, gloves, eye shields) when working with patients.
Lastly, and most importantly – get vaccinated. Hepatitis A vaccines are available for patients travelling to endemic areas to make your trip worry-free. Hepatitis B vaccinations are available starting from birth! You can get your newborn vaccinated before they ever leave the hospital. Remember – Hepatitis B can live for up to 7 days outside of the body, so your baby can be at risk anytime they are in need of medical intervention – by vaccinating your baby, you can remove this risk-factor entirely. Healthcare workers who have not been vaccinated, should also get the vaccine series so that you can be safe and secure in your work. There is also a vaccine for Hepatitis E in China that will hopefully soon be available worldwide.
Viral hepatitis can be a mild inconvenience for some patients and a life-changing consequence for others, however, now that we have new treatments available, it is no longer a death sentence. Protect yourself by knowing your status and your options – schedule an appointment with one of our providers today!
- 30 June 2016
- Nutrition Blog
By: Angela Luciani, RD
July is national ice cream month … As temperatures heat up, many of us are looking forward to cooling down with a summer treat. When you head to the frozen section of the grocery store – you may get brain freeze just looking at all the new and different options out there… light, low fat, slow churned, coconut milk, Greek yogurt… the list goes on. The good news is you can have your ice cream and eat it too – remember, it is how much and how often you enjoy ice cream that can become problematic.
So how do you navigate through all of these options and which ones to choose? It is important to keep in mind that a single serving of ice cream is a half cup. The pint of ice cream you see at the store has a total of 4 servings! Instead of eating straight from the carton, measure out your serving size and put the rest back in the freezer. If you’re going out for ice cream – ask if you can have the kid’s size or only ask for one scoop.
When choosing which type of ice cream to purchase, choose brands whose ingredients you can recognize, and compare the fat and sugar content before deciding which one to go with. Traditionally – ice cream is made with cream; therefore, you will find that the “ultra-premium” ice cream brands, such as Ben and Jerry’s or Haagen-Dazs, will have more calories and saturated fat per serving than others (up to 50% more than regular ice cream). While they certainly are delicious –there are many alternatives you can choose that can provide less calories and less fat, making it a treat that you won’t feel guilty about! Halo Top ice cream is a great option as it provides 240-280 calories and 24gm of protein per pint! They offer flavors including chocolate, mint chip, birthday cake and many more! Edy’s slow churned ice cream contains more milk than cream which can make it a better choice. Frozen yogurt has less calories than ice cream, but still can pack in a lot of sugar, leaving you craving more – self-serve Fro-Yo can lead us to overeating –so you must continue to be mindful of your serving size. For a “lighter” premium option, try choosing the Ben and Jerry’s fro-yo version. Still craving more, or realizing that half serving isn’t going to cut it? – instead of going for that extra serving – add berries or nuts as a topping to make it more filling!
If you can’t have dairy or are looking for dairy-free options – Ben and Jerry’s has come out with a new ice cream product that is made with almond milk.
Don’t be afraid to try making your own! There are plenty of recipes all over the internet on how to make healthier homemade ice cream options. See below for a relatively simple and easy to make recipe!
Banana Nutella Ice Cream – makes 3 servings
- 6 ripe bananas – frozen
- ½ tsp vanilla
- ¾ cup Nutella
- Cut bananas into 1-inch slices and transfer to food processor.
- Blend until smooth consistence.
- Add vanilla and nutella – Pulse until combined.
- Eat right away or store in airtight container.
- 30 June 2016
By: Serena Scanzillo, Fitness & Nutrition Coach
This Summer, Philadelphia is a mecca of outdoor fun. It’s appeals to the masses, and new outdoor trends are picking up fast. As a coach, I love being outside. I host my boot camps outside, I walk to my clients and love running before the hot sun hits to kick my days off on the right foot. Thanks to the endless list of activities coming up over the next few weeks, it looks like we won’t have a shortage of ideas to keep us out and about.
One of my favorite places is the Spruce Street Harbor. You can get lost looking out over the water, or gazing up at the bridge! The entire Harbor is place to visit, let alone enjoy. Strap on your roller-skates for some old school fun at the city’s only outdoor rink and enjoy a variety of food trucks too!
Up the way, they’re hosting FREE yoga at the Race Street pier this year which I can’t wait to get to. There’s morning yoga and twilight yoga - all you need is a mat! Read about their full schedule here.
I love light and fresh treats during the Summer months. My suggestion; map out a fresh juice bar hop! I’ve fallen in love with the watermelon energy juice at Snap Kitchen, and of course, everything at Sip N Glo Juicery in Rittenhouse is perfect. Need ideas on where to hop to?Check out this list of juice bars and try something different at each place. Your friends will be jealous you went!
I mentioned earlier that I host outdoor classes, so add them to you list this Summer. Every Monday night at 630, Tuesday at 12n, and Friday at 630am we meet to workout together at Julian Abele park on 22nd & Carpenter. All the details are here. You’ll need a mat & water! Fees apply.
Need motivation to get your running game on or want to meet people who love running? I suggest the RUN215 group. Their weekly schedule is robust and the community is strong. There’s a run planned every single day, in multiple locations throughout the city, offering distances to suit everybody's training requirements. They often have happy hour runs so you can mingle and meet new friends post workout! Visit their website and plan your next run.
We all need a city break from time to time, which is why The Circuit Trails are an underrated, hidden gem for us adventurers to explore. Greater Philadelphia is the proud home of the Circuit Trails, a vast regional network of hundreds of miles of multi-use trails that is growing in size each year. Pack some snacks, grab your best friend, and set out for an adventure! Plan your next trail experience here.
- 31 May 2016
- Skin Care Blog
By: Dermacenter Aestheticians
It’s that time of year again! Summer is upon us, so as you're soaking up the sun rays and enjoying vacation time, it is a must to take special care of your skin. The summer sun can do a number on the skin including damage such as sunburns, hyper pigmentation, and the dreaded PREMATURE AGING!!! Make sure you protect yourself and preserve your skin for another year! We all love that sun kissed glow so consider a spray tan (From one of our partners) instead of laying out in the sun baking the surface of your skin. Now we all know we are not going to stay inside this summer season so make sure to you wear sunscreen DAILY! Using a higher SPF in addition to your normal skincare routine will help protect those nasty UVA (Aging) and UVB (burning) rays. Sunscreen is your number one first line of defense in the anti-aging war and is vital in protecting the skin. At the DermaCenter we carry a few different options for your sunscreen needs, for all skin types from oily, acne or just aging.
In addition to using a higher SPF you may also switch out the heavier moisturizers for something lighter and water based to help combat oily skin on hot and humid days. Environ's AVST moisturizer is a great summer moisturizer being that it is light, water based and has Vitamin A which is crucial protecting the skin. Also adding in a "treatment" product in the evening is huge in the summer months since the sun is damaging the outer layers throughout the day. Using something with a higher level of Vitamins and Peptides is beyond beneficial in helping to restore the skins surface. Environ's C-Quence is a boost of Vitamin A, C and additional peptides to help the skin look younger and more refreshed.
Through the month of June 2016, at the DermaCenter, we are offering Skin Tightening and Ematrix treatments at a discounted price. Skin Tightening is a treatment that uses Radiofrequency to stimulate collagen below the surface and give you an instant tightening effect. This treatment is known as the lunchtime facelift, have a big event coming up set up an appointment feel instantly tighter and more firm. EMatrix is a treatment that also uses Radio Frequency but actually stimulated Collagen but putting "micro-traumas" into the Dermal tissue, creating cell turnover and regeneration. This treatment is wonderful for fine lines, wrinkles and acne scarring. A combination of these two treatments results in a more youthful looking appearance that will last,
Please contact the DermaCenter at (215)735-7990 to set up a free consultation to see which treatments would be right for your skin.
- 31 May 2016
- Internal Medicine Blog
Hives are raised, red, itchy patches of skin (also called Urticaria, welts, or wheals) that can be frustrating to experience. Hives are commonly caused by a number of triggers, and figuring out the cause is sometimes challenging. Hives can be the result of allergies to medicines like penicillin, or to foods like nut, soy, or shellfish. They can be caused by viral, bacterial, or parasitic infections (especially in children), by physical contact with substances like plants (such as poison ivy or poison oak) or latex, and by insect bites or stings. Some people can even develop hives in response to less obvious triggers, such as exposure to temperature changes, or pressure on the skin. Regardless of the cause, treatment ofhives is usually initiated with medications called antihistamines (Loratadine, Cetirizine, Benadryl); in more resistant or diffuse cases, a short course of oral steroids may be used to reduce the swelling, itching and inflammation.
Occasionally, hives are accompanied by a more serious type of allergic reaction called Angioedema. Angioedema causes swelling of the face, eye area, hands feet or genitals. This can be treated with the same medications as hives, but angioedema should always be evaluated by a health care professional to make sure it does not progress to a more serious type of allergic reaction. Other complications of hives that require emergent attention include hives that are accompanied by throat closing or breathing difficulty; nausea, vomiting or abdominal pain; or passing out--these symptoms will not respond to regular antihistamines alone.
Although typically hives will be a self-limited affliction, with lesions coming and going in minutes to hours, and episodes lasting for a few days, in some cases, they can last for weeks. If hives last for six weeks or more, they are called chronic hives. This type of hives is more difficult to manage, and often, a cause if not found. Symptoms will usually resolve over several months, however. Generally, hives can be successfully managed by avoidance of triggers and prompt treatment of outbreaks. For more information about this and other skin issues, ask you health care provider.
- 31 May 2016
- Internal Medicine Blog
Nutrient Intravenous Infusion is a concept pioneered in the 1970s by John Myers, MD, a physician from Baltimore, Maryland. These infusions are a great means to provide essential nutrients and vitamins to patients who cannot absorb them naturally or to obtain higher concentrations than could be achieved by oral means alone. A good example of this is Vitamin C which may have antiviral and antibacterial properties at concentrations higher than would be expected with regular meals. Over the past 50 years nutrient intravenous infusions have been developed to treat a variety of clinical conditions. Millions of these infusions have been used to treat patients worldwide.
Myers’ original solution has now been modified to treat symptoms related to asthma, migraines, fatigue, fibromyalgia, acute muscle spasm, upper respiratory tract infections, sinusitis, seasonal allergic rhinitis and fluid dehydration. For chronic problems, patients may receive a number of treatments until their condition improves. It is important to note that although intravenous nutrient therapy is not meant to ‘cure’ any illnesses, it can give patients an extra boost to help fight infections, relieve pain or give you the feeling of a little additional energy to continue to recover. We all know how important it is to ‘feel’ better when we are ill, even if this does not mean we are recovered. The way we feel helps give us the strength to continue!
Under the direction of physicians, intravenous infusions are currently offered in a safe manner in an outpatient setting. Each infusion can be individualized for a specific patient’s needs. Following insertion of a small IV, the infusion takes only 30-45 minutes. We will be offering a wide range of formulations for our patients to take advantage of including hangover recovery, jet lag, fatigue and stress relief, dehydration treatment, migraine relief, cold and flu remedy, vitamin boost and hydration, a beauty enhancement formula, and a treatment to maximize athletic performance. If you’re feeling under the weather or need an extra boost, IV Nutrient Therapy may be just the thing for you! Call our office to schedule today! Services are available on Sundays from 8am till 2pm.
- 27 April 2016
- Emotional Well-Being Blog
By: Robin Hornstein, PH.D.
It is likely that you or someone you know has a “weird” obsession with food or their body. These days, the culture of beauty and perfection is understood even when we are young girls watching the world around us. Three year olds more commonly ask their moms if they are fat. You probably can give a lecture yourself on the media ruining the lives of many girls with standards of beauty that most of us won’t meet in our lifetimes. Most women also have been on some diet by the time they are 25 and have their own diets in their heads (cheat days, no carbs if you eat cake at a party, Paleo, Weight Watchers points, healthy eating, juice cleanses, calorie counting). The list is long and the demand on our psyches is high.
I would argue that if more than 10% of your day is spent worrying about what you will or won’t eat and you are upset with yourself for losing the battle of these rules, you may have disordered eating or thinking about food. And if that time spent fretting is full of self-loathing, punishments, make-up time at the gym or other compensatory behaviors, you are headed for the emotional and physical suffering that can become an eating disorder. Further, if your worry interferes with socializing and intimacy with others on any level you are showing more signs of an eating disorder than you might want to live with day to day.
What crosses the line to an eating disorder? Well, first we need to know that the number one mental health disorder that leads to death is Anorexia. It beats out suicide, which is quite alarming and perhaps should be classified as a suicidal illness. I imagine that most of you reading this can define the major diagnoses in the Eating Disorder list: Anorexia, Bulimia, Binge Eating Disorder and Orthorexia may be familiar to you as you probably have read about these or have known someone who has struggled. Orthorexia is the least known and is actually best defined as a systematic elimination of foods one won’t eat as they are defined as unhealthy. The list is obsessive and ends up limiting many enjoyable life moments and affects mood and health. This disorder is not someone who says they don’t want to eat sugar – this is more a disorder where the body image and mood are affected by the choices that one will eat due to many factors. The underlying obsession leads to much anxiety, and Steven Bratmas, MD calls people with this disorder “health food junkies”.
In reality, if you see yourself in these descriptions and feel that you have any behaviors that you hide or get angry when you are confronted with them (bingeing, eating too few calories a day, exercising to excess, only eating certain foods, purging via vomiting or other methods etc.) you may require help to overcome these behaviors. And, it is not only our body that suffers. Living with an eating disorder is a disruption in your life. It is a mental health issue and not just a will-powered choice. Most women with an ED (Eating Disorder) also have other mental health issues that accompany the ED behaviors.
Depression, anxiety, obsessive-compulsive disorder and posttraumatic stress disorder are some of the illnesses that lead to or are caused by having an eating disorder. It affects all areas of one’s life. These disorders harm our bodies, careers, relationships, make us lonely, erode creativity and fun and hamper being a full and successful person in the world. What to do? Seek help. Tell someone and leave the secrets behind.
What I have learned as a therapist for the past 33 years is that secrets can lead to severe illness constricting our happiness and functioning. Tell your physician, a friend, anyone you trust and start to unwind how you got to this place. There are many types and levels of care and your people, as you trust them, can help guide you. One of my clients told me the other day that she goes to the gym and spends her time seeing who she is thinner or heavier than, who has greater endurance than her and how she will beat them next time. When I asked if this was an enjoyable use of her time or if she ever talked to anyone, she looked at me like I had three heads. Body image issues and eating disorders are issues of loneliness and a feeling of being less than everyone else. If this is part of your story, or someone you know, reach out for help. It is everywhere around you. A good team of a physician, nutritionist and therapist can help you untangle the web you are stuck in and find a full and rich life.