May 2018 LACPA Eating Disorder SIG

Gretchen Kubacky, Psy.D. on Polycistic Ovary Syndrome Date: Tuesday, May 15, 2018 at 7 pm

Presenter: Gretchen Kubacky, Psy.D.

Title: Polycystic Ovary Syndrome and Eating Disorders: What’s the Connection?

Description: Polycystic Ovary Syndrome (PCOS) is currently estimated to affect up to 22% of women. It is the primary cause of female infertility and other endocrine disruptions. Women with PCOS have much higher rates of depression, anxiety, and eating disorders, particularly Binge Eating Disorder. Dr. Gretchen will present an overview of the physical and psychological symptoms of PCOS, how those symptoms present clinically, and discuss the challenges of appropriately diagnosing and treating eating disorders in women with PCOS. 

Bio: Gretchen Kubacky, Psy.D. is a health psychologist with a private practice located in West Los Angeles. Dr. Gretchen works primarily with hormonal issues and chronic and invisible illnesses, with a specialty in Polycystic Ovary Syndrome (PCOS). She is the creator of PCOS Wellness, a Certified PCOS Educator, and a member of the PCOS Challenge Health Advisory Board.  She is also a Certified Bereavement Facilitator for children and adults, co-editor of the Los Angeles Psychologist magazine, and a frequent speaker and author on health psychology topics. For more information about her private practice and PCOS education services, see www.DrGretchenKubacky.com and www.PCOSwellness.com.

Location: The meeting will be held in the office of Dr. Gretchen Kubacky, located at The Gardens building, 2001 South Barrington Avenue, Suite 121, Los Angeles, CA  90025 at 7:00 p.m. on Tuesday, May 15, 2018. Suite 121 is on the ground floor, at the north end of the building. After 6:00 p.m., you may park for free on the ground floor of the building. The parking entrance is located on the south end of the building, adjacent to Yoga Raj studio. There is also free and metered parking on the streets surrounding the building. The building and office are wheelchair accessible. 

RSVP: drmuhlheim@gmail.com

SIG meetings are open to all LACPA members. Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

ARFID talk for LACPA Professionals in Los Angeles

ARFID talk LACPA Jennifer Thomas, Ph.D.
Harvard Health Publications, Jennifer Thomas

Date:  Thursday, January 18 at 7:30 PM

Presenter:  Jennifer Thomas, Ph.D.

Title: Avoidant/restrictive food intake disorder: Assessment, neurobiology, and treatment

Description: Avoidant/Restrictive Food Intake Disorder (ARFID) was recently added to the Feeding and Eating Disorders section of DSM-5 to describe children, adolescents, and adults who cannot meet their nutritional needs, typically because of sensory sensitivity, fear of aversive consequences, and/or apparent lack of interest in eating or food. ARFID is so new that there is currently no evidence-based treatment.  This presentation will discuss how to recognize and diagnose ARFID, share preliminary findings from an ongoing NIMH-funded study of its neurobiological underpinnings, and describe a new cognitive-behavioral treatment currently being evaluated in an open trial.  

Bio:  Dr. Jennifer Thomas is the Co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, and an Associate Professor of Psychology in the Department of Psychiatry at Harvard Medical School. Dr. Thomas’s research focuses on atypical eating disorders, as described in her books Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem? and Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults. She is currently principal investigator on several studies investigating the neurobiology and treatment of avoidant/restrictive food intake disorder, funded by the U.S. National Institute of Mental Health and private foundations.  She is also the Director of Annual Meetings for the Academy for Eating Disorders and an Associate Editor for the International Journal of Eating Disorders.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

RSVP to:  drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

 

 

Fall 2017 LACPA Eating Disorder SIG Events

Hope Levin, M.D. Date:  Wednesday, September 13 at 7:30 PM

Presenter:  Hope Levin, M.D.

Title: Psychopharmacological Treatment of Eating Disorders

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio:  Hope W. Levin, M.D. is a board-certified child, adolescent and adult psychiatrist.  Since 2006, she has worked as a staff psychiatrist at UCLA Counseling and Psychological Services where she serves as the psychiatrist on the eating disorders treatment team.  She co-founded the UCLA Campus-wide Eating Disorders Partnership to collaborate with campus professionals who provide treatment to students with eating disorders.   In addition to her work at UCLA, Dr. Levin is a staff psychiatrist at The Renfrew Center of Los Angeles and maintains a private practice in Santa Monica.

Dr. Levin completed her undergraduate education at Cornell University and medical school at MCP Hahnemann School of Medicine.  She completed general psychiatry residency at University of Pennsylvania where she was Chief Resident, and child and adolescent psychiatry fellowship at the Massachusetts General Hospital/McLean Hospital program, Harvard University where she was also Chief Resident.

Dr. Levin gave this talk previously to our group in March 2012. She will present updated information.

RSVP to:  drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

Tuesday, October 3 at 7:30 PM

Presenter:  Bobbie Eisenstock, Ph.D.

Title: Media and Body Image: How Media Literacy Can Help Counteract Unrealistic Body Ideals

Description: In our media saturated world, it’s hard to escape the onslaught of messages that tell us how we should look, sell us products to achieve the ideal body, and pressure us to reshape our bodies with promises of happiness and success. How can we protect our self-image from media’s narrow and unrealistic ideals that can make us feel less confident and accepting of our bodies? Research demonstrates that media literacy can help counteract media’s role in normalizing cultural body standards that are naturally unattainable for most and can adversely affect body positivity. This mini-workshop highlights essential media literacy strategies and resources for self-care in the digital age.

Location:  LACPA Office, Encino

Bio:  Bobbie Eisenstock, Ph.D. specializes in the social and psychological effects of media and new interactive technologies on children, teens, and families. She facilitates media literacy workshops for parents, educators, and health practitioners to promote healthy child and adolescent development. A recipient of NEDA’s Westin Family Award for Excellence in Activism and Advocacy, Dr. Eisenstock is on the faculty at Syracuse University in Los Angeles and California State University, Northridge where she directs the Proud2Bme civic engagement project about media literacy and body image. Her students developed NEDA’s Get REAL! Digital and Media Literacy Toolkit and How to Spread Body Positivity in Your Community.

Here is a link to media literacy tips Dr. Eisenstock wrote for NEDA that were posted on its website earlier this month:

https://www.nationaleatingdisorders.org/blog/media-body-image-what-you-need-to-know

LACPA ADDRESS and PARKING INSTRUCTIONS: 6345 Balboa Blvd, Bldg 2, Suite 126, Encino 91316. The buildings are on the south-west corner of Victory and Balboa, and Bldg 2 is the second building from Balboa.  If you come from the Westside, take the 405 to the 101 and exit going north on Balboa to just before Victory (park on the street or in the Sepulveda Basin Sports Complex (6201 Balboa Blvd.) on the west side of Balboa, just south of Victory).  Or take the 405 to Victory (past the 101 if you are coming from the Westside) and exit West onto Victory.  Take it to Balboa and turn left, now heading south.  On your right, you will see the buildings.  The LACPA office is right by the entrance off the parking lot, on the left if you walk in from the parking area.

Parking at The Encino Office Park lot between the hours of 9am – 6:30 pm is restricted to building tenants only.  We can park there in the evening and on weekends, but not 9 – 6:30 weekdays.

RSVP to:  drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

 

November 2016 LACPA Eating Disorder SIG events

The Los Angeles County Psychological Association Eating Disorders SIG will be hosting 2 events in November 2016

Tuesday, November 1 – 7 – 8:30 pm in LACPA Office (Encino) – DBT for Eating Disorders 

Speaker: Charlotte Thomas, LCSW, Program Manager of Portland DBT’s Pathways to Mindful Eating Program

Talk Description: charlotte

Dialectical Behavior Therapy (DBT) is an evidence based treatment developed by Marsha M. Linehan, PhD for complex multi-diagnostic individuals with pervasive emotion dysregulation and high risk suicidal behavior. Over the past two and a half decades, research has consistently demonstrated DBT as being effective for patients with a variety of complex problems such eating disorders and substance abuse disorders, where emotion dyscontrol is at the core of the patient’s issues and often interfere with treatment and long-term maintenance of therapeutic progress. This presentation will use a session- to-session birds eye view of the implementation of DBT with complex eating disorders in order to demonstrate use of DBT principles and skills in a concrete, “real world” manner. My hope is to communicate my excitement for DBT, share outcomes commonly generated by DBT, and to generate curiosity among individuals participating in the training.

Goals:

Upon completion of this presentation, participants will:

  • Learn about the first 7 sessions of treatment using a composite client with a complex Eating Disorder
  • Understand the biosocial model of DBT as applied to a composite client
  • Learn about the timing and use of strategies such as dialectics, behavioral chain analysis, and diary cards

Speaker bio:

Charlotte Thomas, LCSW

Charlotte received her master’s degree in Social Science Administration (MSSA) at Case Western Reserve University in Cleveland, OH and trained with Lucene Wisniewski PhD, FAED and Mark Warren MD, FAED for the following 4 years in the evidence based treatment of eating disorders. She is now a licensed clinical social worker in the state of Oregon. Charlotte’s professional interest is in treating eating disorders and associated needs including borderline personality disorder, depression and anxiety. She has experience in private practice mental health settings, providing individual, family, and group services for teens and adults. At Portland DBT Institute, Charlotte is the Program Manager for the Pathways to Mindful Eating program and provides direct service to clients, supervision to staff, and serves on the management board for the clinic helping to inform general clinic policy.

 Friday, November 4 – 12 to 1:30 pm in LACPA Office (Encino) in conjunction with the Couples SIG – Panel Discussion: The Impact of Particular Addictive/Compulsive Behaviors on a Couple’s Relationship, and How to Help – Hoarding, Gambling, and Eating Disorders

3 speakers include:

  1. Regina F. Lark, PhD: Family Stuff
  2. Cristin Runfola, PhD:  Uniting Couples in the Treatment of Eating Disorders.
  3. Margaret Altschul, MBA, MA, LMFT: Win, Lose or Draw:  What happens to couples when one partner is a problem gambler?

Speaker bios and talk descriptions below:

Regina F. Lark, PhD: Family Stuff: The impact of compulsive hoarding on relationships with family and friends, creates as much dysfunction as the “stuff” piled around the room. Dealing with it effectively “takes a village” and a strategic plan to calm the relationships between loved ones and the physical environment. Dr. Lark’s presentation will explore the effects of the hoarding disorder and chronic disorganization on the family dynamic, and present strategies for finding clarity amidst the chaos.

Dr. Lark is the owner of A Clear Path: Professional Organizing and Productivity. As a Certified Professional Organizer she specializes in working with people with chronic disorganization, ADHD, and hoarding. She is also a relocation specialist, helping families move or downsize from one home to the next. She is a featured speaker and educator, and is the author Psychic Debris, Crowded Closets: The Relationship between the Stuff in your Head and What’s Under your Bed, Second Edition, (Purple Books, 2014). She serves on the Board of the National Association of Professional Organizers, and is a member of the National Speakers’ Association. She earned a  Ph.D. in History at the University of Southern California.

Cristin Runfola, PhD: Uniting Couples in the Treatment of Eating Disorders. Dr. Runfola will describe recently developed couple-based interventions for eating disorders, including how core cognitive-behavioral couple therapy interventions can be applied and integrated with individual CBT principles for these disorders. Further, she will present data from recent pilot studies conducted with couples affected by anorexia nervosa (UCAN) or binge-eating disorder (UNITE), which yield promising results.

Cristin Runfola, PhD, is a clinical instructor at Stanford University who specializes in the treatment and research of eating disorders. Dr. Runfola’s primary research interest is in developing and testing the efficacy of clinical interventions designed to improve outcome for eating disorders. She underwent extensive training in cognitive-behavioral couples therapy and worked with colleagues at UNC-CH to develop and test manualized protocols for treating anorexia nervosa and binge-eating disorder in a couple context. She is the recipient of various awards, such as the AED Clinician Scholarship Award and NIMH/AED Early Career Investigator Travel Fellowship Award, for her work.

Margaret Altschul, MBA, MA, LMFT: Win, Lose or Draw: What happens to couples when one partner is a problem gambler?

Imagine discovering that your joint bank accounts are gone, your credit cards are charged to the max, and your car is about to be repossessed. This is often the scenario confronting couples when one person is a problem gambler. Problem gambling by one partner brings to a relationship all of the chaos, fear and betrayal of addictions and affairs combined. This presentation will help you gain awareness and understanding about Problem Gambling and learn how you can help couples dealing with the unique challenges this addiction creates.

Margaret Altschul, MBA, MA, is a Licensed Marriage and Family Therapist with a background in education and business. In addition to working with couples, Ms. Altschul applies her training and experience in using EFT and Gottman methods to help adults improve difficult relationships with parents, siblings and people at work. Margaret is authorized by the CA Office of Problem Gambling to provide counseling (at no cost to the client) to people with gambling addiction as well as family members affected by gambling.  She is Director of the Wagner Program at American Jewish University where she trains human services volunteers in basic counseling skills

* LOCATION for both events: LACPA ADDRESS and PARKING INSTRUCTIONS: 6345 Balboa Blvd, Bldg 2, Suite 126, Encino 91316. The buildings are on the south-west corner of Victory and Balboa, and Bldg 2 is the second building from Balboa. If you come from the Westside, take the 405 to the 101 and exit going north on Balboa to just before Victory (park on the street or in the Sepulveda Basin Sports Complex (6201 Balboa Blvd.) on the west side of Balboa, just south of Victory).  Or take the 405 to Victory (past the 101 if you are coming from the Westside) and exit West onto Victory.  Take it to Balboa and turn left, now heading south. On your right, you will see the buildings. Go a bit past the parking lot for the building (we are not allowed to park there during the day), past the Army’s center to the next driveway, which is for the Sepulveda Basin Sports Complex (2nd driveway past the Busway), and park in there. Or park on the street just south of the entrance for the sports complex parking lot. Both sides of Balboa have all day free parking. Allow a 3 – 5 minute walk to the buildings. Walk into the building’s parking area and go to the second building. The LACPA office is right by the entrance off the parking lot, on the left if you walk in from the parking area. Wherever you park, please check the signs

Parking at The Encino Office Park lot between the hours of 9am – 6:30 pm is restricted to building tenants only. We can park there in the evening and on weekends, but not 9 – 6:30 weekdays.

RSVP to: drmuhlheim@gmail.com

SIG meetings are open to all LACPA members. Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org 

December 2016 LACPA Eating Disorder SIG

Shannon-Kopp-Headshot-e1444137530220Date: Wednesday, December 7 at 7:30 pm (Note: new date)

Presenter: Shannon Kopp – Author of Pound for Pound: A Story of One Woman’s Recovery and the Shelter Dogs Who Loved Her Back to Life (HarperCollins Publishers) and Founder of SoulPaws Recovery Project.

Title: The Healing Power of the Paw: How Animals Can Play a Vital Role in Eating Disorder Recovery

With the highest mortality rate of any mental illness and afflicting up to 30 million people in America, eating disorders can have heartbreaking consequences. For eight years, Shannon Kopp battled the silent, horrific, and all-too-common disease of bulimia. Despite a near decade of weekly therapy, medication, loving support from family, and a hospitalization and rehab stay at Rosewood Center for Eating Disorders, she continued to grow progressively sicker.

Then, at twenty-four, she began working with shelter dogs at the San Diego Humane Society, where she felt a deep sense of calm and comfort around the animals. Gradually over time, when Shannon wrestled with anxiety, she began turning to the loving presence of a dog (rather than to the eating disorder). A dog’s ability to live in the present moment helped to pull her out of her head and back down to earth. The dogs grounded her, and they created a vital sense of emotional security.

Shannon adopted a dog and began bringing her dog with her to therapy, and soon, Shannon was sharing on a deeper and more honest level than ever before. This marked the beginning of her eating disorder recovery—she will celebrate seven years free from bulimia on August 28th.

Research on the human-animal bond (known as Anthrozoology) has increased steadily over the years. Studies have shown that the presence of an animal may decrease stress levels by lowering blood pressure and creating a sense of general well-being—for the both human and animal!

Today, Shannon offers free animal therapy—SoulPaws Workshops— to those suffering from eating disorders in her community. (Learn More About SoulPaws Workshops Here: http://shannonkopp.com/workshops/)

Location: The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio – Shannon Kopp is an eating disorder survivor, animal welfare advocate, and the best-selling author of Pound for Pound: A Story of One Woman’s Recovery and the Shelter Dogs Who Loved Her Back to Life (HarperCollins Publishers). She is also the founder of SoulPaws Recovery Project, offering free animal therapy to those suffering from eating disorders. Shannon’s story has been featured on CNN, Fox News, Huffington Post, Salon, NPR and more. www.shannonkopp.com

http://www.harpercollinsspeakersbureau.com/speaker/shannon-kopp/

RSVP to: drmuhlheim@gmail.com

SIG meetings are open to all LACPA members. Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

April and May 2016 LACPA Eating Disorder SIG events

Please join us:  

Wednesday, April 20 at 7:30 PM

During April all LACPA Special Interest Groups (SIGs) and Clubs are available to non-members as a way of introducing them to some of the many FREE benefits of LACPA membership.

Presenter:  Lyn Goldring, RN, Director of Nursing, Monte Nido and Affiliates

Title:  Medical Complications in Eating Disorder Treatment

Description:  Eating disorders affect every system of the body. The physical consequences of severe food behaviors often go unseen because the body is highly adaptive. Developing an adequate “medical tool kit”allows clinicians and health care providers know what questions to ask and what physical test should be done to evaluate the severity of the Eating Disorder. With wisdom and humor, Lyn gives practical advice on understanding and addressing medical issues in a non-medical setting.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio:  Lyn practiced her nursing skills all over the world before finding her way to Monte Nido. Withconsistent compassion she helped to create our current nursing program, managing the well being of our clients’ and a team of nurses at both houses. Lyn’s wisdom and British wit are an essential element of our program, while clients find a safe haven in her kindness.

RSVP to:  drmuhlheim@gmail.com

In an effort to reach out to our community, LACPA is opening up SIGs to nonmembers for a limited time only. Take advantage of this opportunity and encourage your colleagues to attend a SIG during APRIL to experience one of the many benefits of being a LACPA member. In accordance with current policy, non-members will NOT be allowed to attend SIGs during any other months of the year.

Tuesday, May 10 at 7:30 PM

Presenter:  A. Janet Tomiyama, Ph.D., Assistant Professor,Department of Psychology, UCLA, Director, UCLA Dieting, Stress, and Health Laboratory www.dishlab.org

Title:  Dieting, stress, and weight stigma

Description:  Does dieting work to promote long-term weight loss and health? This talk will discuss evidence suggesting the answer is no, and will cover the potential negative consequences of dieting, including stress. Further research on stress and its effects on comfort eating will be presented, as well as novel research on weight stigma and its negative effects on eating, stress, and long-term weight gain.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio:  A. Janet Tomiyama, Ph.D., is an Assistant Professor in the Department of Psychology at the University of California, Los Angeles. She received her B.A. in Psychology in 2001 from Cornell University, and her M.A. and Ph.D. in Social Psychology with concentrations in Health and Quantitative Psychology in 2009 from the University of California, Los Angeles. In 2011, she completed a Robert Wood Johnson Health and Society Scholar Fellowship jointly at the University of California, Berkeley and the University of California, San Francisco. Her research centers around eating, dieting, stress, and weight stigma.  She is one of the leading researchers demonstrating the flaws of BMI as an indicator of health. http://www.nature.com/ijo/journal/vaop/ncurrent/abs/ijo201617a.html

RSVP to:   drmuhlheim@gmail.com

May event is only open to LACPA members.

Los Angeles Eating Disorder Events for Professionals January 2016

We are so lucky to have two amazing dynamic internationally recognized speakers regarding eating disorders in January via the Los Angeles County Psychological Association (LACPA).  One is a FREE SIG event (members only) and the other is a CE event with a charge (open to all professionals).

1)  Eating Disorder SIG meeting featuring international speaker and fat acceptance activist, Ragen Chastain

Wednesday, January 20 at 7:15 pm 

Title:   Elimination is Oppression – The Ill-Advised Fight Against Obesity

Presenter:  Ragen Chastain

Description:  You can’t have a “War on Obesity” without creating a war on fat people. There is no non-stigmatizing way to say “The world will be better when no one who looks like you exists.” The shame, stigma, bullying, and oppression that have arisen from massively failed attempts to “eradicate” obesity have far-reaching negative health effects on people of all sizes, including those struggling with Eating Disorders.  The solution is not to double down and do more of the same. The research is clear that body size and health are not the same, and that a focus on body size in healthcare does a disservice to people all sizes.  We can, and we should, create complete, thriving public health programs without the use of eliminationist language, without creating a culture of appearance-based stigma and oppression, and without waging war on anyone.

Location:  The office of Dr. Lauren Muhlheim (4929 Wilshire Boulevard, Suite 245, Los Angeles) – free parking in the lot (enter on Highland)

Bio:  Ragen Chastain is an internationally recognized thought leader in the fields of self-esteem, body image, Health at Every Size, and corporate wellness.  She is a sought after speaker on the college, corporate, and conference circuits who has set the stage on fire everywhere from Google Headquarters to Cal Tech to the Models of Pride Conference.  She is the author of the blog DanceswithFat,  the book Fat: The Owner’s Manual, a columnist for Ms. Fit Magazine, and frequently appears as a topic expert on television and in print media. Ragen is a featured interviewee in the documentaries America the Beautiful 2 – The Thin Commandments, Ragen’s More Cabaret, and A Stage for Size.  She lives in Los Angeles with her partner and their adorable dogs and in her free time she is training for her second marathon and her first IRONMAN triathlon.

RSVP to Dr. Lauren Muhlheim at drmuhlheim@gmail.com

SIG meetings are open to all LACPA members.  Nonmembers wishing to attend may join LACPA by visiting our website www.lapsych.org

2)  A CE event (tell your colleagues who are nonmembers; we provide CEUs for psychologists, nurses, drug counsellors, MFTs, LCSWs, and LPCC)

“Unraveling the Enigma of Male Eating Disorders” with Stuart Murray, Ph.D. on Saturday, January 30, 2016 

10:00 a.m. – 1:00 p.m. CE Credits 3.0 

Held at the NEW LACPA Office

6345 Balboa Blvd. Building 2, Suite 126

Encino, CA 91316

Click here to register online:

http://www.lapsych.org/events/event_details.asp?id=726923

This three hour workshop will provide a historical, theoretical, and clinical overview of eating disorder in males. Dr Murray will provide a historical overview of the development of our diagnostic framework, highlighting how this may be inaccurate in indexing male eating disorder concerns. Dr Murray will also provide an overview of the most recent empirical evidence pertaining to the transdiagnostic array of EDs in males. Finally, this workshop will include an in-depth discussion of the clinical quandaries faced in working with EDs in males.

Stuart Murray, Ph.D., is an Assistant Professor at UCSF, where he leads an international research group dedicated to advancing our understanding of male eating disorders. He also serves as the Director of the National Association for Males with Eating Disorders, and as the Co-Chair for the Academy of Eating Disorders Special Interest Group on Males & EDs. To date, Dr. Murray has published more than 70 scientific journal articles and book chapters, and has conducted workshops and seminars internationally on the topic of male eating disorders.

Presentation at NEDA 2015 conference

Lauren and Katie presenting NEDA 2015

Katie and I had the honor of presenting in the Individual, Family, and Friends track at the National Eating Disorder Association Conference in San Diego yesterday.  The title of our talk was:  Family Based Nutrition Therapy:  Creating A Supportive Environment.  It was a chance to share the way we work to support families who are helping children with eating disorders.

Here are some of the key points of our talk:

The Hidden Benefits of Full Fat Dairy by Katie Grubiak, RD

Galbani Whole Milk Mozzarella Cheese
full fat dairy
Galbani Whole Milk Ricotta Cheese
Greek Gods’ Greek Yogurt

History of the Low-Fat Movement

Since the 1980s, physicians, the federal government, the food industry, and popular media have championed the low-fat approach to dieting and weight control. The idea stemmed from a few studies published in the 1940s, which showed a correlation between high-fat diets and high-cholesterol levels. Because high-cholesterol levels were known to be a major risk factor for heart disease, low-fat diets were highly recommended as a preventive measure for at-risk individuals, and eventually for the entire nation. This advice became so widespread by the 1980s that reduced-fat and low-fat options dominated the diet-related product market.

The Argument for Low-Fat Dairy

Although this national preoccupation with low-fat products has waned since the 1990s, low-fat dairy products have sustained their popularity. Low-fat dairy products are lower in calories and saturated fat than their full-fat counterparts, while still boasting substantial amounts of protein and calcium. To experts worried about slowing the impending “obesity epidemic”, low-fat dairy at first seems an obvious choice – especially if choosing low-fat products can help prevent heart disease.

The Issue with the Low-Fat Dairy Argument

There’s just one problem with this logic – according to a review article recently published in the European Journal of Nutrition, there is no conclusive evidence to suggest that full-fat dairy consumption is associated with increased risk of obesity, heart disease, or diabetes. In fact, in 11 of the 16 studies reviewed, high-fat dairy intake was inversely associated with obesity risk. In a 12-year longitudinal study conducted in Sweden, researchers Dr. Sara Holmberg and Dr. Andres Thelin found that men who reported a low intake of dairy fat (skim milk, no butter, etc.) had a higher risk of developing obesity in the 12-year period than were men who reported a high intake of dairy fat.

Why Whole Dairy?

Much of this research may come as a surprise to those familiar with the calories-in, calories-out model of weight maintenance. How could eating dairy products that are significantly higher in calories help people avoid weight gain?

Researchers aren’t certain why full-fat dairy may aid in healthy weight maintenance, but there are a few ideas gaining traction in the field: 

  • Fullness 
    • To produce low-fat dairy products, “excess milk fat” is separated out of whole dairy. Much of this “excess milk fat” is made up of fatty acids found in milk, which are thought to make people feel full sooner and stay full longer. Thus, low-fat dairy products simply don’t keep you as full as whole dairy products do.
    • The fatty acids in whole milk also make whole dairy products richer, thicker, and more satisfying, which can add to the experience of fullness, and keep you full for longer.
  • Role in Gene Expression & Hormone Regulation.
    • The fatty acids found in whole milk may be involved with gene expression and hormone regulation in the body. Though these relationships are unclear, it is possible that fatty acids speed up metabolism or limit the body’s storage of fat.
  • Real Food, Not Just Nutrients.
    • Though macronutrient content can tell us a lot about the health benefits of food, whole fat dairy is more than just the sum of its (major) parts. Real food is a complex mix of macro (fat, carbohydrates, protein) and micro (vitamins and minerals) nutrients. Absorption of all of these macro and micronutrients is dependent upon several factors, so altering the macronutrient breakdown of dairy products (by removing fat) changes the way these products are metabolized by the body.For instance, Vitamins A, D, E, and K are fat soluble nutrients, which means that absorption of these nutrients is compromised when no fat is present.

When I have helped my clients with eating disorders to add full fat diary products back into their diet after a period of having avoided them, positive changes take place.  They often notice a decrease in food obsession and a reduction in volume of intake. Although most clients fear overeating whole full fat (and higher calorie) products, this does NOT happen. Instead, portion control often occurs more naturally since satiety comes from the taste, texture, & actual full fat macronutrient presence.  Clients recognize that they CAN feel in control but still go to their favorite real full fat foods which they previously feared and avoided. In reality, the low fat foods were the ones that they could not limit.   I have only seen satiety benefits as well as metabolic benefits of a diet higher in fat, 30-35% of total calories. To try it for yourself, I suggest:

Some recipes incorporating whole fats

  • *Maple Hill Creamery 100% Grass-Fed Organic Milk Creamline Yogurt-Lemon flavored with granola & banana for breakfast
  • *The Greek Gods Greek Yogurt-Honey Strawberry flavored with cut up pear for a snack
  • *Toasted Caprese Open Faced Sandwich-
    • French Sandwich Roll-cut in half
    • Expeller Pressed Extra Virgin Olive Oil
    • Fresh Basil Leaves
    • Heirloom Tomatoes Sliced
    • Galbani Fresh Whole Milk Mozzarella or Galbani Whole Milk Low-Moisture Mozzarella Cheese

    • Pink Himalayan Salt

  1. Drizzle the olive oil over each half of the sliced French roll
  2. Place sliced Whole Milk Mozzarella Cheese over the French roll with olive oil
  3. Lay Basil Leaves on top of the Mozzarella
  4. Lay sliced Heirloom Tomatoes over the Basil
  5. Grind & sprinkle Pink Himalayan Salt over the Tomatoes
  6. Opened faced-Toast in toaster oven for 3-5 minutes or heat in oven 350 degrees F for 5-8 minutes

Sources:

  • The full article from European Journal of Nutrition can be found here.
  • The full article from the Scandinavian Journal of Primary Health Care can be found here.
  • For a through and clear explanation of this topic, refer to this TIME Magazine article.
  • An additional study in the American Journal of Clinical Nutrition can be found here and is summarized here.
  • Another article is here.

Research Assistant, Erin Standen contributed to the writing and research of this post.

Eating Disorders in the Orthodox Jewish Community

eating disorders in the Orthodox Jewish communityHaving worked with several Orthodox clients and also having participated in a Chabad Orthodox congregation when my family lived in Shanghai, I was excited to join in on the Academy for Eating Disorders’ Tweetchat on Eating Disorders in the Orthodox Community last month. The chat was informative and the full transcript of the chat is available here. A summary of some of the information covered in the chat as well as from a review of other sources follows.  In addition, I received some feedback from Devorah Levinson of Relief Resources (a non-profit serving the Jewish community), which I’ve incorporated.

Eating disorders do not discriminate. They affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses. As such, they are found in the Orthodox Jewish community as well as every other religious community.

Eating disorders are caused by a combination of genetic and environmental factors. Among the environmental factors implicated in the development of eating disorders among Orthodox females is a pressure among young Orthodox women to be thin. Some believe this pressure stems from the culture surrounding dating and matchmaking in the Orthodox community. For women of marrying age (frequently around 18 or 19 years old), thinness is greatly preferred, so women feel pressured to be thin in order to be matched with a desirable husband.  However, Devorah Levinson of Relief Resources wrote this in a response to my initial post: “Unfortunately I am not a big believer in the orthodox dating process being a cause or large contributor to the development of eating disorders. The dating process or variations of it have been in place for hundreds of years. The only thing that has changed is the beauty ideal. A beautiful wife has always been an important item on ‘the checklist.’ What’s important for us to note is that our vision of beauty has changed. Years ago in the Orthodox world it was actually the heavier woman that was sought after because she exuded health and financial stability. Just like how Marylyn Monroe was the ideal woman with her curvaceous figure and now would be considered overweight – it is the media and secular society that is so strong it has managed to change even the most insular communities’ visions of beauty. So I disagree with that being a large factor. I actually think the internet and easier access to outside media within our community has brought the thin ideal so close to home.”

Stigma surrounding eating disorders is pervasive in the Orthodox Jewish community, which can make getting help very difficult for individuals and their families. Moreover, in the case of the ultra-orthodox, the social disgrace surrounding an eating disorder could harm a woman’s prospects of marriage. Still, guest @JudyKrasna explained that Jewish law values health and life above all else, so despite the stigma that exists in the community, individuals are not prevented from getting treatment for religious reasons.  Devorah wrote, “stigma is a big challenge and it was one of the main reasons Relief was established. We wanted to be able to help our community access appropriate care for all mental health issues.”

The cultural significance of food and fasting in the Orthodox Jewish community is also important to consider. Dietary laws for Orthodox Jews require that they keep to a kosher diet, which can limit food options for individuals in treatment. Moreover, certain celebrations and holy days involve fasting and/or feasting, which can be additional obstacles for those struggling with eating disorders.

Eating disorders are the same across races and religions. Therefore, members of the Orthodox community do not necessarily need to use Orthodox providers for treatment. Instead, members of the Orthodox Jewish community should seek the best treatment options available. When selecting a residential treatment center, however, it is important to consider a provider’s availability of kosher options. When faced with a lack of residential centers that provide kosher options, Family Based Treatment (FBT) may be an effective treatment strategy.

Devorah adds, “Regarding kosher food, I have tried very hard to encourage parents to not let that be a stumbling block or deciding factor in making a treatment decision. I try and help families find the best and most effective treatment facilities and then we work out the kosher food situation. Most facilities will accommodate to some extent. After that, because of the medical issues involved many Rabbis understand the severity of the situation and will give families dispensations to not be as meticulous with their observance of these laws for the time the patient is in the program. In general I have unfortunately not seen success with programs that were either created for Orthodox patients or even had an ‘orthodox track’.  My goal has always been to find the most effective evidence based treatment and then promote cultural sensitivity amongst the clinicians. I have traveled to several facilities and have always been welcomed with warmth and openness.”

For providers working with members of the Orthodox Jewish community, cultural competency is key. To build this competency, treatment centers and providers should familiarize themselves with available resources (see below), and should also ask patients directly about how to better address their specific needs. In addition, treatment centers should work to provide kosher options for Orthodox individuals. Even with these improved treatment options, the issue of stigma within the Orthodox Jewish community remains an obstacle. For this reason, it is especially important that we reach out to others outside the eating disorder field, especially rabbis and educators, to raise attention to the problem, and ultimately, to reduce the stigma surrounding eating disorders in the community.

Resources:

  • Relief Resources is a non-profit organization that provides services for individuals who suffer from mental health disorders and caters to the needs of the Jewish community.
    • Relief Resources also has an Eating Disorder Hotline at (718)-431-9501 ext. 103.
    • Devorah Levinson, the referral specialist and Director of the Eating Disorder Division at Relief Resources, wrote this article for the parents of Jewish Orthodox Children with eating disorders.
  • Suggestions for kosher dietary recovery is available in this article.
  • To learn more about eating disorders in Orthodox Jewish communities, thorough articles are available from NEDA Psychology Today The Jerusalem Post, Gurze-Salucore, and The New York Times.
  • Eating Disorders Recovery Today and TreatingEatingDisorders.com offer extensive background information about some of the vulnerabilities to eating disorders that exist in Orthodox Jewish communities.
  • Orthodox Union recently released a short documentary, “Hungry to be Heard” covering the topic, which can be found at their website and it was designed to be presented to parents in schools and synagogues to raise awareness. 
  • Temimah Zucker, a blogger for The Times of Israel, is a survivor of Anorexia and runs support groups geared towards the Jewish community. Her blogs cover a variety of topics related to Judaism and eating disorders, which can be found here.
  • The Renfrew Center offers specialized programs and groups for observant Jewish individuals, and their residential programs offer kosher options for all meals.

Research Assistant, Erin Standen contributed to the preparation of this post.