“My husband has no conception of it. He knows a little bit about that I had an eating disorder and that I’ve yo-yo dieted and things like that, but he really doesn’t understand the mental processes that go behind it, and the constantly being, I’m going to say obsessed.” ~ Ruby, mother of one.
Talking with a person who has an eating disorder might look different than other conversations. For instance, using words that directly reference appearance can be triggering for those with eating disorders. It has been shown that women with eating disorders spend longer time focusing on words that deal with appearance in comparison to women who do not meet the criteria for an eating disorder (Myers, Ridolfi, & Crowther, 2015). Learn More
Conversations with People and Their Eating Disorder
Recognizing Body Shame & Fat Talk
By Elizabeth Claydon
Body shame comes in so many forms and can manifest itself internally or externally. With the many nuances involved in body shame, I thought it time that it was broken down into a more easily-understood graphic depicted above. Learn More
Many women who are recovering from an eating disorder or still have an eating disorder are very concerned about their children picking up on their behaviors or modeling their eating. Additionally, given the complicated relationship that someone has with food whether they have an eating disorder or are recovered from one, it is challenging to figure out how best to talk about eating and weight with children. Learn More
Creating a healthy relationship with food for your child
Weight Gain Distribution
Weight gain and body shape changes can be very daunting during pregnancy especially for women who have an eating disorder or eating disorder history. However, it can be helpful to understand how the weight is attributed to the baby and how it is distributed. Being able to connect that weight gain specifically to the baby or pregnancy components can help the woman reframe the weight gain positively. Learn More
It can be frightening when you are confronted with the possibility your loved one or family member has an eating disorder. However, it is important to remember that they are probably frightened too, and that this is when they will need you the most. The following recommendations are related to how to help for eating disorders in general and then a few specific to eating disorders and pregnancy. Learn More
How to help a loved one
Relevant Blog Posts
February 2020 Sensitivity Training
By: Malerie Razzis
West Virginia University
This past February, the Healing Bodies, Healthy Babies research team was able to conduct their very first sensitivity training. There were months of preparation prior to the first session with considerable work from team members including Zoya Khan, Caterina DeFazio, Taylor Shultz, Oghenerukeme Asagba, and Hattie Rowe. During Summer 2019, the team worked in the WV STEPS lab to film examples of patient-clinician interactions. These videos have been made available for the public to view on Youtube. Prior to the first sensitivity training, all members of the Healing Bodies, Healthy Babies team also underwent the sensitivity training.
The sensitivity training that was developed for the clinicians provided various clinical strategies that would be reasonable to integrate into their daily treatment of patients, particularly those with eating disorders and pregnancy. Previous studies have laid some groundwork about the prevalence and characteristics of eating disorders in pregnancy, indicating a greater need for clinical understanding of eating disorder symptomatology and appropriate screening tools to be incorporated into prenatal and postpartum care. Pregnant women with a history of eating disorders or an active eating disorder have a greater risk of giving birth to a child with lower birth weight, smaller head circumference, microcephaly, and small for gestational age (Kouba, Hällström, Lindholm, & Hirschberg, 2005). Due to these health risks, it is important for clinicians to learn how to properly treat patients with eating disorders.
A questionnaire was administered prior to the sensitivity training, as well as after the completion of the sensitivity training. Prior to training, only 76% of clinicians indicated that a patient’s eating disorder history would be extremely relevant to their treatment. Upon the end of training, this number increased to 96% of clinicians indicating that it would be extremely relevant to their treatment. When asked about their comfort when treating patients with eating disorders, 61% of clinicians expressed being less than comfortable providing treatment. After undergoing the sensitivity training, this number shifted to 84% of clinicians indicating that they were either somewhat comfortable or extremely comfortable with treating patients with eating disorders. These results were promising to the Healing Bodies, Healthy Babies team.
Since this was the first sensitivity training, the results are preliminary. “I am hopeful that once we conduct more trainings, we will have more data to analyze! This will allow us to investigate the significance of our data and how the sensitivity training can be implemented to better aid clinicians,” reported Zoya Khan. Khan is an undergraduate student that is an active member of the Healing Bodies, Healthy Babies team. She would like to be able to administer the sensitivity training to a variety of clinicians including physicians, physician assistants, nurses, etc. in the future. “Every person has a unique insight to offer, which will allow us to determine how we can provide clinicians with resources to treat patients with eating disorders,” she says. Another goal that she has for the team is to continue developing free resources that are made available on the Healing Bodies, Healthy Babies website. “I look forward to continuing to work with Dr. Claydon and the rest of the Healing Bodies, Healthy Babies team!”
Khan, ZA, DeFazio, C, Claydon, EA. “An evaluation of weight sensitivity training for clinicians” Poster presentation at the Spring Undergraduate Research Symposium, Morgantown, WV, April 2020.
Kouba S, Hällström T, Lindholm C, Hirschberg AL. Pregnancy and Neonatal Outcomes in Women With Eating Disorders. Obstetrics & Gynecology. 2005;105(2):255-260. doi:10.1097/01.aog.0000148265.90984.c3.
Terminology for Mental Health Professionals
By Hattie Rowe
West Virginia University
As medical knowledge increases, so does responsibility. We are continually enlightened of more sensitive ways to approach conversations with patients. People with eating disorders can be sensitive to others and the vocabulary directed towards them (Kuipers, G., den Hollander, S., van der Ark, L.A., & Bekker, M. 2017). Research has shown that people who have eating disorders focus more on appearance-related words (Myers, Ridolfi, & Crowther, 2015). Staying up-to-date on positive and person-oriented terminology for patients is a responsibility for all who work with individuals who have eating disorders.
The following terms have been proposed by researchers and professionals as more appropriate terms to use in conversation with patients who have eating disorders.
Kuipers, G. S., den Hollander, S., van der Ark, L. A., & Bekker, M. H. J. (2017). Recovery from eating disorder 1 year after start of treatment is related to better mentalization and strong reduction of sensitivity to others. Eating and Weight Disorders, 22, 535–547. doi: 10.1007/s40519-017-0405-x
Lilienfeld, S.O., Sauvigne, K.C., Lynn, S.J., Cautin, R.L., Latzman, R.D., Waldman, I.D. Fifty psychological and psychiatric terms to avoid: A list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases. Frontiers in Psychology. doi:10.3389/fpsyg.2015.01100
Media Resources. Retrieved from https://suicidepreventionlifeline.org/media-resources/
Myers, T. A., Ridolfi, D. R., & Crowther, J. H. (2015). Reaction times to appearance-related or non-appearance-related word choice among women with and without eating psychopathology. Cognitive Therapy and Research, 39, 204–214.
Nielsen, E., Padmanathan, P., and Knipe, D. (2016) Commit* to change? A call to end the publication of the phrase ‘commit* suicide’. Wellcome Open Research, 1:2.
Puhl, R. M., Peterson J. L., Luedicke J. (2013) Motivating or stigmatizing? Public perceptions of weight-related language used by health providers. International Journal of Obesity. 37: 612-9. doi: 10.1038/ijo.2012.110
Spencer-Thomas, S. (2018). Language matters: Why we don’t say “Committed suicide”. International Risk Management Institute, INC.
Retrieved from https://www.irmi.com/articles/expert-commentary/language-matters- committed-suicide
Weissman, R. S., Becker, A. E., Bulik, C. M., Frank, G. K. W., Klump, K. L., Steiger, H., … Walsh, B. T. (2016). Speaking of that: Terms to avoid or reconsider in the eating disorders field. International Journal of Eating Disorders, 49, 349–353.
Options for Weighing
Since weight and body image concerns are areas of concern for pregnant and postpartum women with eating disorders, it’s important to know the options around weighing whether you’re a patient or a clinician. Clinicians make these decisions around weighing on a case-by-case basis or have a conversation about weighing preferences at an early prenatal appointment. Patients may want to review this list to determine what options they feel most comfortable with and then engage their clinician in a conversation about their preference. (more…)
Weight Gain Distribution
Weight gain and body shape changes can be very daunting during pregnancy especially for women who have an eating disorder or eating disorder history. However, it can be helpful to understand how the weight is attributed to the baby and how it is distributed. Being able to connect that weight gain specifically to the baby or pregnancy components can help the woman reframe the weight gain positively. (more…)
Shifting the Eating Disorder Voice During Pregnancy
By Hattie Rowe
West Virginia University
Major changes in life can be stressful for anyone. But for women who have struggled with eating disorders, adapting to changes may look more difficult. People who suffer from an eating disorder have unhealthy coping strategies related to their body. Whether these life changes induce stress or excitement, adjusting to something new can elicit anxiety at the unknown. (more…)
Family & Loved Ones Quotes (all names are pseudonyms to protect the women’s real identities)
My husband has no conception of it. He knows a little bit about that I had an eating disorder and that I’ve yo-yo dieted and things like that, but he really doesn’t understand the mental processes that go behind it, and the constantly being, I’m going to say obsessed.~ Ruby, mother of one
I even told my mom, like you will never say that to my daughter. Ever. I do not want you saying anything like that to her. My mom, even to this day, still makes comments like, “Well, it’s a good thing she’s a skinny baby because she could be more active that way.” It’s like, you know, she’s got fat cheeks, she’s got fat thighs now, I’m happy.~ Ruby
Fortunately, my husband, when they were second grade and third grade, my husband, because I was making like bizarre food. He completely took over food. He brought in chips. He normalized food for my girls. I think that probably saved them, considering that my own biological mother had an eating disorder and then I did. I had one.~ Ann