“Although again, you know, when you’re gaining weight in pregnancy, it feels like it’s for a positive reason.” ~ Rose.

Terminology for Mental Health Professionals

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.

References:

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.
doi: 10.1007/s10608-014-9653-5

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.
doi: 10.12688/wellcomeopenres.10333.1

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.
doi: 10.1002/eat.22528

Breastfeeding While in Recovery

Breastfeeding While in Recovery

By Hattie Rowe
West Virginia University

Breastfeeding is a unique and personal choice for every woman. The decision whether or not to breastfeed should be made by the mother, and not by her eating disorder. Research has shown that women who experience eating disorders and body image issues are less likely to initiate breastfeeding and more likely to wean their child sooner than average (Micali et al., 2009; Zerwas & Claydon, 2014; Claydon et al., 2014). (more…)

Recognizing Body Shame & Fat Talk

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. (more…)

How to tell your doctor

How to tell your Doctor

Telling your doctor, nurse, or other healthcare professional about your eating disorder (whether past or present) can feel overwhelming. Often, it might have been a secret that you have kept from even those closest to you. However, it is important that your clinicians have all the information about your medical history so that they can help you during and after your pregnancy. (more…)

How to help a loved one

How to help a loved one

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. (more…)

Options for Weighing

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 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…)

Creating a healthy relationship with food for your child

Creating a healthy relationship with food for your child

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. (more…)

Coping strategies from women who have been there

Coping Strategies from Women who have been there

Adjusting to all the changes that come with pregnancy can be a challenging process even for women without an eating disorder or history of an eating disorder. Women who have had eating disorders identified a few areas that helped them better cope with pregnancy so that they could improve the process for themselves and their baby. (more…)

Conversations with People and Their Eating Disorder

Conversations with People and Their Eating Disorder

Conversations with People and Their Eating Disorder

By Hattie Rowe
West Virginia University

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). While in everyday conversation you may not notice certain phrases as triggering, people with eating disorders are more sensitive to the type of language directed at them in conversation.

A person with disordered eating may experience an “eating disorder voice” taking over the true identity of the person. It’s helpful to identify these two, conflicting selves. When engaging in conversation, addressing both “selves” or “voices” can help you discern who it is you are really speaking to.

When talking with a loved one who seems hostile, don’t let the “eating disorder voice” control the conversation. Try to remember that the person to whom you are speaking with is struggling with an internal battle that may cause them to be defensive. The goal for quality conversation with a person who has an eating disorder is to speak to their true self. Use empathy, patience, and love to speak to the voice that wants to recover. Although you may be feeling overwhelmed, the eating disorder voice can thrive off of this fear and turn it into your loved one feeling persecuted. It is best to have a conversation after you have prepared yourself and are in a good place emotionally.

Choosing certain words or statements over others might seem miniscule, but it can actually make a big difference in patient recovery. According to the American Psychiatric Association (APA),

Here are some general tips on how to have conversations about food, body, and concerns with a patient or loved one who has an eating disorder.

References:

Farrar, T. (2014). Approaching Someone With An Eating Disorder. Retrieved from https://www.mirror-mirror.org/approach.htm

Guarda, A. (2019). Expert Q & A: Eating Disorders. Retrieved from https://www.psychiatry.org/patients-families/eating-disorders/expert-q-and-a

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(2), 204–214. https://doi-org.www.libproxy.wvu.edu/10.1007/s10608-014-9653-5

How to start a discussion with someone you think might have bulimia nervosa. (2018, February 20). Retrieved from https://bulimiaguide.org/ways-to-start-a-discussion-with-someone-who- might-have-bn/

Terminology for Mental Health Professionals

Terminology for Mental Health Professionals

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.

References:

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.
doi: 10.1007/s10608-014-9653-5

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.
doi: 10.12688/wellcomeopenres.10333.1

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.
doi: 10.1002/eat.22528

Breastfeeding While in Recovery

Breastfeeding While in Recovery

Breastfeeding While in Recovery

By Hattie Rowe
West Virginia University

Breastfeeding is a unique and personal choice for every woman. The decision whether or not to breastfeed should be made by the mother, and not by her eating disorder. Research has shown that women who experience eating disorders and body image issues are less likely to initiate breastfeeding and more likely to wean their child sooner than average (Micali et al., 2009; Zerwas & Claydon, 2014; Claydon et al., 2014). (more…)

Recognizing Body Shame & Fat Talk

Recognizing Body Shame & Fat Talk

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. (more…)

How to tell your doctor

How to tell your doctor

How to tell your Doctor

Telling your doctor, nurse, or other healthcare professional about your eating disorder (whether past or present) can feel overwhelming. Often, it might have been a secret that you have kept from even those closest to you. However, it is important that your clinicians have all the information about your medical history so that they can help you during and after your pregnancy. (more…)

How to help a loved one

How to help a loved one

How to help a loved one

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. (more…)

Options for Weighing

Options for Weighing

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 Distribution

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…)

Creating a healthy relationship with food for your child

Creating a healthy relationship with food for your child

Creating a healthy relationship with food for your child

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. (more…)

Coping strategies from women who have been there

Coping strategies from women who have been there

Coping Strategies from Women who have been there

Adjusting to all the changes that come with pregnancy can be a challenging process even for women without an eating disorder or history of an eating disorder. Women who have had eating disorders identified a few areas that helped them better cope with pregnancy so that they could improve the process for themselves and their baby. (more…)

Shifting the Eating Disorder Voice During Pregnancy

Shifting the Eating Disorder Voice During Pregnancy

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…)