How to Help Someone with an Eating Disorder

  • posted by Marci Evans
  • Saturday, October 08, 2016

Chances are you know someone with an eating disorder. And chances are you don’t know how to help them. This article on helping someone with an eating disorder is a great resource. Here are the take-home points:

  • Communicate your concerns. Share your memories of specific times when you felt concerned about the person’s eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention.
  • Avoid conflicts or a battle of the wills. If the person refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.
  • Avoid placing shame, blame, or guilt on the person regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
  • Avoid giving simple solutions. For example, "If you'd just stop, then everything would be fine!"
Source: Adapted from National Eating Disorders Association

If you are a dietitian who wants to work with eating disorder clients, check out my new online training to help you know how to treat eating disorders.

The Role of the RD: Outpatient Eating Disorder Treatment

  • posted by Marci Evans
  • Sunday, October 02, 2016

Eating disorders are psychological issues, so you may be wondering why having a dietitian as part of a treatment team is even necessary. In fact, if food is an issue for you, the idea may seem downright frightening! Here are a few ways a dietitian can be immensely helpful in treating eating disorders:

• Reduce food and body fears by reframing distorted beliefs that the eating disorder has created. This includes a better understanding of physiology, digestion, and metabolism.
• Teach and model what and how much nutrition is appropriate
• Provide a safe place for talk about food and body fears
• Create opportunities to practice eating foods that feel scary
• Teach the difference between emotional and physical hunger
• Establish and teach “normal” eating- eating that is based on physical cuing and free from guilt, anxiety, shame, and compensatory or obsessive responses

Below are two excellent links to articles on this very topic:
1. Eating Disorders: Nutrition Education And Therapy
2. Nutrition Intervention in the Treatment of Eating Disorders

Whether you are new to the field or looking to deepen your counseling skills, my new online eating disorder training for dietitians will improve your clinical practice. Learn more about the course here.

The Weight of Weight Stigma

  • posted by Marci Evans
  • Monday, September 26, 2016

The following post was written by Elizabeth Jarrard, RD.


Sticks and stones can break my bones but words will never hurt me. Right? Words like “fat” “obese” get tossed around a lot in our society. Unfortunately they are often also associated with words like “gross” or “lazy.” These words do hurt. The stigma of weight hurts not only the person at which they are directed, but our society in general.

What exactly is weight stigma? According to BEDA “Weight stigma is bullying, teasing, negative body language, harsh comments, discrimination, or prejudice based upon a person’s body size.”

Weight stigma and bias can be verbal (insults, teasing, stereotypes, or derogatory names) or physical-bullying.

We now see that discrimination based upon weight is more prevalent than race discrimination-with a 66% increase over the past decade. “There’s an atmosphere now where it’s O.K. to blame everything on weight,” said Dr. Linda Bacon, a nutrition researcher. Research suggests images in news media of obesity extremely negative, biased, & stigmatizing- which creates prejudice. In some cases stigma results in employment discrimination where an obese employee is denied a position because of their appearance regardless of their qualifications. This isn’t just a few people-43% of overweight people report weight stigma by employers or supervisors.

Recent research has highlighted just how deeply weight stigma runs-and it’s not just in job interviews or promotions. According to Huizinga et al The higher a patient’s body mass, the less respect doctors express for that patient. Weight stigma is a significant risk factor for depression, low self esteem and body dissatisfaction. Victims of weight stigma have increased levels of stress (seen explicitly in cortisol levels and increased blood pressure), decreased desire to exercise.  This creates a negative life environment that may perpetuate cycles of overeating and underexercising-creating an unhealthy lifestyle.

So what can we do?

No matter what size he or she might be it’s important that you talk to your child about weight stigma and foster within them a positive self esteem.  

  • Help us all to create school environments that are conducive to learning-by reducing weight stigma.
  • Are you a health provider? Talk to your patients without weight stigma. Yale Rudd Center is a fantastic resource for all providers.
  • As an employer-make sure you are not perpetuating weight stigma.
  • Just because someone is overweight doesn’t mean they don’t exercise, they don’t eat healthfully or they are lazy. Stop those you see using weight stigma and bias. Change the stereotypes within your own mind. 

We must learn to take a Health at Every Size approach and treat all individuals the same-whether they are our clients, our friends or just people we meet on the street. Weight is a number, and you can not tell someone’s entire life or health history from judging their outward appearance. 

Falling in Like with Exercise

  • posted by Marci Evans
  • Monday, September 19, 2016

 In the space of 7 days I had 3 clients tell me that they recently discovered that they truly loved getting physically active. Yes, I mean exercise (a dreaded word for some of you, I know, bear with me). And I had to blog about this because all 3 stated that they started loving exercise when two things happened:

1. They were eating enough on a consistent basis. They were no longer overly restricting but getting adequate fuel to be able to sustain a workout.

2. They were NOT doing it with the intention of trying to lose weight. They were exercising because it was fun and felt good.

Now that, my friends, is what makes my job feel totally worthwhile. So many people, particularly women, dread working out. And I’d gamble that those women who hate exercise choose an activity they hate (does 60 minutes on the elliptical sound like hell to anyone else?) and are overly hungry (ie on a diet and trying to lose weight).

Just imagine what would happen if you had enough energy to dance your way through a zumba class, hike through the mountains, go for a stroll with a friend, take a restorative yoga class. If this sounds like something only dreams are made of, consider my tips for finding peace with exercise.

1. Don’t call it exercise if you hate that word.

2. Don’t do it in the name of weight loss. Check out this blog post for more detail as to why this point is so important.

3. Select activities that rejuvenate your body, not exhaust or deplete it.

4. Make sure that the types and amounts of exercise you are doing alleviates mental and physical stress, rather than contributing to or exacerbating stress.

5. Find the things you genuinely enjoy and NEVER with the intention of providing pain or punishment.

While my 5 tips may fly in the face of the advice in every Shape magazine article ever written, they just might help you find a happier, healthier balance when it comes to keeping your body strong and healthy.

And now, I gotta’ get out of my office to take stroll!

Picture Source


Eating with Emotion

  • posted by Marci Evans
  • Monday, September 12, 2016

Originally published October 2013. 

I don’t often use a lot of self-disclosure on my blog. In fact, the last time I shared something personal was July 2011 when I talked about my body image. But after finishing my dinner tonight I had a little conversation with myself that I wanted to share.

I love chocolate…like, a lot. I especially love German chocolate. Ok, to be more specific I LOVE Milka Schoko and Keks and I love the Butter Biscuit by Rittersport. As luck would have it, Trader Joe’s sells those Rittersport bars at a very reasonable price. I typically have at least one back up bar in my treat bowl at home. (Yes, another reveal, I have a treat bowl at home.)

So I came home tonight after a very full day at work. In fact, it was an unusually full day. I sat down to a meal that was just what I needed on a cold, rainy evening. I was tired and hungry and couldn’t wait to eat. After I finished my meal I started to think about my Butter Biscuit waiting for me in the treat bowl. I got all excited knowing that it was just what I wanted to finish my meal. I broke off a line of chocolate and noticed that I was eating it with tremendous delight. The chocolate was making me quite happy, quite warm and fuzzy, and I noticed the stress of my day begin to dissipate.

And that’s when I started to think about the difference between eating WITH emotion and emotional eating. I talk about emotional eating most days with my clients and I can assure you that there is a difference! Emotional eating has a few particular qualities:

  1. It is used to cover up, diminish, numb or avoid challenging emotions.
  2. It happens with great speed and little pleasure. It goes in the mouth and down the hatch before you can savor a single bite.
  3. It leaves you feeling physically unwell after you have eaten.
  4. It creates disconnection with yourself.
  5. It is often followed by guilt, remorse, and shame.

Now what I described above is light years away from eating WITH emotion! Eating WITH emotion includes getting super excited to eat a meal you love or try a new restaurant you’ve heard friends raving about. Eating WITH emotion is eating things that are super yummy and satisfying. Eating WITH emotion leaves you feeling physically satisfied and content and emotionally balanced or even happy!

Not every snack is going to be the zen experience I described earlier. Not every meal will send you to Cloud 9. BUT, I truly believe that experiences of eating WITH emotion are vital to our health and well-being.

So when was the last time you ate WITH emotion? What did you eat? And if you haven’t lately, what’s stopping you? Hop to it, your body will thank you. J