Build Enduring Strategies with the Intuitive Eating Group Program

  • posted by Marci Evans
  • Tuesday, May 23, 2017

We're so excited to announce our new Intuitive Eating Group Program

Do You Want to Improve Your Relationship with Food?

Looking for Guidance on How to Honor Your Nutritional Needs?

Struggling with Recovery From an Eating Disorder?

Marci RD Nutrition has a 5-week Intuitive Eating Group Program that will Transform You and Your Life!  We will help you navigate the complex journey of learning to listen to your body’s needs while in a supportive group environment! 

This program, led by Eating Disorder and Intuitive Eating expert, Sarah Patten, will help you:

  • Discover how to listen and reconnect with your body's hunger and fullness cues
  • Learn to trust yourself to make decisions around what or how much to eat
  • Take back your power around food
  • Reconnect to your body's innate wisdom to determine the right amount of food for you
  • Develop self-trust around eating challenging or “forbidden” foods
  • Practice being more mindful at meal times in a safe and supportive environment
Why Join our Group Program? 
  • Exposure to challenging meals in a supportive environment fosters greater self-trust while decreasing fear and anxiety over time.
  • Avoidance of particular foods or eating in a social setting is a big risk factor for relapse and can hold one back from making peace with food once and for all.
We will help you become more confident in your ability to feed yourself in an adequate, varied, and enjoyable way. 

 

intuitive eating support group

Who Should Consider Participating?  

  • People looking to heal their relationship with food and develop lifelong skills around eating and body trust. Participants must be appropriate for an outpatient level of care and must be working with an individual therapist and dietitian.
  • An initial 15-minute phone screening is required to determine appropriateness of fit for the group and to allow for Sarah to understand each individual's goals and challenges prior to joining.
Groups will be led by Sarah Patten, a registered dietitian, eating disorder expert, Intuitive Eating specialist, and registered yoga teacher.  To register for the program, contact Sarah via email or by telephone: 

617-945-2404


 

What Does the Program Include?
 
Five (5) weeks of meal support led by a Registered Dietitian and Intuitive Eating specialist that includes the following:
  • Inclusion in a small group – limited to 6 participants
  • Personalized goal setting
  • Orientation to the keys of effective exposures
  • Mindfulness based eating exercises
  • Dining together as a group
  • Guided meditation experiences
  • Post-meal processing
  • Handouts and resources
  • Access to a Registered Dietitian who leads you in this program
When Will the Group Be Held?
 
Dates:
June 13th, 20th, 27th, July 11th and July 18th
 
Time:
7:00 pm-8:15 pm
 
Location:
Marci RD Nutrition Counseling Office
22 Hilliard St., Cambridge, MA 02138
1st floor, door on the right
 
Your Investment in the Program:
$225.00 for the 5-week program - Registering for the full series is required.
 
Registration Information
  • Group size is limited to 6 participants.
  • To reserve your seat in the program, contact Sarah. Your seat in the program will be officially reserved once payment is received in full.
 
We look forward to have you join us for the 5-week Intuitive Eating Group Program!

Your Values – Your Key to Contentment

  • posted by Marci Evans
  • Friday, May 19, 2017

I’m a registered dietitian by training but so many of my clients tell me “You’re more than my nutritionist Marci, you’re like my life coach!

I take that feedback seriously!! My clients trust me to join with them on their life journeys and that is a privilege.

There are a couple of reasons my clients think of me as “more than a nutritionist:”

  1. I like to hear about every facet of their life so I can understand how food and body image issues fit into the larger picture. My office is a not a one stop shop for a meal plan.
  2. I look for the meaning and symbolism in their food and body issues. That teaches me all about what struggles lurk beneath the symptoms and helps us discover genuine solutions. Attempts to fix oneself through food and body projects can never resolve the deeper pain that lies at the root.
  3. I work with my clients to help them to connect to their core values. I believe that living out of alignment of your core values is a key source of pain and suffering. And living a life that lines up with your core values, even when crappy things happen, brings contentment and peace. In fact, I talked about this in my interview with Fiona Sutherland on her podcast “The Mindful Dietitian.” In that episode, I share a lot about my own relationship to mindfulness, how I went from skeptic to believer, how mindfulness has helped me in my personal and professional lives, and how it relates to self-compassion.

Another key to component I discussed in that episode is the importance of completing a values-based inventory. And today, I’d like to invite you complete one! It may feel a little challenging but I can promise you, it’s totally worth getting to know yourself better.

Step 1: Review a list of values. Below is an example but you can also google “list of values*” to find one that you like!

Step 2: Choose your top 10 values and write them down.

Step 3: Narrow the list to your top 5 values.

Step 4: I know this is painful, but narrow it down again to your top 3 values.

Now that you have your top 3 values I’d like to invite you to ask yourself “when it comes to my relationships (including food, body, exercise, friendships, work, money) where am I in alignment? And where am I out of alignment?”

And if you are feeling brave, head on over to facebook.com/marciRD and share one of your top values and one specific way you’d like to live more in alignment with that core value.

Since we’re all in this together, I’ll go first. Click over to Facebook for the conversation. Hope to see you there!

 

 

 

 

*Source: https://personalmasterycoaching.wordpress.com/2015/04/19/values/


 

Motherless on Mother’s Day

  • posted by Marci Evans
  • Saturday, May 13, 2017

For some, Mother’s Day is a joyful time. For other’s, it can be quite painful. For those of you who fall into the latter category, this blog post is for you. With honesty and bravery, one of my client’s shares her story as well as 6 tips for getting through the weekend. I know you’ll enjoy this one as much as I did. Big thank you to the author for allowing me to share this on my site.

Question: What are ways that you take care of yourself during difficult times?

Here’s the blog. Enjoy.

 On the Friday that I was officially diagnosed with an eating disorder, my mother had her first seizure. That weekend she was diagnosed with a brain tumor, the following Monday she had brain surgery, and that night we were told that her cancer was terminal.

As my mother’s illness progressed, so did mine. As she grew sicker, I grew more symptomatic; my eating disorder became a protective factor against my mother’s illness. If I was focused on destroying myself, I was less vulnerable to the feelings evoked by watching the cancer destroy my mother and my best friend. I was wracked with guilt for “making” myself sick when my mother was fighting a real illness; years later, I have come to a less black and white way of thinking about this. I wasn’t making myself sick; I had an illness that I couldn’t control and that I didn’t choose. In a lot of ways, my illness served a purpose; to numb feelings, to distract from my mother’s pain, to battle feelings of guilt and shame, and to quiet the voice in my mind telling me that I was not enough. In some ways, I felt that I should be the one to die and not my mom.

This summer, it will be fifteen years since my mother’s death. The pain has changed but it has not gone away. The pain of losing one’s mother never does. There are times that it comes upon me in waves; holidays, the anniversary of her death, the birth of my own son, other instances of grief and loss, and, of course, Mother’s Day.

Scrolling though my Facebook feed over the past couple of days, I have seen many, many posts on Mother’s Day. NEDA has had a few of their own, asking how people’s mothers have been helpful in their recovery. These posts always cause a pang inside of me. Thoughts of “I wish I had a mother”, “I wish my mother had been there to help me through recovery”, and “It’s not fair that my mother is gone” spiral through my mind. I know there must be others out there dealing with the pain and loss that is triggered on this special day, and I wanted to post some ways that I have used in the past and will use this year in order to cope while motherless on Mother’s Day.

  1. Step Away from Social Media
    This year, on Mother’s Day, I will delete my Facebook and Instagram apps from my phone and will not log in through the Internet. For me, this is a self-care decision. My feed is bound to be full of pictures of people with their mothers, of tributes to amazing moms, and of people feeling blessed and lucky to have their mothers in their lives. I honestly don’t begrudge people who are lucky enough to have their mothers with them, and I think it’s beautiful that there are tributes on social media. However, I do not need to see them on a day that is already quite painful. It only serves to bring to light my own issues of grief and loss.

  2. Do Something to Honor Your Mom
    This will look different for everyone. For me, it’s often been taking day trips to places my mother loved. It has also been looking through the photo album I put together after she died, writing her a letter, and visiting her grave. Perhaps you could do something that the two of you liked to do together; shopping, visiting a garden, taking a walk, or going to a coffee shop. The important thing is that you are honoring her memory by doing something that she loved, and taking care of yourself by cherishing the happy moments you had with your mom.

  3. Nourish Yourself
    It might be tempting to restrict on Mother’s Day. It always is for me. Sometimes, the emotions dampen my appetite; other times, I want to restrict to numb those very emotions. It is important to follow your meal plan or to eat intuitively on Mother’s Day in order to heal both your body and your mind. Even though it might feel right in the moment, restricting or otherwise engaging in eating disordered behavior will only make you feel worse in the long run. Take care of yourself the way your mother would have taken care of you. Pretend you are a child dealing with something difficult; you would want to nourish that child with food that will give them the physical and emotional energy to get through a difficult day.

  4. Have Self-Compassion
    For me, reading authors such as Pema Chodon, Tara Brach, and Kristen Neff has been very healing and helpful in developing self-love and compassion. I am currently reading Kristen Neff’s “Self Compassion” and would recommend it to everyone struggling with an eating disorder, depression, or anxiety, as well as anyone who experiences negative self-talk. Neff recommends that in moments of suffering, one can repeat a mantra: “This is a moment of suffering. Suffering is a part of life. May I show myself kindness in this moment? I am deserving of self-compassion.” Sometimes, when I feel sad, I turn that sadness into other emotions; guilt, self-hate, anger, insecurity. This Mother’s Day, I plan to talk to myself as I would a young child who I care about very much. “Honey, you’re feeling sad. It’s okay to feel sad. You have a sad situation; your mother passed away, and it’s a day to celebrate mothers, and you feel lost and alone. However, you are not alone. There are people around you who love and care about you very much. It’s okay to feel sad. This is sad.”

  5. Reach Out
    I am lucky enough to have an amazing treatment team who provided extra support this week, through appointments, notes in my journal, voicemail messages, and even an extra appointment on Mother’s Day. I know that this is not possible in every situation, but it doesn’t hurt to ask for support in whatever form you find most helpful. You can also reach out to trusted family or friends. Ask for what you need.

  6. Celebrate Yourself
    If you are a mom yourself, remember that this is your day, too! It is not only a day of remembrance and perhaps grief, but also a day of celebration for all you do as a mom. I am a single mom of a young child, so it really is up to me to plan my own celebration! This year, my son and I will be going out to lunch and picking out a bouquet of flowers to brighten up my bedroom. I also hired a babysitter so I could take a few hours to myself, to get a pedicure or go to the bookstore to read. Find something you love to do and go out and do it! Today is not just about your loss; it’s also about celebrating all you have done to be a great mom to your children.

Mother’s Day can be a hard day for many, especially those who have lost a mother. It is important that, on this day, we do our very best to take care of ourselves. Treat yourself like you would your five year-old self; with nurturance, compassion, and love.

Dietitians: Are you Ready for the EDRDpro Symposium?

  • posted by Marci Evans
  • Wednesday, March 22, 2017

Yes, the EDRDpro Symposium is the only international, web-based eating disorder conference for nutritionists, therapists, and students.

Have you ever had the chance to participate in something that makes you giddy with excitement?? That’s exactly how I feel about the upcoming #EDRDpro Symposium - a 4 day online symposium with 15 eating disorder experts. How lucky am I to be included??

Whether you are a dietitian or not, I invite you to seriously consider registering for this event. There is an amazing lineup of experts on the topics of eating disorders and body image for this incredible 4-day event. The range of topics is multi-faceted and timely: building your brand, working with athletes, mastering the media, how to move away from a weight-centric treatment focus, exercise in recovery, raising healthy eaters, and so much more!

Many of you have asked for more information on my most recent venture - the complicated mix of digestive disorders and eating disorders. At the #EDRDpro Symposium I will be speaking on “The Gut Microbiome, Digestive Health, and the Eating Disorder Client.” I’ll be providing attendees with “my Top 10 Tips for Supporting Digestive Well-Being” in a user-friendly handout, along with an in-depth presentation which covers the most up to date research. I can’t wait to share it with you!

edrdpro symposiumYou may be wondering how I developed such a passion for speaking on digestive well-being, specifically for the eating disorder client. I can sum it up in a few bullet points:

  • Childhood gastrointestinal (GI) issues are among the top 10 risk factors for the development of an eating disorder
  • Up to 98% of clients with an eating disorder also struggle with some sort of GI issue. I care because it’s affecting so many people and very few know how to deal with both issues simultaneously.
  • Ongoing GI issues takes a toll on emotional well-being, body image, and the length of time it takes to recover from an eating disorder

The amazing thing is that there are so many solutions to improving gut health AND eating disorder recovery. And I want more people to know about it.

Here are more of the details on this event:

Early-Bird Registration is March 20th-27th and the cost is $299

Prices increase to $399 after March 27th (which is still a steal in my book!)

With registration you get:

  • 15 webinars available to you to watch at your own pace
  • 15 hours of CPE credits
  • Bonus videos and tips
  • Resources and tools to use in your practice
  • Expert insight
  • Private Facebook group just for participants to ask questions, build communities, and interact with the expert contributors during the symposium.

I hope to see you there! Remember to register early

 

Digestive Disorders and Eating Disorders: A Complicated Mix

  • posted by Marci Evans
  • Monday, March 06, 2017

Several years into my work as a nutrition therapist I found myself really grappling with a clinical dilemma. Many of my clients were not only suffering from an eating disorder but they were also suffering from pretty severe digestive issues. And these digestive issues were not only complicating their recovery but they were seriously impacting my clients’ quality of life. In fact, many clients who had made tremendous strides in their eating disorder recovery were suffering with digestive symptoms that other clinicians had promised would go away once they got better from their ED.

So I delved into the research, participated in a year long integrative nutrition therapy training, exchanged supervision with colleagues who specialize in digestive health, attended workshops, and I thought A LOT. In fact, I want to make a big shout out to my friend and colleague Lauren Dear who is an amazing digestive health dietitian and has taught me so much. (Sidebar: I have the honor to speak with Lauren at three upcoming conferences. See below!)

All of this study (and continued study!) led to a series of talks on the intersection of EDs and digestive disorders that I have and will be giving in 2017. And with enthusiasm, I’m writing to let you know that I am also in the process of developing an online self-study course on the topic. I will have it ready this spring and can’t wait to share it with you. I believe in my heart it will help you feel more capable in helping your clients heal. Below I’ll provide links with upcoming places I’ll be speaking on this important topic. But for now, I’d like to share some juicy tidbits!

Critical Research Nuggets:
  • Up to 98% of clients with eating disorders have a functional gut disorder (FGD) (Note: FGDs are things like Irritable Bowel Syndrome, gatric reflux, bloating, constipation, and diarrhea (to name a few).
  • People who suffer from FGDs and EDs share the same underlying mental health challenges- namely anxiety and depressive disorders
  • These mental health challenges can lead to digestive symptoms that can perpetuate long after the ED symptoms have resolved
  • EDs can actually cause FGDs and FGDs can make a person vulnerable to the development of an ED. This means it is BOTH the chicken and the egg.
  • Childhood GI issues are a key risk factor for the later development of an ED
  • Both EDs and FGDs negatively impact body image. A person who suffers from both has a double whammy to contend with!
  • Anorexia Nervosa changes the gut microbiome by deceasing bacterial diversity. Lower numbers of bacterial diversity are associated with greater levels of eating disorder psychopathology.
Specific Concerns for the ED Population
Traditionally, medical providers and dietitians have encouraged an elimination diet of some kind to treat these enduring and often puzzling symptoms. However, eliminating foods is really the opposite of the goal of nutrition therapy for EDs. Restriction, even if medically indicated, complicates ED recovery. In my personal experience, I have seen well-intended clients/practitioners advocate for an elimination protocol that has led to full blown relapse. So what are we to do as clinicians who feel desperate to help our clients fully recover and treat any concomitant digestive health concerns? I have a few take home points for you to consider.

Key Take Home Messaging

 There are many non-harmful interventions to try with clients.

  1. Most if not all behavioral interventions that support ED recovery will also support digestive health. Root out remaining ED behaviors as most will reinforce negative GI symptoms.
  2. Sensitive systems require CONSISTENCY & BALANCE.
  3. A stressed out person will likely have a stressed out gut. Help clients embrace hypnotherapy, meditation, deep breathing, guided relaxation. The relationship between head brain and gut brain is REAL!
  4. Food variety improves the gut microbiome and is a key ingredient to ED recovery.
  5. The goal is to include as many foods as possible for mental, emotional, and psychological well-being.
  6. Integrate the use of digestive enzymes, probiotics, and well-researched supplements to help manage symptoms.
  7. Fuel healthy bacteria by integrating fermented foods and drinks.
  8. Incorporate a stool or squatty potty for more anatomically supported elimination (ie the squat position makes it way easier to poop!).
  9. Eliminate “diet foods” as they contain a lot of additives that worsen digestive symptoms and are often a culprit in the ED
  10. Play with changing the texture of foods rather than eliminating them all together
One Last Request
Clinicians, please stop telling your clients that all of their GI problems will resolve by eliminating ED behaviors and enduring the refeeding process. While this may be true for some clients and for some symptoms, the research is quite clear that this is often not the case! But the good news is that with a varied and creative toolbox, it’s possible to support ED recovery and improve your client’s digestive well-being.

Upcoming Talks

MEDA’s National Conference- March 11th, co-presenting with Lauren Dear
ANCE- The Massachusetts Dietetic Association’s Annual Conference- March 31st, co-presenting with Lauren Dear
EDPRO Online Symposium- April 28th-May 2nd (early bird registration opens March 20th!)
iaedp Online Live Webinar- August 10th, co-presenting with Lauren Dear

 

Selected Citations
Abraham, S., & Kellow, J. (2011). Exploring eating disorder quality of life and functional gastrointestinal disorders among eating disorder patients. Journal of Psychosomatic Research, 70(4), 372–377.
Boyd, C., Abraham, S., & Kellow, J. (2010). Appearance and disappearance of functional gastrointestinal disorders in patients with eating disorders. Neurogastroenterology and Motility, 22(12), 1279–1283.
Janssen, P. (2010). Can eating disorders cause functional gastrointestinal disorders? P. Janssen Eating and functional gastrointestinal disorders. Neurogastroenterology & Motility, 22(12), 1267–1269.
Kleiman, S. C., Watson, H. J., Bulik-Sullivan, E. C., Huh, E. Y., Tarantino, L. M., Bulik, C. M., & Carroll, I. M. (2015). The Intestinal Microbiota in Acute Anorexia Nervosa and During Renourishment: Relationship to Depression, Anxiety, and Eating Disorder Psychopathology. Psychosomatic Medicine, 77(9), 969–981.
Peters, SL. (2016). Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. Sep;44(5):447-59.
Sato, Y., & Fukuco S. (2015). Gastrointestinal symptoms and disorders in patients with eating disorders. Clin J Gastroenterol, Oct;8(5):255-63.
Surdea-Blaga, T., Baban, A., Nedelcu, L., Dumitrascu, D. (2016). Psychological interventions for irritable bowel syndrome. Journal of Gastrointestinal and Liver Diseases, 25(3).
Voci, S. C., & Cramer, K. M. (2009). Gender-related traits, quality of life, and psychological adjustment among women with irritable bowel syndrome. Quality of Life Research, 18(9), 1169–1176.