Lent: Supporting or Derailing Your Health?

  • posted by Marci Anderson Evans
  • Friday, March 27, 2015

This post is written by Sarah Patten, a registered dietitian nutritionist with Marci RD.

I hesitate to type these words for fear of jinxing what I'm about to say, but after being pummeled with blizzards for the past few months and experiencing the official snowiest winter in Boston's history, it seems as though the worst is over and that there is a hint of spring in the air. The sun feels a bit stronger, the days are a tad longer, and we've had a couple of days now where the temp feels slightly more tolerable. Things are looking up!

With the onset of spring comes thoughts of flowers blooming, birds chirping, and for those who observe – the lent and Easter season. Lent is the Christian season of preparation before Easter. Traditionally, it's a time to reflect prior to the Easter celebration. Not all churches observe Lent, but those that do encourage a period of “fasting, repentance, moderation, and spiritual discipline.” Though it's roots are in spirituality and religion, the forty day period of Lent has somehow transformed in our society for many people to be a time to “give up” or “deprive” oneself of something that they enjoy or feel “indulgent” around. Almost all of us have heard chatter surrounding other's Lent goals – most typically we hear about people giving up chocolate, fried food, junk food, meat, dessert, eating after 6, or maybe even snacking altogether.

How has this religious tradition morphed into an opportunity for us to create even MORE rules around food? For some, this may be a challenge they choose to embrace with the best intentions. But for others, it appears to be more of a guise to diet and restrict their intake in the name of spirituality.
All of these thoughts came to mind after meeting with one of my clients a few weeks ago, just as Lent was beginning. I have been working with this client for quite some time on healing her relationship with food, rejecting the diet mentality, giving herself unconditional permission to eat, and not basing her self worth on the number displayed on her scale. This client has made tremendous positive progress in her relationship with food and has been increasing her focus on improving her body image and the way she talks to herself. It's been a pleasure to watch her evolve along this journey, and I was blown away when she came into our session a few weeks ago reporting that upon hearing all of her friends and coworkers talk about what “bad foods” they were planning to give up for Lent, she decided to put a different spin on this period of reflection. Instead of depriving herself of the foods she enjoys, she decided to give up negative body comments and negative self talk for forty days!

I was truly inspired by hearing these words. How fabulous to spend one's energy devoted to fostering a positive body image and speaking kindly to oneself rather than creating yet another set of temporary food rules. That's not to say this new challenge has been easy. My client has continued to notice these automatic negative thoughts popping up, but with her heightened awareness, she is able to catch them and reframe them much more quickly. Through our weekly sessions since Lent began, I've heard her speak about how much more beneficial it feels to have an encouraging and supportive inner voice rather than a critical and negative internal dialog. She's hopeful that the changes she's made in self talk will remain long past the Easter holiday – a profound shift that couldn't have been accomplished by giving up something like chocolate. Although the season of Lent is approaching it's end, I would encourage all of us to learn from this example. We all deserve to speak kindly to ourselves and our bodies 365 days/year – why not start today?

What goals, for Lent or otherwise, have had a positive impact on your health?

Intuitive Eating, Obesity, Weight, and Dieting

  • posted by Marci Anderson Evans
  • Thursday, March 12, 2015

It's National Nutrition Month and in celebration, I wanted to share some important research about Intuitive Eating, Obesity, Weight, and Dieting. Intuitive Eating shaped my life and my career so it only felt appropriate to bring it to light during National Nutrition Month. Enjoy the vlog! And below I have included the Intuitive Eating Scale-2 by Tracy Tylka to help you determine how strong of an intuitive eater you are as well as the references I used to develop my vlog. Happy and healthy eating!


Intuitive Eating Scale- 2


Directions for Participants


For each item, please circle the answer that best characterizes


your attitudes or behaviors.  For each item, the following response scale should be used: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree.


1. I try to avoid certain foods high in fat, carbohydrates, or calories.


2. I find myself eating when I’m feeling emotional (e.g., anxious, depressed, sad), even when I’m not physically hungry.


3. If I am craving a certain food, I allow myself to have it.


4. I get mad at myself for eating something unhealthy.


5. I find myself eating when I am lonely, even when I’m not physically hungry.


6. I trust my body to tell me when to eat.


7. I trust my body to tell me what to eat.


8. I trust my body to tell me how much to eat.


9. I have forbidden foods that I don’t allow myself to eat.


10. I use food to help me soothe my negative emotions.


11. I find myself eating when I am stressed out, even when I’m not physically hungry.


12. I am able to cope with my negative emotions (e.g., anxiety, sadness) without turning to food for comfort.


13. When I am bored, I do NOT eat just for something to do.


14. When I am lonely, I do NOT turn to food for comfort.


15. I find other ways to cope with stress and anxiety than by eating.


16. I allow myself to eat what food I desire at the moment.


17. I do NOT follow eating rules or dieting plans that dictate what, when, and/or how much to eat.


18. Most of the time, I desire to eat nutritious foods.


19. I mostly eat foods that make my body perform efficiently (well).


20. I mostly eat foods that give my body energy and stamina.


21. I rely on my hunger signals to tell me when to eat.


22. I rely on my fullness (satiety) signals to tell me when to stop eating.


23. I trust my body to tell me when to stop eating.



Scoring Procedure


1. Reverse score Items 1, 2, 4, 5, 9, 10, and 11.


2. Total IES-2 scale score: Add together all items and divide by 23 to create an average score.


3. Unconditional Permission to Eat subscale: Add together Items 1, 3, 4, 9, 16, and 17; divide by 6 to create an average score.


4. Eating for Physical Rather Than Emotional Reasons subscale: Add together Items 2, 5, 10, 11, 12, 13, 14, and 15; divide by 8 to create an average score.


5. Reliance on Hunger and Satiety Cues subscale: Add together Items 6, 7, 8, 21, 22, and 23; divide by 6 to create an average score.


6. Body–Food Choice Congruence subscale: Add together Items 18, 19, and 20; divide by 3 to create an average score.





Herbert BL, Blechert J, Hautzinger M, Matthias E., Herbert C.(2013). Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite, 70(Nov):22–30. 


Tylka TL, & Kroon Van Diest AM. (2013) The Intuitive Eating Scale-2: Item refinement and psychometric evaluation with college women and men. J Couns Psychol. Jan;60(1):137-53. 


Madden C.E., Leong, S.L., Gray A., and Horwath C.C. ( 2012). Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutrition. Mar 23:1-8.


Tylka, Tracy L. Development and psychometric evaluation of a measure of intuitive eating.J Counseling Psych;2006. 53(2), Apr:226-240.


EDAW 2015: The Invisible Eating Disorder

  • posted by Marci Anderson Evans
  • Monday, February 23, 2015

I'm very grateful to a client of mine who agreed to write this post for Eating Disorders Awareness Week. Since this week is all about generating greater understanding and myth busting, I felt that my client's perspective and story was incredibly important to share. It's important because what she has to say is profound and also reflective of how most people live in their eating disorders. While many people believe that an eating disorder is something that is clearly visible, the truth is that most eating disorders are not outwardly obvious. If you came to my office and watched the myriad of clients who come and go, you would see a variety of ages, races, genders, shapes, and sizes. Please take the time to read what it is like for so many sufferers to feel invisible in their illness.

There were years when my eating disorder was very visible. My eyes were wide and hollow, my lips were chapped, my weight was low, my skin was pale.  At the time, I was constantly either being recommended for a higher level or care or actually in a residential treatment center or hospital.  The people in my life knew I was sick.  They were mindful of saying things that might trigger me (even though they still managed a few gems) and continually expressed their care and concern. 

Fast forward to 2015.  After a final bout of residential treatment in 2010, I am in a stronger place, certainly, in my recovery.  Pregnancy, although a tenuous time, solidified my commitment to living in a way in which my behaviors are aligned to my values.  After I had my beautiful son in 2013, a glow returned to my skin.  A light returned to my eyes.  I smiled again.  I felt joy.  And I gained weight.  Is it painful?  Yes.  Would I do it again?  Absolutely.

I had my eating disorder for 15 years.  I’ve been at a healthy, average weight for about 2 years.  And in those two years, my eating disorder has become invisible.  To friends and family, I am recovered.  To them, it seems, recovery is a magical process in which all suffering, mental and physical, is erased with a healthy weight and outwardly “normal” eating habits.  It is like those fifteen years of my life never existed. 

In some ways it is a relief to be seen, once again, as the person who has it all together.  But then, wasn’t that what led to the development of the eating disorder in the first place? It’s confusing to be seen as someone who is so strong when the vulnerabilities that led to the eating disorder are still there and are still being addressed in outpatient treatment.

A family member of mine often asks me, “Why do you still see those people,” meaning my therapist and nutritionist.  If I were to be honest, I would say that the underlying issues still remain, despite being at a normal weight.  My intense need for acceptance, my low sense of self-worth, my shame around food and my body, my issues of grief, loss, and abandonment, and all of the other myriad factors contributing to my anorexia still remain despite the fact that I eat and that I appear healthy.  But instead, I just say, “Because they help.” 

I wonder about being honest with my family and friends about where I am in my recovery.  What holds me back?  I am afraid that they won’t believe that I am still suffering, because I don’t feel like I deserve to suffer if my outside doesn’t match my inside.  I worry that my words won’t be enough.  I worry that if I said how much I am hurting inside, I would let people down.  I worry that I am not worthy of care or even of treatment because I’m so much “better” than I used to be. 

One thing I am learning in recovery is that I don’t have to share my story, my most vulnerable self, with the world. I don’t have to wear my pain like armor. I can use my words to express my pain to those few I can trust with my most authentic self. It took a long time for me to be able to put words to my experience, and I am learning that those words are precious. In many ways, it is much easier for me to use my body to express that I have a need; a need to be cared for, loved, accepted, valued, treasured. Using my words is much harder, but in the end, a far more effective way of communicating.

A Love Letter to Me

  • posted by Marci Anderson Evans
  • Saturday, February 14, 2015

Happy Valentine's Day! I love having any excuse for celebrating. And Valentine's Day, which may be a reminder to some of you of your single status, is really all about love. And the MOST important love you can have is love for yourself. While it may sound cheezy, why not honor today by writing yourself a note of love. 

Or perhaps better yet, get involved with the Dear She campaign. I just learned about this yesterday and was so excited to pass it along. Here's an excerpt from the Dear She Website:

"Dear She was created for women and girls of all ages to help deal with matters of body image and self confidence. Dear She utilizes the therapeutic qualities of writing as a form of self expression by writing anonymous love letters to the self. You can write us a letter in the share section! Tell us anything you want, anything you want to get off your chest, it’s safe with us. You can also send us a tweet, an image of a drawing, a Facebook message, or anything that helps you work through a struggle that so many women face. These “letters” as we like to call them, will be collected into a book that you can view and purchase here on our site. Collecting the letters together, in whatever format they come in, will help create a sense of community. Readers will be able to experience the stories of women from all different walks of life, with different perspectives on the same topic. This community is brought even closer together by our blog. There you can see what we’re up to here at Dear She, check out Letters of the Week, project updates, and other neat stuff! Dear She is a safe space to express yourself, seek comfort, and love yourself."

If you don't end up writing yourself a note, I hope you'll do something to show yourself a little love today. I plan to take an afternoon nap which is something I love but rarely have time for. What will you be doing get a little love fest going on?

Fat Fashion Part 3 & Marci's Musings

  • posted by Marci Anderson Evans
  • Monday, February 02, 2015

Picture Source

I’m excited to share with you the final post in my series on larger lady fashion. While the first to posts were quite practical, this one provides you with some excellent points to ponder as well as some handy tips. Her writing is in response to the New York Times Article Plus-Sized Fashion Moves Beyond the Muumuu. Enjoy and feel free to share your own thoughts! 

While reading this article, several things stood out for me, like the usual "ooh, a designer used a plus-size/curvy model!" who turns out to be size 10! But the part I'm still processing is the suggestion that larger women subscribe to clothing rental services (WHAT??) because high-end designers believe that "When you’re taught to look at your body as a work in progress, you’re not going to spend $1,000 on a coat to last forever because you’re not hoping for it to last forever." We've been talking about this for a year! This is precisely what self-acceptance is not. The very thought of women renting clothes, as though their bodies are some sort of extended-stay hotels they don't really live in but are just passing through! I may need to write a letter to the editor about this....

One really good point the article makes is that "there's no Vogue for the plus-sized." This is what troubles me the most about plus-size fashion. There was a gorgeous, short-lived magazine years ago called Mode. Most of the clothes were very expensive (e.g., Marina Rinaldi, Anna Scholz) but beautiful and edgy. And the models were stunning and photographed like high-fashion models, not cheesy catalog posing. It was a revelation, that there could be such a beautiful, high-quality, high-end magazine for plus-size women. Everything about it was fine: the photography, the copy, the paper, the ads. My heart broke when through several editors and then finally went out of print.

Which brings me, I guess, to why it's been so hard to think of plus-size blogs to recommend. Most of them don't inspire me; my style is changing, but it is nothing like what most of the bloggers like, especially the younger ones. A lot of it looks cheap and disposable. The best two I've found are Stephanie Zwicky's Blog and And I Get Dressed, but what I really love are the French "street style" blogs and posts I find on google or Pinterest. I've always gone for "investment" clothes--buying a few well-made, classic versatile pieces I can mix or match and wear for years (as in decades, sometimes, like my winter coat and a few sweaters). My best style revelation happened in the mid-1990s when I lived in London and needed an outfit to wear as my friend's "best ma'am." I went to Liberty and met an amazing sales assistant named Nora (or Norma). We hit it off because she had family in NY and she was of West Indian descent. She introduced me to designers like Issey Miyake and Shirin Guild, whose clothes were sculptural and inventive--they suited me perfectly and made me feel beautiful and chic. Liberty's women's department isn't large but it's amazingly curated--clothes as works of art, dressing as adornment and self-expression, not trendy and also not particularly youthful (I was always the youngest and poorest woman there). I couldn't and wouldn't wear most of the clothes, but I learned a lot just spending time looking around and studying the clothes and how they were put together on the manequins--and also studying the other shoppers' style and confidence.

The Nordstrom website has a huge, excellent plus-size section with very good sales (over the holidays I cleaned up on some Eileen Fisher sweaters). Ebay is also really good. I can't afford paying retail for Issey Miyake, but a lot of his stuff is available practically new from Japanese sellers. His Pleats Please line is amazing--stretchy, comfortable, and colorful (though there are plenty of neutrals, too).

One issue that I've been thinking about over the past week or so is internalized self-hatred--and whether that's part of my not liking most of the plus-size blogs. I'll look at them and think, oh god, do I look like THAT? And I hate that in me.... Much to discuss, I guess....

I hope this series has each of you thinking about your own relationship to your bodies- how you treat them, how you invest in them, and how they do or do not reflect your own feelings of worthiness. I hope this evolves into a meaningful thought experiment for each of you. Clothing and fashion is incredibly personal. For some it matters very little. And for others, it is a representation of how you feel about yourself. At the end of the day, each of you are deserving of self-love. And how you choose to make the manifest in your life is a journey I how you will embark on thoughtfully.