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By: Jennifer Rollin, LCSW-C, Therapist & Founder of The Eating Disorder Center  As someone who is pregnant, I've been going to a lot of doctor's appointments lately. They commonly ask about the history of medical issues in my family. However, not once has someone asked me if I have a history of struggling with an eating disorder. Additionally, a few times they have made diet culture comments in my appointments that have the potential to be triggering to people actively struggling with an eating disorder or who have a history of suffering from an eating disorder. I do not find myself feeling triggered by these comments at this point as someone who is recovered from an eating disorder, but I experience them as frustrating. I also want to acknowledge that I have straight-sized privilege, so I know I am getting far less comments than many folks in larger bodies face at the doctors office. I have pictured people actively struggling with eating disorders having to face these same comments from medical professionals and that fills me with concern. Now, I don’t say this to scare people away from going to the doctor. Medical monitoring during eating disorder recovery is important and I have been able to connect and collaborate with some wonderful eating disorder informed doctors. However, there are not enough doctors who are informed about eating disorders and I believe that the consequences can be dire. It’s important to learn how to advocate for yourself at the doctor’s office, as you deserve access to medical care. While no one should have to become their own advocate to receive quality medical care, unfortunately this is often needed. The following are some tips for coping at the doctors when you are in eating disorder recovery. Tips for Coping at the Doctors in Eating Disorder Recovery: 1. Advocate for Blind Weights (Or Skipping the Scale) at the Doctor’s Office. It’s your right as a patient to request blind weight checks, where the number isn’t disclosed to you, or to stand on the scale backward during appointments. While some doctors may not be familiar with this request, it’s crucial to communicate your needs. Additionally, you are also able to deny stepping on the scale entirely. Some nurses may give pushback, so come up with a plan with your eating disorder therapist regarding how you will handle that. You may also find that the weight is included in the patient portal, so preparing a plan for how to handle this (or try to avoid it) in advance can be helpful. If asking for blind weights or avoiding the scale entirely feels intimidating, consider asking your therapist for a note to support you in this request. At The Eating Disorder Center, our therapists are always ready to advocate for our clients. 2. Practice Setting Boundaries. It’s important to note that this is entirely up to your personal comfort level if you share with your doctor that you have an eating disorder. Of course you do not have to disclose your mental health status or history to anyone, if you do not wish to do so. However, it might be helpful to practice setting boundaries at the doctor’s office by sharing things like, “I’m in recovery from an eating disorder, so please do not make comments on my weight or talk to me about food choices.” Of course, we cannot control if others respect our boundaries. However, it’s great practice in standing up for ourselves and becoming our own advocates! Additionally, if you are finding that you are voicing boundaries and a doctor is not respecting them, that is likely a sign that you’d benefit from finding another medical professional (if you are able to access someone else). 3. Create a Cope Ahead Plan With Your Therapist. In Dialectical Behavioral Therapy, we use a skill called a cope ahead plan. This is where you start to explore potential triggers, coping strategies, your support system, and coping statements that you can use when you anticipate that you’ll be in a difficult situation. Having a plan in advance for how you will cope if a doctor’s appointment ends up being triggering can help to instill confidence. You Deserve to Advocate for Yourself at the Doctors! I know it can be hard to find eating disorder informed and compassionate providers. However, I just want to remind you that you deserve to feel safe enough with your providers. If your doctor is not respecting boundaries, is engaging in unhelpful diet or weight related talk, or you are not feeling that they are not empathetic towards you, you are well within your right to find a different provider (if you are able to access one). Your mental health is a crucial part of your overall health and finding providers who are compassionate and knowledgeable is important. Schedule a free 15 min consult for eating disorder therapy in MD, VA, DC, NY, FL, PA, or recovery coaching worldwide. Click here. The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington D.C. We also provide eating disorder therapy in Arlington, Virginia and virtually throughout Virginia. Additionally, we offer eating disorder therapy virtually in New York (NYC), Florida, Pennsylvania, and California. We provide eating disorder and EMDR trauma therapy in Rockville, Maryland and virtually throughout Maryland. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com
By Jennifer Rollin, MSW, LCSW-C  She has just finished dinner when the urges begin. It feels like the food in the pantry is calling to her. All she can think about is the package of Oreos, the peanut butter and bread, and the chips. She wants nothing more than to get lost in the cycle of eating. To numb out and to feel that initial pleasure as she washes down a package of Oreos with gallon of milk. But part of her doesn’t want to do this again. She wants nothing more than to be able to stop this terrible cycle. It's so exhausting. And she's always filled with shame and guilt after a binge. Yet, she doesn’t know how to cope with these intense urges. The following are a few of my tips for what to do when you feel urges to binge eat. The PAUSE Skill I developed a skill that people can use, which is called The PAUSE Skill. 1. Pause. Take a moment to pause at the first sign of when you feel the urge coming on. and then take a deep breath. Tell yourself that if you still want to binge after using this skill, you can-but first you are going to try this practice. 2. Allow space. Remove yourself from the kitchen (or whatever environment is triggering the urge, if you can) and go somewhere where you can sit down. Tell yourself that you are not trying to stop the binge, rather you are just practicing delaying action for right now. Ask yourself if you are feeling physically hungry. If so, choose to sit down and to eat something mindfully (ask yourself what taste, temperature, and texture of food you are craving and try to find a good match). If you are not physically hungry, continue with the rest of the skill. 3. Use other coping strategies and coping statements. Figure out what works best for you. Trying to process your emotions in the moment, might not be your best course of action (this would likely be better served at a time when you are not highly triggered to want to binge i.e maybe in therapy or in the morning). When urges are intense, I recommend choosing 5-10 distraction coping strategies that you can do for at least 10 minutes each. You can also tell yourself some coping statements. Here are a few that I particularly like:
4. Separate your “eating disorder self,” thoughts, and urges. Start to notice the things that your “eating disorder self” is telling you and then practice responding from “your true self.” Your “eating disorder self” will always come up with reasons for you to binge eat. Think about what you would tell a friend in a similar situation. Remind yourself that just because you have an urge does not mean that you need to act on it. With practice, you can learn how to sit with and ride out the urges that you experience. Urges typically will naturally diminish on their own. Remind yourself of how you usually feel after a binge episode. Bingeing gives a temporary high or feeling of “comfort” or respite from long-term distress and unhappiness. Typically, people feel physically and mentally terrible after a binge episode. 5. Enlist help from a supportive person. Practice reaching out to supportive people instead of turning towards your eating disorder, even if it’s just to talk to someone as a means of distraction. Reaching out for support can bring your “true self” to the forefront. It’s also so important to practice being kind to yourself. Recognize that you are using bingeing either as a response to physical or emotional deprivation (i.e., you aren’t eating enough throughout the day, you are eating things yet feeling guilty about them, or you are avoiding certain foods), and/or to cope with uncomfortable or unpleasant emotions. You can also remind yourself that you are not saying that you must give up bingeing forever. You can always go back to it. However, try to take it one day (even one moment) at a time. What if you tried something different this time? Recovery Is Possible If you do end up bingeing after taking these steps, it’s important to be compassionate with yourself. You are not alone in struggling with this and you are not simply “lacking willpower.” You are struggling with something that no one would choose. It’s also important that you don’t do anything to try to “compensate” for the binge, as this will only keep the binge/restrict cycle going. Additionally, bingeing is often a resilient response to emotional distress, past trauma, and feelings of low self-worth. You are trying to 'help yourself,' and it might even feel helpful in the short term, however in the long-term bingeing is likely not serving you. If you could ride out the urge even for a little bit, this shows that you were practicing an important skill and with time (and additional support) you can learn how to ride out the urge completely. If you have outlasted the urge to binge completely, take a moment to recognize and acknowledge this. Ultimately, you deserve a meaningful and joyful life. No matter what you may be telling yourself, finding freedom from bingeing is possible. I’ve worked with many people who were able to fully recover from their eating disorders. Full recovery is completely possible. Yes, for you too. Want help for binge eating? Book your free 15 minute consult for therapy or coaching. Sign up for my training on Finding Freedom From Binge Eating. The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We also offer therapy for obsessive compulsive disorder. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington D.C. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com |
The Eating Disorder CenterWe are a premier outpatient eating disorder therapy center in Rockville, Maryland.
We also provide eating disorder recovery coaching to people worldwide via Zoom. Click here to book your free 15 minute phone consultation! Phone: 301-246-6856 Email: [email protected] Archives
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