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Ashley Solomon, Psy.D is a psychologist who specializes in the treatment of eating disorders, body image, trauma, and serious mental illness.

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Tag: media literacy

10 Feb

How Our Current Approach to “Health” is Failing Our Children

Ideas to Consider No Comments by Ashley @ Nourishing the Soul

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In a paper published this fall in the journal Pediatrics, Drs.

Leslie Sim, Jocelyn Lebow, and Marcie Billings from the Mayo Clinic share two harrowing stories of teenagers who initially met criteria for through various attempts at weight loss developed eating disorders.

And lest you think these were case studies highlighted for their uniqueness, they were not. In fact, the authors point out that over 45% of the adolescent patients that present to their clinic have a history of obesity. The fact that eating disorders can flourish in the context of obesity — and perhaps, obesity intervention — is nothing new, particularly to those of who treat these young people.

Take “Kristin,” the 18-year-old who presented to the study authors’ clinic with an eating disorder. She had been told she was obese at 12-years-old and provided what is all too common for youth of higher body weights — a prescription by her doctor to focus on healthy eating and exercise. Kristin’s weight continued to climb, however, until age 14, at which point she reduced her caloric intake and began running many miles per day. Her weight began to fall, and with it Kristin stopped menstruating, became dizzy, and had difficulties with blood pressure while standing.

When she returned to her doctor, she was simply given birth control pills to address the loss of her period and told to drink more water. Over the next few years, Kristin continued to present with serious issues and lose more weight, all of which was by and large ignored by her various providers, who included her PCP, a sports medicine physician, and even a nutritionist. When her mother expressed to her doctor that she feared Kristin may have an eating disorder, the doctor pointed to her “normal BMI” and dismissed the concern.

We are failing our children.

The current emphasis – obsession – with BMI and weight reduction has locked our culture into a vicious paradigm in which losing weight is the holy grail and the health consequences are simply the price we pay.

It’s not just physicians who are to blame — not hardly: it’s public health advocates who get on soapboxes demonizing fat; it’s state legislators who push for penalizing people for being at what is often their genetically predetermined weight range; it’s school districts who put BMI on report cards; it’s states who think that campaigns like this one could possible be effective. But it’s not all just “them” either. It’s the little things the we do as well — the fat talking we do, the beauty privilege (and thin privilege) some enjoy, the media we support with our hard-earned money.

So how do support our youth in developing health and wellness without sending them spiraling into self-doubt, shame, and disordered eating?

Kathy Kater, LCSW has been working on this issue for several decades. She says, “Children who are anxious about weight begin to view their bodies from the outside-in—objectifying and judging themselves harshly according to external standards.” She’s figured out that the answer is not in addressing BMI or setting up systems of “punishment” for kids.

Instead, it’s about creating healthy kids and communities by teaching kids to connect with their bodies in new ways, challenge weight stigma, embrace healthy approaches to food and activity, and develop positive role models. Her Healthy Bodies curriculum has helped countless kids develop a more grounded perspective on their health. And it’s not just for overweight or obese kids — it’s for all kids.

It might not feel satisfying to some who are still in “panic mode” and arming up for the “war” on obesity. It doesn’t call for weight control or hyper-vigilance about Hershey Kisses. What is does is promote a balanced state of health, one that can be sustainable and non-stigmatizing.

To learn more about Kathy Kater’s work, the Healthy Bodies Curriculum, and how you can help be an agent of change towards health in your family or community, join me as I co-moderate a fun AED TweetChat with Kathy on Friday, February 14th at 1:00pm EST: Connecting Bodies with Hearts: Teaching Kids To Care, Not Compare.

What are you seeing in your community or personal experience? How is the approach to weight and health impacting the kids you know? 

09 Feb

Why The Biggest Loser is Dangerous (and has nothing to do with Rachel…)

Advocacy 2 Comments by Ashley @ Nourishing the Soul

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There’s a delicate balance in discussing the case of The Biggest Loser contestant Rachel Frederickson’s extreme weight loss. Commentators around the country — world? — run the risk of focusing too much on Rachel herself and the 155 pounds that she shed to be crowned the TBL champion. Around the internet this week we’ve been bombarded with claims that Rachel is “anorexic,” “has an eating disorder,” or is, “disgusting.”

I’m always curious when I hear the popular media report that someone is “anorexic.” I wonder when the “anorexic” person sat in that journalist’s office and reviewed the DSM-5 criteria, and where exactly they received their graduate degree in psychopathology. You get my drift… The fact is that assigning who has and eating disorder and who does not based on physical appearance is a dangerous practice. It’s harmful not only to those individuals being diagnosed, but to everyone with eating disorders.

Unfortunately, many of the writers who have addressed the TBL finale have fallen into the trap of trying to diagnose Rachel. The real issue, though, is The Biggest Loser itself. It makes me sad and frustrated that it took Rachel’s win to shine a spotlight on the freak show that is this competition. (It wasn’t bad enough, apparently, that they put their abhorrent antics to adolescents last year…)

We’ve be hearing for years that The Biggest Loser promotes extraordinarily dangerous weight-loss practices.  Contestants have reported exercising working out (for eight hours per day in some cases) while significantly injured, prohibited from consuming doctor-prescribed substances, and eating far below even the minimum amount of calories to sustain a person. Worse, contestants have reported that they were treated as sub-human, humiliated and shamed throughout the competition (go read Golda Poretsky’s expose — parts I, II, and III — now if you want more gut-wrenching details).

As angered as I am about what I consider to be human rights violations on the part of the TBL machine, what makes me most angry about the whole enterprise is the fact that they are duping the American public. They are systematically lying to the masses and the result is weight stigma and the promotion of unhealthy behaviors. The lies range from telling the public that a contestant lost X number of pounds in a “week” when it is anywhere from 5 to 14 days (and thus setting up dangerous and unrealistic expectations for home weight loss) to claiming the contestants are given a stabilizing  network of support, which is then pulled out dramatically when the cameras are turned off, according to a former trainer.

The show touts health, wellness, and the just how HAPPY you’ll feel when you’re THIN! But what’s behind the curtain is something much darker. Like most of the media, TBL is an enterprise dedicated to ratings and product endorsement. Does Rachel Frederickson’s weight loss concern them? I’m inclined to think not given the show’s history, and would imagine that producers are eating up (no pun intended…) the astronomical attention given to the show since the finale.

So if you’re as disgusted as I am, what is there to do? There are letters to write and petitions to sign, but the most useful thing we can do with our time and energy is to shift our tube time to another program. Don’t get counted in the show’s statistics, even if you’re watching is disgust. Don’t buy into the TBL enterprise with all of their merchandise. And most importantly, don’t get sold the idea that this kind of weight loss is realistic, sustainable, or healthy.

What was your reaction to The Biggest Loser finale? 

03 Feb

Trigger Warning: Are These Warnings Really Helpful?

Ideas to Consider 3 Comments by Ashley @ Nourishing the Soul

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{image credit :: World Bank Photo Collection}

Amanda Marcotte, a writer over at Slate, recently 2013 the “Year of the Trigger Warning.” She points out that trigger warnings have proliferated across the blogosphere in the past year, expanding their reach in the type of sites on which they appear and content from which they attempt to protect readers. Marcotte highlights the outrage that was met by Shonda Rhimes when the show she created, Scandal, failed to provide a warning to viewers of a rape that was depicted on the show. Rhimes eventually acknowledged the purported mistake and tweeted, “I agree that a trigger warning would have been a very good and responsible thing.”

So what’s a trigger warning? While they’ve been used widely in the feminist blogosphere, trigger warnings aren’t particularly common in more mainstream media. They refer to the act of alerting a reader or viewer of material that could be potentially evocative and create distress. They often appear briefly but boldly at the start of a post or other media and list the specific content that might be disturbing to some individuals. Example: [Trigger Warning: Suicide, Rape]

Some suggest that trigger warnings are more common among feminist writers and artists because there is an increased attunement in these communities to the pervasive effects of trauma. The idea, it seems, is that these warnings allow individuals to make more informed and conscious decisions about what they are prepared to ingest. If someone has recently gotten clean from drugs, for instance, they may choose not to read an article with detailed descriptions of substance abuse.

Trigger warnings are all too common in the eating disorder community as well, at least in the community that is recovery-focused. There seems to be an expectation of curtesy among individuals with eating disorders and those who write about them to alert readers if the content could be disturbing or “triggering” to others.

But there remain a couple fundamental issues when it comes to trigger warnings that, to me, feel unresolved.

First, what does the term “trigger” even mean? Is it a noun or verb or both? It strikes me as an interesting word choice that has evolved to have so much meaning. The first definition listed by Merriam Webster for the word “trigger” refers to the lever that one finds on a gun to fire it. I think there’s a bit of irony there in using a word that refers to force and violence when talking about something evoking difficult or unwanted feelings.

The second definition reads, “something that causes something else to happen.” And this is where I struggle with the concept of triggers. From my vantage point, I see the idea of “triggers” referring to things that evoke strong emotions in the “triggered” person. Perhaps other uncomfortable experiences like re-enactments or flashbacks could occur to.

But I often hear the idea of triggers being used to refer to something that, like the definition says, “caused something else to happen.” But the truth is, it takes a multitude of factors for any given behavior or event to happen. Specifically, something that “triggers” one person to engage in self-harm may have no impact on someone else.

The chain events is more complicated than the idea of “triggers” allows. Take eating disorders, for examples. We sometimes use the analogy of eating disorders being like a gun. Genetics shape and mold the gun, the environment loads the gun, and certain events (e.g. bullying, dieting) pull the trigger. But if there was no gun to start with, or if it hadn’t been loaded, pulling the trigger would be impossible or non-eventful.

I personally feel that there may be an over-reliance on this concept. I think it over-simplifies the situation and externalizes the root of the feelings (e.g. “Seeing her eat that pizza triggered me to binge,” rather than considering what you were feeling prior to seeing her eat that, how hungry you were, the availability of binge food, etc.).

Back on the issue of trigger warnings in media, the other issue that is yet unresolved is the very basic question of whether these warnings are actually helpful or effective. For one, I think many people who may be most vulnerable to content (and who could potentially benefit from avoiding reading the post) are often the same people who will read it. This is part because there’s the fact that we are all a little rebellious (who doesn’t at least want to press that button that says not to press it…).

This is also because these are individuals who are emotionally struggling and often in need of support and relating. Personally, whenever I’ve struggled with something difficult, I’ve found myself seeking out stories of others going through the same thing. It made me feel less alone. Misery loves company, after all… So when they come across an article about something they personally have experienced (e.g. death of a friend, physical abuse, miscarriage), they may be more inclined to read it, even if they may be too emotionally vulnerable to do so.

Spending so much time recently turning this idea over and over in my head, I did a review of the research. I figured that that would help me better assess the utility of trigger warning. But it turns out that there’s really nothing out there that I could find addressing this issue. Basically, we don’t know if and how trigger warnings impact readers or viewers. I’d actually love to start doing some research on this, as it’s fascinating to me.

So we are left to rely on our own intuition. It could be that trigger warnings become a slippery slope of individualized censorship, or they could be protective of individuals who are too vulnerable in the moment for exposure to certain things.

I don’t have a firm answer, as I think this issue isn’t black and white and I like to consider what the data tells us before being more decisive on an issue (and there’s none! at least not that I’ve found — if you can, please let me know!).

I will say that I fear trigger warnings might be an example of falsely satisfying our own sense of altruism but not actually helping people. One writer had some interesting questions that he asked about trigger warnings, but summed up that he supposed they couldn’t harm anyone. I think it’s possible that they could (even while helping others). Perhaps perpetuating the idea of “triggers” could be harmful in and of itself, as it takes away from the complexity of given issues. Perhaps it gives us a false sense of security, or even keeps people in a pattern of avoiding things that would ultimately be helpful to have exposure to and work through (with a trained therapist, in many cases, of course).

But what do you think? Should writers include trigger warnings? Have they been helpful for you? 

28 Jan

It might be time to take a second look…

Media Literacy No Comments by Ashley @ Nourishing the Soul

You probably don’t know her name, but you very likely know her story. If you’re honest, you’ve probably made a snarky remark or two about her. But do we really know her story?

The woman is Stella Liebeck, better known as the woman who spilled coffee on herself and sued McDonalds for it. This was way back in 1992, but most of us either remember the news coverage or have heard the urban legend versions of the story in the years since.

As legend has it, Stella spilled the coffee on herself while recklessly driving with hot coffee between her legs and then decided to take out her frustrations for the discomfort on the McDonalds Corporation, eventually being awarded almost three million dollars. The story is often touted as an example of the ridiculous litigiousness of our society. Varying themes on the story emphasize things like U.S. businesses being helpless victims to slighted consumers or the court system having no common sense.

This video totally changed my perception.

Wherever you fall on this particular case, watching this video made me realize something important, something having really nothing to do with coffee or courts or even Stella herself.

What it made me think about is how quickly we take news at face value. Complex situations get muddied when drug through the media. Nuanced researched gets translated into a watered-down sentence (two if we’re lucky). Human beings, multifaceted as we are, get made into “good guys” or “bad guys” without a second thought.

I’ve been fortunate to have the opportunity to share a few insights into eating disorders in some news outlets and every time, I have the same experience: I’m happy to that eating disorders are getting the some exposure, but I’m left cringing that the news outlet has taken a sound-bite from me and left it at times completely without context or depth. While no one was trying to paint me as a villain, they could have practically made me say anything they wanted by pulling apart and editing my words. It’s actually a scary realization.

These experiences and the experience of seeing research of colleagues reported in the media without attention to things like… data… have left me a skeptic. I like to think it’s a healthy, media-savvy skepticism. Whenever I read a story that leaves me feeling shocked, outraged, or any other strong emotion, I try to do a little digging. A recent example was the report on a recent study in which media outlets everywhere started proclaiming that you cannot be fat and fit, despite years of research previously stating otherwise. Reading the reports, you would be wholly convinced that this is truth. It’s only when you start to dig a bit, read the original research, listen to others open-mindedly, and avoid taking anything at face value can you arrive at a closer approximation of the truth.

So next time you find yourself paining any issue or person with a single stroke, take heed. The issue might be worth a second look – even 20 years later.

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