FEEDING OURSELVES
   An effective alternative to dieting

In The Press

THE URGE TO BINGE

Binge eating disorder (BED) is rapidly gaining acceptance in the psychiatric field as an illness separate from anorexia and bulimia. BED affects as many as five million adult Americans, 60 percent of whom are women, and is characterized by recurrent episodes of eating large quantities quickly and past the point of fullness. Like me, sufferers frequently eat alone so as not to be discovered, and they often feel disgust or guilt over the bingeing.

Emily Fox Kales, Ph.D., director of the outpatient Eating Disorders Program at McLean Hospital, in Belmont, Massachusetts, has done extensive research on BED. She says, "Individuals with BED typically cycle between futile dieting efforts and binge eating. Unlike bulimics, however, they do not purge their excess calorie intake through vomiting or other behaviors. Instead, they gain weight and generally grow obese." The onset of BED usually occurs in adulthood and is often linked to major life transitions, chronic depression or traumas.

Treatment for BED includes counseling and cognitive-behavioral therapy; antidepressant medication may also be prescribed. "Traditional dieting is counterproductive for someone with BED," says Kales, "because it does not address the underlying psychological problems." But as in my case, once the cause of the eating is identified and dealt with, BED victims can successfully lose weight. (K.P.G.).

THE MINUTEMAN CHRONICLE, Thursday July 15, 1993
Concord Counselor Teaches People How To Make Peace With Food

Making peace with food.

Most people never thought they were at war with it, but millions have spent painful years, even as long as a quarter-century, locked in battle with a substance they can’t live without.

Eventually, some of them come to the conclusion that diets just don’t work – the newest fad isn’t the ultimate weapon that will forever destroy an obsession with food.

In growing numbers, they are finding their way into the ranks of the anti-diet movement. Proponents of the new détente with food are crowding bookshelves once reserved for Dr. Atkins and the Pritikin Diet. They’re appearing on talk shows, commiserating with Oprah Winfrey, who recently completed the classic cycle of a brilliantly successful diet – and equally brilliant failure to sustain what she’d accomplished.

Feeling fat – again

Alice Rosen, a Concord resident who holds a master’s degree in education and is a licensed mental health counselor, has a circular chart that follows the cycle. “Every time you feel guilty, you have to punish yourself for it,” she said.

You go from feeling fat to dieting and exercising rigorously to feeling deprived, to becoming increasingly aware of uncomfortable feelings, to eating compulsively to dull the pain and express your rebellion, to feeling fat, then feeling shame, guilt, and self-punishment, to eating compulsively once more, which brings you back to the beginning of the circle. Feeling fat – again.

It's s not just about food." said Rosen. "it's a much more complex issue, and it’s not a magical thing.

Rosen will say much the same thing when she leads an Intensive three-day workshop for Feeding Ourselves. from her Concord home at the end of the month.

'Diets are magical. There's the assumption that If I diet. I'll lose this weight. and be happy, and I'll get the man I want, I'll get the job I want, I'll be able to achieve Intimacy, and I'll be happy with myself."

Compulsive eaters think food is the cause of their pain. she said. They think their fat is the cause of the pain.

"But it's the symptom." Rosen said. 'of the underlying problems. Of not being able to care for yourself in the world. You protect yourself, you punish yourself, on a lot of levels - not just nutritional levels."

A social epidemic

Between 20 to 50 million Americans are on diets today. Fifty percent of girls diet before the age of 9. Seventy five percent of girls engage in unhealthy dieting before the age of 16.

This Is an escalating epidemic. Rosen said. and none of It can be separated from the power of our culture. and media

The weight loss Industry is not driven by people's desire to be happy and healthy a lot of it comes from external forces reinforcing the idea that you're not good enough."

That idea Is superimposed on deeper, underlying messages from the family that get handed down from generation to generation, Rosen said. 'Parents who are not available, abusive, alcoholic. neglectful. too controlling. too enmeshed the child Is not able to have boundaries. The child could not express emotions. Negative emotions are not to be had - so you have to stuff them.

Rosen emphasized she doesn't want to blame parents too much they already spend too much time blaming themselves. and as a result. don't make the changes they should.

Understanding your body

What Rosen tries to show women in her workshops is what a colossal waste of time and energy goes into thinking about food. Though bulimics, and healed anorexics who have gone on to bulimia do come to Feeding Ourselves. it mainly draws compulsive eaters

If there's a "type" that describes these women. she said. it's something like this. "They're intelligent. They’ve read every book, they know all the calories, they attempt to take control over the thing that cannot be taken control of, and they've forgotten their body has its own body of knowledge of self regulation.

Tapping back into that knowledge is one of the things Feeding Ourselves teaches. Many have forgotten what It feels like to be hungry and are terrified that experiencing the sensation will send them straight into a binge. Rosen offers the reassurance that just as the body knows when it's tired, when its bladder is full, it also knows when it is full of food. and when it is satisfied.

"It also knows what It wants, given a chance to crave." Rosen said. "But they shut that down."

Truly," Rosen added. "on many levels, the body is the enemy. ... This intellectual woman has truly forsaken her body. She doesn't love her body, she's scared of her body, and she’s ashamed of her body."

Relearning how to eat

Unlike mainstream diet programs, from the start. Rosen makes it clear that Feeding Ourselves Is not a quick fix "This Is a process." she said. "This Is an exploration. You can't make changes. until you know what It is you have to change."

She asks women to keep track of why they eat, when they eat. "Is the first thing you do when you walk in the door is open the fridge,” she asked. "Is your hand bag still in your hand? Look at the pattern of your eating. What were you feeling? Look at the pattern of your food behaviors. and say what can I change about this?

We relearn how to eat." Rosen said. "We learn what children know. Essentially, a child stops eating when they're satisfied."

Relearning what to eat was something Rosen experienced for herself. "I was blown away." she said. "I thought I could never have enough.

No forbidden foods

In the Feeding Ourselves approach. there are no forbidden foods. “You can have your cake, and eat it, too, literally," Rosen said. This legitimizes eating. making it a valid activity, for people who have long felt they should deny themselves, because they are fat.

We ask people to stock their cupboards." Rosen said. The message is that's there's always enough. and you can have it if you want It. By destigmatizing foods that way, the lure of the forbidden dissipates.

"In this forum" Rosen continued, “you can gain weight at first. until you begin to trust yourself. You really begin to understand you will give yourself what you want when you need it.

That was a very scary thing for Cynthia. now the alumna of both an introductory and an advanced Feeding Ourselves workshop. 'It’s very scary" said the Newton resident. "craving something you can eat as much of as you want You can have it plentifully. because sooner or later, you won't want it anymore."

But it's also liberating, she said. and once you realize you don't have to hoard something. or eat it all up before it disappears. you have reached a very different way of thinking about it.

'Mentally," she said. "I think you can't go back. You may not be practicing what you know. but the veil of unawareness has been lifted."

Lifting that veil is where the work lies, according to Rosen.

Rosen knows. having gone through it herself. She has learned to honor her body, she said, and trust it to use food appropriately for nourishment, and pleasure. That is part of having made peace with food.

Cynthia is still working on it. "I'm close I'm close." she said. "There are times when I don't feel quite at peace. and then are times when I eat something, and I will say why did I eat that. But it doesn't control me the way it used to."

THE MINUTEMAN CHRONICLE, Thursday, July 15, 1993
Workshops Help Break The Eating Cycle
by Bethany Becker (Staff Writer)

Social attitudes about women's body image and weight are the newest form of foot-binding, according to Cynthia. a Newton woman who has struggled with compulsive eating.

Attending workshops and pursuing study on her own was the way she eventually learned to interpret - and eventually reject messages she now views as destructive.

Alice Rosen, a Concord counselor who leads workshops for Feeding Ourselves, maintains that women start to "wake up" as they internalize new attitudes about themselves and other women through their group work.

Cynthia said she looks at others very differently, now. "You sit down in the group. and you're not sure what it's about." she said. "You think. 'she's thin - what's she doing here. I'm thinner than this one the whole way women have of sizing each other up by their weight I just don’t do that anymore.”

"A bulimic sees an obese person is really a person an obese person gets to see a thin person has her pain, too." Rosen agreed. Once they get to that point their interaction Is "rich.she said.."It's very rich. It's richer than chocolate cake."

Rosen. and the leaders of eating disorder support groups at both Concord's Emerson Hospital and Burlington's Lahey Clinic, all suggest that either during. or after participating In a group it's a good thing to have a counselor waiting in the wings.

Issues come up," Rosen said. "It's good to have a helper." People want quick solutions to both the classic eating disorders. anorexia and bulimia as well as compulsive eating. but there just aren't any out there.

It's a process. they said. Many times a workshop or a support group Is a good place to start even though it's not easy. Barbara Michaud. program coordinator for Anorexia Bulimia Care, Inc.. said. 'it takes a lot of courage to pick up that phone. to ask for help. The first step is always the hardest"

Hospitals and organizations within the Chronicle region. and just beyond It. offer a variety of workshops, support groups. and referrals.

Anorexia Bulimia Care Inc (ABC), moved from Lincoln to Cambridge this week. The new office is at Fresh Pond. at 545 Concord Ave. Cambridge, MA . 02138-1122. ABC offers a crisis hotline and Informational services. as well as a professional referral network, 'befrienders," a newsletter, speakers bureau, 10 to 20 week support workshops, and groups modeled on 12-step programs. ABC charges a $25 annual membership fee. Family membership is $50. For more Information, call (617) 492-7670.

Emerson Hospital in Concord 's Eating Disorders Support Group meets one hour a week. Leaders require an intake interview prior to participation, and ask for a commitment of 10 weeks. After that time, participants may choose to attend until they are ready to move on. Intake assessment charge Is $25. Fee per session Is $12. For information (508) 369-1400, ext. 3520.

Feeding Ourselves - workshops aimed at compulsive eaters rotate In or near the Chronicle region. Two summer workshops are scheduled: A three-day intensive workshop at 27 Hemlock St. In Concord, July 23-25 (Tuition is $250) and an intensive workshop for alumni, at the same address, July 30 through Aug. 1. (Tuition Is $295.) Ongoing groups and advanced programs are offered throughout the year. For Information, contact Pat Nelson, at 30 Bartlett Ave. , Arlington,. 02174. (617) 661-3727.

Lahey Clinic In Burlington, 41 Mal l Road , offers both individual and group counseling for adolescents and adults with eating disorders, as well as family counseling. Group sessions meet for 90 minutes each week for eight weeks. combining nutrition and behavior modification strategies. For Information. call (617) 273-8963.

THE WASHINGTON POST, Health, November 2, 1999
The Mystique of Meatless Cuisine: Vegetarianism Has Joined the Mainstream
but Myths About This Diet Endure
by Lawrence Lidner

Special to The Washington Post

You’ve been touched by vegetarianism, whether you know it or not. Taco Bell has removed the chicken broth from its seasoned rice. And Wendy's has taken the gelatin out of its reduced fat/reduced calorie garden ranch sauce. Clearly, the non-meat-eating movement has come out of the dark reaches of the counterculture, no longer lurking among the granola bins at the back of the health food co-op.

But while vegetarianism has gone mainstream, misconceptions persist. Following are some vegetarian myths-and the facts behind them:

Myth: If you eat fish or chicken but no red meat, you're a vegetarian.

Fact: Some people who eat chicken but no beef call themselves pollo-vegetarians, and some fish eaters refer to themselves as pesco-vegetarians. But if you eat chicken or fish, you're not a vegetarian. You're an omnivore, someone who feeds on both animals and plants. "I get at least one inquiry a week asking" about that, says David Breier, consumer research manager at the Baltimore based Vegetarian Resource Group, a nonprofit organization dedicated to educating the public about vegetarianism. It's a contradiction in terms, she explains, to call yourself a vegetarian and eat food produced by slaughter.

Myth: A vegetarian diet is automatically better for you than one that includes meat, poultry or fish.

Fact: Vegetarians generally have a lower death rate from heart disease than non vegetarians, along with a lower incidence of diabetes and obesity. Vegetarians are also less likely to be afflicted with lung and colorectal cancer.

The reason, at least in part, is that their diets tend to be low in saturated fat and high in fiber, antioxidants and other protective substances. But going vegetarian does not ensure a more healthful diet.

Vegetarians can pile on the fat and calories if they eat too much cheese, ice cream, butter and other full-fat dairy products. A vegetarian diet loaded with candy, cookies and chips to the exclusion of fruits, vegetables and whole grains ' is also less than desirable, for obvious reasons.

A nutritious vegetarian diet, just like a nutritious meat-eater's diet, has to be planned. That's particularly true for vegans, who eschew animal foods entirely and thus don't get the vitamin D in milk or the B12 in dairy foods and eggs. They either need to eat foods fortified with those nutrients, such as breakfast cereals, or take a multivitamin pill. Ovo-lacto vegetarians, who do eat eggs and dairy products, should get some extra B12, too. Research suggests that they have low levels of that nutrient.

Myth: Vegetarians have to resort to eating "weird” foods.

Fact: In many ways, vegetarian diets, particularly those of ovo-lacto vegetarians, resemble the 'typical" American diet. Pizza; bean-based soups with salad and bread; eggplant Parmesan; macaroni and cheese; peanut butter and jelly sandwiches-they all fit.

Myth: When a teenager goes vegetarian, it’s simply a sign that the adolescent is trying to develop her or his own identity.

Fact: Many teenagers do experiment with vegetarianism as they form their own world views and work on coming into their own. But a growing number of adolescents-girls in particular use vegetarianism as a screen for their weight control efforts.

"Vegetarianism is often a politically correct opportunity" for girls to act on "their fear of fat," says Emily Fox Kales, of the Department of Psychiatry at Harvard Medical School and an eating disorders specialist at McLean Hospital in Belmont, Mass. "Most of them aren't interested in eating healthy or saving the planet," she comments. "They're interested in 'feeling light. If they say they're vegetarians, it allows them to eat a largely nonfat diet raw fruits and vegetables. Then they start to think that if they eat a chicken meal or a hamburger, they feel “too heavy inside.” They say 'I feel gross.' But what they're really saying is that their body image tells them they have gotten fatter. Often, it's the beginning of an eating disorder."

One of the theories about the eating disorder anorexia nervosa, Kales says, is that it's "linked to obsessive/compulsive traits." Vegetarianism, she points out, can become a vehicle for obsessive compulsion "Did any meat touch this food? Does this broth have chicken?" she asks figuratively. Someone can become more and more phobic about calories and fat, she points out, under the guise of concern about not eating any animal foods.

"If you asked me if I saw as much of this 10 years ago," Kales notes, "I would say no." It's a trend on the increase, she says.

Myth: Vegetarians eat too little protein.

Fact: It's almost impossible not to get enough protein if you consume enough calories. Consider that a 160-pound man requires about 60 grams of protein a day. He can get 11 of them from a cup and a half of pasta alone. A half cup of tomato sauce with a cup of broccoli on the side adds another eight grams, for a total of 19. Beans, nuts and soy products also contribute appreciable amounts. Vegetarians who consume eggs and dairy products get plenty of protein from those foods as well.

Myth: Vegetarians have to eat certain foods at the same time to make their proteins complete.

Fact: Protein from plant foods, unlike protein from animal foods, is "incomplete,' meaning it does not have the full complement of amino acids needed to mal, "whole" proteins that can be used by the human body. To make complete proteins, various food combinations are required. But research now shows that these combinations beans with grains; cereals with leafy vegetables; peanuts with wheat, corn or rice; soy with corn, wheat or rye don't have to be consumed at the same time. As long as you get these foods over the course of the day, your body can build the proteins you need.

Myth: Vegetarian diets don't contain enough iron or calcium.

Fact: Iron is a problem nutrient for a significant number of people, whether the are vegetarian or not. Women of childbearing years need 15 milligrams of iron a day, while other women and men need 10. But vegetarians can easily meet these requirements with a balanced, well constructed diet. A half cup of tofu contains seven milligrams; a single tablespoon of blackstrap molasses, four; and a half-cup of lentils or two tablespoons of pumpkin seeds, three. The iron in these plant foods, known as non heme iron, isn't as available to the body as the heme iron in beef, poultry and fish, so vegetarians must take in more than others. But those vegetarians following a responsible diet generally do.

As for calcium, even those vegetarians who don't eat dairy foods can get plenty. A half cup of tofu has between 100 and 250 milligrams (check labels). A half cup of collard greens has almost 180 milligrams, as does a tablespoon of blackstrap molasses. Five dried figs or a half cup of turnip greens have about 130 grams. Of course, there's always calcium fortified orange juice, at 300 milligrams per cup.

WORCESTER MAGAZINE JANUARY 17, 1996
The Obsessive Media: What their message creates and how we buy into it
by Alice J. Rosen

She's young, her hair unkempt, her shoulders thin and bared. The black and white image portrays a neglected youth with dead eyes, hungry for attention. She appears to be under a spell as she seductively backs away from the approaching, steady sound of heavy breathing. As the camera and breathing close in on her face, she speaks in a beckoning whisper: "Obsession."

I feel sick to my stomach, knowing all too well that this TV ad shows the sad truth that many girls lose their youth and innocence to be sexually possessed and dominated by men. Only the night before, I sat with a group of women who come together to heal from food obsession disorders and heard Enid (name and facts have been altered) tell, for the first time in front of other women, about her seduction when she was 11 by her stepfather, the man she loved and looked up to since she was 5 years old.

She told how at first it was confusing, but how it felt so good and special. In no time, however, she became his slave. She existed for five years only to satisfy his "obsession," losing her girlhood, her peer group, her body and the ability to create satisfying future relationships. She learned to use food to numb and distract herself from her feelings and grew a wall of fat to protect herself. Enid carried her painful secret for 15 years and has many more difficult years ahead in her healing process.

Why would anyone want to wear a scent that attracts "the obsessed"? Even taken as an artistic metaphor, it is viscerally disturbing. Is the power of seduction and the fleeting rush of pleasure and attention worth the betrayal and loss of self? Is that what you are selling, Calvin? Is the bruised, Kate Moss image what we aspire to for our young girls? Is this what we envision a turn-on for our young men?

Well, I'm not buying it. The suggestion from this ad and from countless other media messages that women need to be thin, weak and young in order to attract male attention, and that this ability to attract is their ticket to power and security is ludicrous and nauseating. Yet we support it. We pay to see these messages, worship the images and buy the products. Even Digital P.C. capitalizes with the mantra, "You can't be too thin or too powerful." Seventy pound anorexic girls starve and work out daily in homage to this belief. That message is just about the only thing that they do swallow.

Every woman knows, because the media has taught her well, that any moving flesh on her body is repulsive and indicative of failure, laziness and general lack of control. Hanes sells that message adroitly when it states that its hosiery is a replacement for liposuction. Another ad for elastic hose says, "Need a shrink?" Clearly, fleshiness is a sign of emotional imbalance, and just squeezing oneself into Spandex is equivalent to a therapeutic relationship. The age-old message is that if you are thin you will not have any problems. But whose problems have melted away because of weight loss?

Computer imaging, photography magic and cosmetic surgery create forms that fool the eye and mind of unsuspecting consumers. We hold as an ideal people whose whole job is to look good, who spend four hours on makeup and hair before a shoot, who exercise daily. If we are not good enough (pretty, thin, rich, powerful), we are more apt to consume in order to achieve the perfection, perfect the deception or distract ourselves with a temporary "high" or sedation. Media, in its omnipresence and state-of-the-art seductiveness, contributes to creating and taking advantage of our insecurities. Its motive is profit. Is this not an abuse of power?

Women and girls, in ignorance of their own intrinsic power and value, take extreme measures to control their bodies. Many endure painful, expensive procedures and resort to obsessive restrictions, starving themselves and engaging in violent purging behaviors. We support a $32 billion weight loss industry, one out of 200 girls between the ages of 12 and 18 is anorexic; one out of four college women is bulimic. A poll from a recent Esquire magazine found half of the 18 to 25 year old women would rather be dead than fat So, when Vogue magazine has a haute-fashion spread of skeletal, empty eyed women, devoid of energy, looking like their life's blood was sucked out of them, they know whom they are selling to.

We buy the message that our bodies are the enemy and cannot be trusted. Our united mission is to wipe out and obliterate all fat. We fear and revile fat and feel morally empowered to publicly express these feelings. Opi and Anthony, on Worcester, 's WAAF radio station, make great fun of the "dogs," those girls who don't measure up to the impossible to achieve media-engineered feminine ideal. They have perfected the art of objectifying young girls. Young men are encouraged to call in and brag about how they check out a prospective date and drive by if she is a "dog," joking that they should have thrown her a bone. They solicit calls from young men who describe vividly those female body parts that turned them off the most while they were engaged in "intimate" activities, and they ask female callers about their weight, measurements and physical attributes. Young girls are under a lot of pressure to measure up to unobtainable ideals.

These pressures to be both vulnerable and perfect for someone else are crazy making. The implication is that to express our needs and show our true selves we risk abandonment. A 17 year old bulimic client puts it this way. "I do not feel permission to have either my hunger or my anger I am afraid that people will not like me if I speak myself and am afraid of being ignored if I gain weight." Perhaps the epidemic of eating disorders is an expression of rage and hurt turned inward in our young women. You can stuff it for just so long and then you just have to retch... or speak out.

Alice J. Rosen, LMHC specializes in eating disorders and chronic pain. She has a private practice in Concord, Mass., and has been affiliated with Feeding Ourselves for 14 years. A columnist for Food Issues, Rosen has a strong interest in education and prevention and is an active member of BAM (Boycott Anorexic Marketing).