Despite the recent weather in New York, summer is finally here. The song “Summertime” comes to my mind—and the living is easy.

Or is it?

As we discussed in our newsletter a couple of months ago, summer is a time when it is hard to hide out. During any other season, layers of clothes can distract and camouflage what we really look like. But the living is not so easy when layers of clothes are shed and our bodies are exposed —along with our insecurities about our imperfections (the ones we THINK we have). Who doesn’t look at other’s bodies and compare and contrast (even silently)? I know very few people, men and women, who don’t express some dissatisfaction with their bodies, but generally that doesn’t rule their lives. Like “normal eating”, body dissatisfaction is on a continuum. With eating disorders, body comparison enables the ever present critical voice to get LOUDER and LOUDER!!

It also doesn’t help when popular magazines have whole sections dedicated to the comparison of body parts. For example, People Magazine rates the best beach bodies, the best arms, abs or whatever other body part one tends to notice during these months. Everyone is under a microscope and parts of bodies take on a focus that encourages dissatisfaction, embarrassment and even shame. Most people are able to shrug off their imperfections. But with eating disorders, that critical voice gets so loud that one’s mood can shift rapidly if any excessive skin or fat is detected. Within minutes a person can go from feeling happy to wanting to disappear from the face of the earth because of this critical voice. I recall a patient who reported to me that in the time that it took her to get to my office from her home, her mood shifted from “good” to “anxious and depressed” because she realized that her stomach was not as flat as she wanted it to be when she compared herself to someone she noticed along the way. This young woman wanted to go home and disappear after this encounter.

As the critical voice increases, so does the hiding and avoiding of people. The living is hardly easy. How can we get this critical voice to lose its power and get softer and softer ?

Instead of comparing ourselves to that one, genetically blessed individual who catches our eye on the street, why not also compare ourselves to 5 other individuals at random? New York City is filled with its fair share of well-dressed and in-shape individuals, but it’s also filled with normal, average folks as well.

And remember, when you are happy and smiling and present (enjoying the long summer days and good weather) you are much more attractive—and that can be done without losing 5,10,15 lbs or getting rid of those “fatal flaws”.

Finally, what about highlighting another voice—one that is accepting, a voice that tries to make you feel better not worse, a voice that is kind not abusive.Think about what you could say when the body criticism starts to scream—because when body criticism speaks loudest, it’s time to take care of yourself—not to be punishing

How about something like “Hush little baby, don’t you cry”. (or for those too young to know the lyrics of “Summertime”, let Rhianna speak to you—”we’re beautiful like diamonds in the sky”) .

“Summertime”… and the living can be easy—er!

The new psychiatric diagnostic manual, the DSM-5, is about to be released this month. Many of the new diagnostic categories are being questioned. One of particular interest is that of Binge Eating Disorder. Bingeing, or eating a large quantity of food in a shorter period of time than is typical, is a disordered behavior according to theDSM-5. An individual who has eaten excessively at least 12 times in a period of three months meets criteria for Binge Eating Disorder. That means if you “blow out” once a week, you have an eating disorder. Really??

For many, this may be true, but I’m really curious these days about how women (i’m starting there, at the risk of momentarily losing my male audience) REALLY eat.

I know the usually prescribed base for people struggling to maintain healthy eating is three meals a day, two snacks. But once people slide into the reality of everyday life, is that how we really eat? When I give talks to teens, they tell me they frequently skip breakfast, eat “junk” through the day, “pig out” after school if they have raced through the day without eating much. Are they eating disordered? Harried moms pick at their kids meals before they go out and then worry that they “overdid it” when they finally sat down to dinner, relaxed, eating until they are more than full. Is that a binge? (They will assuredly tell me it was a vast amount of food in a short amount of time—and afterwards they have their laments). Colleagues tell me that when a paper is due, they sit down, make a mess of their notes, their thoughts and their eating as they get their thoughts on paper. Later, they clean up their words, their thoughts, their eating. Is that disordered?

In this culture where most everything is now diagnosed and pathologized, I am wondering what “normal” eating really is. A study of 2000 British women revealed that participants confess to eating two snacks a day—but usually when no one is watching because they are embarrassed about eating the snacks. If women can’t even eat a snack in public, what else are they doing that they are embarrassed about or can’t even report in an anonymous study? My guess is it’s much more than two snacks a day.

Remember how sexuality was spoken about a few decades ago? (Well, maybe you don’t remember—but this is how it was)—Pre-60’s, women all knew what they were supposed to do in bed (missionary position) and no one talked about anything more. Everyone likely assumed there was more to the picture… but no one really knew what people did behind closed doors. This of course all changed with research and literature (think The Joy of Sex). With open discussion about what men and women REALLY did, knowledge, shame and a sense of choice about sexual possibilities radically changed.

In the arena of food, however, we are back where we were in the arena of sex generations ago. We are still in the dark ages, with mystery surrounding what women really eat and shame coloring our ability to even talk about it.

We all know that disordered eating has to do with one’s world being out of balance—food and weight are used to cope with feelings, to withdraw, to protect one’s self. We all have moments of that—sometimes even once a week—Does that mean we are all eating disordered?

A patient of mine once asked me if women REALLY do eat candy if they are not bingeing. Yes, i answered—all the time. But that question prompted my wondering how we can better know what women really do—and what is healthy—and what is not. The new DSM-5 presents many answers. But how can we use the new manual to allow for new questions as well. What do women REALLY eat? When is eating healthy? When is it not?

As fellow EDRC psychologist Lauren Waine notes:

“The cost of not knowing how women really eat may be the continued marginalization of people with normal human behavior, with the net effect being a veil of shame, self-reproach, and the felt need for secrecy and hiding among all people”

I couldn’t say it better.

The sun is beginning to emerge, the weather has warmed (a bit) and we are finally allowed the wisp of hope for spring and summer. Yes, bathing suit weather may actually soon be upon us.

This means that millions of women (and men too, despite my gender tilted language) are going to slough off winter layers, stand in front of the mirror—and be horrified. The airbrushed and photo-shopped bodies they’ve seen in magazines all winter will look nothing like their own. Panic will ensue and for many, the promise of summer will mean extreme dieting, fasting, cleansing and vomiting.

And many will ask “What’s so bad about that?
It’s temporary, the weight will come off. It’s just a phase. ”

Except for many, it won’t be.

“Just” a week of dieting, fasting and purging is always the way a severe eating disorder starts. There is never a guarantee regarding who will be okay and who won’t. It’s just too easy to do. Didn’t every two-pack-a-day smoker start with just one cigarette?

Every culture has its toxin. There’s cocaine in South America (piles of it as appetizers, I remember. I really saw that). There’s plenty of marijuana in Mexico, alcohol abuse in Indian tribal communities, cigarettes in France, food in America. It’s hard to be a human being.  We crave time out.

So is bulimia the new cigarette smoking? And if so, how do we remind our teens and our patients, that vomiting not that cool, just as dangerous (maybe more) and won’t even achieve the effects that someone wants (most people suffering from bulimia are of normal weight or above. Check the charts. Unfortunately no one wants to be of normal weight anymore. That is surely not an incentive to binge and throw up).

We like to turn to substances and the outside world to fix our weight, to fix our feelings and to fix our soul. The problem is that these solutions always work—for a minute. Then feelings, hungers, eating and distress inevitably come back. And the need to start eating, purging and dieting starts all over again. Talk to anyone caught in this battle—it’s torture.

So when the warm weather sends you into a swirl of body-obsessed panic, catch your breath. Dare to take a walk to the river and when the body torture thoughts come up, go inside, just for one moment. The sun, the warmth, the promise of spring holds the hope of good times and bared bodies. But what will you look like inside of yourself? What will give your life meaning this summer? What will your soul look like? If the sun and warmth can get you outside so that you have a moment to reflect and go inside, it will be one moment more that your body, the culture and the need to be skinny and cool are not the only things that matter. Take ten minutes away from the mirror. Take a walk outside. And take a big, long breath. Summer is about to begin.

Every year whenever March comes around, I look at my calendar to see when Passover will be that year. I have to admit that Passover is my favorite holiday because the focus of the celebration is on freedom, renewal and community. I particularly like the Seder when family and friends, young and old, come together to tell the story of Passover. This is the story of how the Israelites liberated themselves from bondage; it is the story of the struggle they went through before they reached their destination to live in freedom.

For anyone with an eating disorder, sitting at a holiday table this month, be it in celebration of Passover or Easter can, in and of itself, feel like slavery. The meals are endless, the food overflowing and the way to one’s own freedom seems difficult to contemplate. However, the story of Passover reminds us that courage is important and that fierce struggle can result in freedom. This is a story worth listening hard to.

Passover and Easter are also about renewal and rebirth. Both highlight the beginning of spring and the beginning of a new life. They focus on one’s ability to clean house and to dress up. New clothes– hats included!- are part of the holidays and one struts about looking forward to new commencements and a change in life. With renewal comes hope and excitement of the possibility of change.

Passover and Easter focus on getting together with friends and family. The holidays are about a sense of belonging and seeking out people to be with and celebrate. They are about being with people one knows and loves but they are also about making new friendships and connections. It is easy to be at a dinner table, deep in one’s thoughts and worries, with a focus on food blinding the night. No matter where you are these holidays, look up, slowly make your way around the table and think for a moment about each person who is there. Take another moment and remember the meaning of the celebration itself.

For all of us, there are moments when it can take some courage to sit through a family meal. Easter and Passover are holidays dedicated to courage, hope and renewal. Let them be, at least for a moment, the gift, not the struggle, they are meant to be.

Is there any holiday filled with more “forced-march” trepidation than Valentine’s Day? I’ve had my share of fun Valentine’s Days—but I’ve also had horrified moments of expectations not met. And i’ve certainly had “successful” Valentine’s Days that unfortunately meant sitting in a restaurant in a line of 10 couples, table to table, guys on one side, girls on the other, all playing out the protocol of what romance should look like. It all felt pretty silly and almost embarrassing at the time.So yes, there is the forced march into intimacy –but also, what about all those chocolates? if you don’t get them, that’s supposed to be a sad statement in our culture (really? maybe just bad timing. If Valentine’s Day were a month away, it could be a different story). And what if you do get those chocolates? Now what? How many do you have to eat to prove you’ve celebrated successfully?

This Valentine’s Day, how about celebrating in a new way? Can you have one moment of connection with someone you love? and as far as i’m concerned, that doesn’t have to be a cupid-arrowed partner. What about your kids? a friend? What (horror on Valentine’s Day) about yourself?

This is a holiday about connection and intimacy that has gone awry. It’s a holiday too that often has people focusing on what they DON’T have—not what they do.

So why not use this day to have one intimate connected moment with anyone, including yourself. Focus for that moment on what you DO have, not what you don’t. And in terms of those chocolates—if you are going to have them, stay present, mindful—Don’t have one unless you are ready to taste what you are eating and actually enjoy it.

This doesn’t have to be a holiday where you are robotically ushered into a pro-forma set up in a restaurant, a holiday where you are pressured to be and act close. It doesn’t have to be a wild run of a day with chocolate wrappers strewn throughout. Make it a true holiday—a day to pay attention to who is important to you, yourself included. Otherwise, you too will run the risk of being a Hallmark card run amok.

Celebrate—in a fashion that feels true to yourself and your hungers for closeness, self acceptance—and even for those chocolates.

(And, as our support group leader Jamie notes—It’s nice to give and receive love on any given day. So perhaps if we practice celebrating love (for ourselves, our family, our friends) on a more regular basis, this day might hold less of a punctuated, personal meaning? Thanks Jamie—I couldn’t agree more!)