Archive for May 24, 2016

Understanding Co-Occurring Disorders

Individuals struggling with an eating disorder are often only partially diagnosed and treated for their problem.  This is due largely to the likelihood of an eating disorder co-occurring with other psychological issues.  A co-occurring disorder, by definition is any two or more behavioral health disorders experienced by the same person at the same time.  If the eating disorder is treated without properly diagnosing every aspect of an individual’s mental health, their treatment can be significantly affected and can lead to relapse.

Disorders That Commonly Co-Occur With Eating Disorders

  1. Anxiety/Depression – The most common psychological problems that co-exist with eating disorders are anxiety and depression.  According to the Anxiety and Depression Association of America (ADAA), approximately two-thirds of individuals with an eating disorder, also suffered from anxiety or depression.
  2. Post-Traumatic Stress Disorder (PTSD) – Most cases of PTSD are the result of being exposed to a traumatic event that makes an individual feel helpless. Childhood sexual abuse is one of the bigger triggers for PTSD to co-occur with an eating disorder. As it pertains to eating disorders, some individuals turn to binge eating to help cope with their PTSD.
  3. Substance Abuse and Alcoholism – According to a study1 published in the American Journal of Psychiatry, about 12-15% of women with bulimia also have an alcohol abuse problem.  An additional 10% of women had a co-occurring drug abuse problem with their eating disorder.
  4. Cutting/Self-Harm – More common among individuals between the ages of 12 and 24, intentional self-harm is a co-occurring mental disorder that sometimes accompanies an eating disorder.  Individuals who start cutting and other forms of self-harm without intent to commit suicide are often times suffering from body image issues and low self-esteem.

Treating the Underlying Causes of Eating Disorders

When an individual suffers from an eating disorder, as well as one or more co-occurring psychological conditions, it is very important to treat each issue.  By addressing only one symptom or disorder, doctors fall short on getting to the root of an individual’s emotional and behavioral problems.  A patient that is only being treated for one of their psychological disorders is more likely to struggle after treatment.  This individual is prone to relapse and more likely to seek treatment again.

Not all individuals with an eating disorder suffer from other co-occurring disorders, but it is important to always be mindful and watch for the signs.  Patients that are given a full assessment of their psychological health are much more likely to get the treatment they need to overcome their disorders.



Schuckit, M., Tipp, J., Anthenelli, R. & Bucholz, K. (1996).  Anorexia
Nervosa and Bulimia Nervosa in Alcohol Dependent Men and Women and 
Their Relatives. The American Journal of Psychiatry, 152, 75-.

Social Media: Toxicity at Our Fingertips—Part 1: The Problem

Part 1 of a 2-part series on the harmful effects social media can have on our self-esteem and body image.

By Elly Byron


The concept behind Social Networking Sites like Facebook, Twitter, and Instagram is inherently harmless: they allow one to stay in touch with old friends, to share photographs, and to update others on important life events. However, to adolescent girls in particular, these sites have taken on a more infiltrating role in the lives of those who use them. Younger generations seem to post with a sense of urgency, out of fear that they will not keep up, will miss out, or—heaven for-bid!—be seen as having anything less than a vibrant social life. And so, any well-plated meal is captured, any fashionable outfit documented, and every social gathering put on hold until a flattering shot has been taken. Though this, too, may seem harmless, I am of the firm belief that a lifestyle that prioritizes the maintenance of a certain image on social media is damaging to the self-esteem of young women in America.

A central issue with the excessive use of social networking sites is that they are, by nature, vehicles for making visible unrealistic standards of living, beauty, and popularity. Too often does the life lived on the Instagram feed not match up with its counterpart in the real world, as individuals feel the compulsory and competitive pressure to maintain the best possible image on social media. While few will post a picture where they are alone on a Friday night, none of us hesitate to showcase the moments that make our lives seem more glamorous than they are. By so doing, we sell an image of ourselves and of our lives that is neither real nor attainable: no life consists solely of perfect hair, laughs with friends, beautiful views, and latte art. Not only do others buy into that image, but we ourselves, when faced with the disparity between what we think our lives should be and what they actually are, believe the lie that we are not enough. Com-paring our own ordinary lives to the filtered and seemingly perfect lives of our peers, we fail to realize that, in every case, behind every photograph is a girl with the same insecurities, struggles, and sweatpants as our own. It is an online culture of competition driven by feelings of inadequacy, a vicious cycle that provides the fuel for its own fire.

social-1206612_960_720Many studies have investigated the relationship between social networking site usage and qualities associated with poor mental health, depression, and low self-esteem. For instance, one psychological construct that encompasses much of what I’ve just described is called ‘upward social comparisons:’ that is, comparing oneself with others that might be considered superior to oneself, usually resulting in a decrement in self-esteem. In my opinion, this is partly why the most highly followed accounts on these sites are upper-class, highly attractive individuals who lead lives many of us envy. Recent research (Vogel, Roberts, & Eckles, 2014) has confirmed that exposure to upward social comparisons via these sites is indeed linked to lower self-esteem: put simply, when participants viewed target profiles where individuals displayed traits like an active social life and healthy habits, they had lower self-evaluations than when they viewed target pro-files with the opposite characteristics. The problem is, I would argue most individuals on social media spend more time looking at the profiles of ‘superior’ individuals, than inferior ones. This activity is correlated with depressive symptoms, particularly when the individuals are female adolescents low in social popularity (Nesi & Prinstein, 2015). Not only are these the young women who are typically the most vulnerable to low self-esteem, but they also tend to be victims of cyber bullying, which is another issue entirely.


Manago, A. M. (2015). Identity development in the digital age: The 
case of social networking sites. The oxford handbook of identity 
development. (pp. 508-524) Oxford University Press, New York, NY. 

Nesi, J., & Prinstein, M. J. (2015). Using social media for social 
comparison and feedback-seeking: Gender and popularity moderate 
associations with depressive symptoms. Journal of Abnormal Child 
Psychology, 43(8), 1427-1438.

Vogel, E. A., Rose, J. P., Roberts, L. R., & Eckles, K. (2014). 
Social comparison, social media, and self-esteem. Psychology of 
Popular Media Culture, 3(4), 206-222.

What is Beauty?

What is beauty? Take a moment and reflect on that question.

What is the first thought that pops into your head? Is it a type of person? Someone that meets the thin/fit ideal?

Body image can be a reflection of what our culture thinks as “beautiful.” Body image can also stem from more than just appearance based comparisons. How we feel about ourselves on the inside can be a reflection of how we see ourselves on the outside.

What if beauty has more meaning than physical appearance? What if beauty describes the true essence of what it means to be human? Could interpreting beauty differently change the way we see ourselves?

For the next few weeks, Love Your Body Thursday will be dedicated to how others define beauty.

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This post brought to you by:

Dirk Miller & Jennifer Cramer Miller

Are You Beach Body Ready?

By Emily Singerhouse, written as part of a media literacy curriculum at Inver Hills Community College

This is an image of a woman in a bikini standing next to a text that says, “Are you beach body ready?” The ad was distributed by Protein World- a meal replacement and dietary supplement company. They promote a “healthy lifestyle” and using the products they produce to help consumers lose weight.

The ad is designed to focus your attention to the model, who appears to be airbrushed. She is wearing a yellow bikini, drawing your eyes directly to her body. The photo indicates we should get ready to have a bikini body. It seems Protein World made this advertisement to make people feel as if their bodies aren’t “ready for bikini season,” luring them into their campaign. Protein World made this advertisement to catch the eyes of society in order to make them wonder if their bodies aren’t ‘ready for bikini season’ which could make them want to try their products.

However, perhaps the model felt as if she had to be a certain way to be ‘beach body ready’. She has a sad, mysterious face in the advertisement. It looks as if she doesn’t want to do it, but as if she has to be ready for the beach.  Having a negative body image can cause stresses in any person’s life.  The image she is portraying refers to the myth of gender and the overt sexualizing of women. It is designed to get our attention for how revealing the model is. Negative body image comes in different perspectives—both in front and behind the camera.

This sales tactic is unfortunately paired with the negative portrayal of women’s bodies and is being largely criticized. Protein World first posted this ad in the United Kingdom (UK) and received many complaints that they should be banned because it promotes a negative body image.  Women in the UK spoke out against the dietary advertisement. Everybody’s body is “beach body ready”.  There was a large uproar about the ad, for the words they used to catch the reader’s attention; it is considered body shaming. Using advertisements to sell the idea of not being “ready” to show their body off on the beach is wrong. After receiving complaints that it should be banned, the ad was recalled in the UK because it sells a negative body image.
Months later, this ad was posted in a New York City Subway Station. Not surprisingly, New Yorkers had similar reactions that resulted in backlash against the photo. However, instead of legal action to renounce the sign, groups have taken it into their own hands to reject the message the ad sends. Notes of “oppresses women,” and “everyone’s body is beach body ready” were posted over the New York Subway Station ad and captured on social media campaigns.

If you had the chance to write on the “beach body ready” sign in the New York City subway station, what would you write?

Staying on the same page

By Laura Collins

It is a common problem: parents not on the same page during eating disorder treatment.

Mom gives in too easily or dad forgets the “rules.” Maybe one spouse thinks they should back off and the other is ready to hold a hard line. Mom is super-vigilant and her partner believes in the power of trust.

What I have learned in watching countless couples struggle during eating disorder treatment:

•      It is better to be on the wrong page together than on different pages, so back your partner up. When you disagree, work it out in private. Those struggling feel unsure and even unsafe when the people taking care of them are not sending the same messages. If one direction isn’t working you can both change course together.

•      You may not (yet) be an expert on eating disorders, but you are the best authority on your own child. Learn all you can together about the disorder, and keep sight of what you both know of your loved one.

•      Your relationship to each other is the eating disorder’s worst enemy and it will try to divide you. Married, separated, or divorced: you can make your working relationship a brick wall against arguments and confusion.

•      The parent role is unique: it combines authority with protection. The best interest of the patient is also the best interest of the parents. Partners need to “be parental” even when they may feel over their head.

•      Caregiving can be exhausting and overwhelming, but remember that you are what stands between your loved one and great harm. If not you, who?

•      It is not about us. Myths about parents causing eating disorders are long gone. Parents have the opportunity to step up just as we do for any grave illness or accident, not because we caused it but because of our unique relationship and lifelong commitment.

•      Keep adult stuff among adults. Patients and siblings do not need to know or understand every decision and concern. Comfort and counsel one another.

•      Believe in one another. Each partner has strengths (and weaknesses) and qualities that brought you together. Find time to praise and use those strengths to support your loved one.

•      Eating disorders leave patients feeling anxious and uncertain. Fewer choices can help. If a question is open-ended or multiple choice it is often too challenging, at least early in treatment. Stick with clear, simple rules and few choices. That makes it easier to stay on the same page with one another, too.

•      Horizontal therapy works: head to bed. It doesn’t matter what you do there, but giving gravity a break really helps.



Laura Collins Lyster-Mensh is an award winning American activist and writer living in Virginia. A podcaster and international speaker, Lyster-Mensh’s books, essays, blogs, poems, and public speaking bring her infamy in some circles, praise in others, and an international readership.

Check out her blog Laura’s Soap Box

Follow her on Twitter @LauraCollinsLM