COVID-19 and Recovery
By: Jessica Cushing-murray
The CoronaVirus, COVID-19, the world pandemic. The chaos that is our lives today.
Maybe you know someone who has been diagnosed with this virus, or maybe you are lucky and you and your family have been safely and successfully quarantining as directed. But whether or not this world pandemic has affected your medical health, a big question is has it affected your recovery?
For those of you in recovery from eating disorders, you know that a big part of recovery is learning to become more flexible: with what you eat, how much you eat, your habits before and after you eat, your exercise routine. So this Coronavirus outbreak is likely having an impact on your ability to do your normal routine.
Whether you are in quarantine, or still working an essential job, all the COVID19 restrictions and precautions might feel like they are taking away from your autonomy. This post is here to remind you that no matter how long you've been in recovery from an eating disorder, it is still important to check in with yourself and with where you are in your recovery journey.
A few things that have crossed my mind over the past few weeks: your appointments with registered dietitians/physicians/psychologists that may have been canceled or postponed, the idea that we need to be "stocking up on non-perishable food" may be changing how you grocery shop, the closures of state/national parks and gyms may keep you from your normal exercise routine. All these have affected me in different ways. In my head I think "well I want to be safe, so I should buy a good amount of non-perishable foods, even if they aren't included in my usual food groups," but that can be stressful. For those of us in recovery, any deviation from our daily routines can be stressful, especially when it involves food.
So, there are a lot of things to consider. But while some of these changes may give you some stress or anxiety, it's a great time to practice the flexibility we learned when we first started our recovery journey. It won't kill us to buy boxed mac n’ cheese at the grocery store, just in case this pandemic worsens. Losing your gym to COVID closures doesn't mean you can't exercise: go outside and go for a walk, buy a yoga mat and sign up for the free at-home workout lessons posted by Chris Hemsworth! And give yourself the flexibility of not needing to achieve at the level you were before quarantine.
It’s ok if you are not working out as much as normal right now.
It’s ok to rest.
It’s ok to just survive.
No matter what the world situation is, now is the time to practice all the important lessons you learned at the beginning of your recovery process and stay strong! Don’t let this pandemic change all the hard work you have put into your recovery. Remember that you are strong and that this too shall pass.
Are you struggling with worsening ED thoughts and behaviors during quarantine? Not Your Average Nutritionist is here to help! Our dietitians are well-versed in telehealth, and have openings for new clients. Contact us today!
Libby also created a video for grocery shopping when you have anxiety that you can view HERE.
I am privileged to have a job that I love.
Yep, you heard that right. I love my job.
But how did I get here? And did I always love it?
When I started college my major was pre-veterinary medicine. I was going to be an equine (horse) Veterinarian. I was good at science, I loved horses, and was obsessed with James Herriot (check out the BBC miniseries, or his books), DVM.
But life had other plans.
About half-way through my first year I came to a realization that I did not want to get called out at 3am in the middle of a blizzard (I was in Wisconsin) to stick my arm up a horse's butt... What can I do with people, and normal hours?
At this same time, I was deep in diet culture. I was restricting, losing weight, and reading every women's heath diet article magazines had to offer. Yep, I had an eating disorder (though I didn't know it). While I was reading all those articles, I started noticing some bylines had "Registered Dietitian" as their title. Hmmm, a job helping people lose weight? I'm good at that! So I went to my career counselor and set off to change majors and schools so I could go into nutrition.
Fast forward to the end of my undergrad experience, and I was not using ED behaviors anymore (thank you to my amazing nutrition professors for helping me see the light through the science of the human body) though my mind still had work to do, and I was off to my dietetic internship and becoming an RD.
Why did I just tell you all that?
To explain where I came from.
Now we can get into how I got to where I am today, and why it is more meaningful to me.
My first client was a young woman with anorexia nervosa. Working with her I found a deep passion for psychology and figuring out what makes people have disordered behaviors around food.
Because of her, so many things happened for me:
- I found eating disorder dietitian mentors that helped me figure out what to do next
- I read everything I could get my hands on about eating disorder nutrition therapy and eating disorders in general
- I took some psychology classes at a local community college
- I got a business license and officially went into private practice (I had other jobs throughout the years as well, but PP was my first "real job" as a RD)
- I really began to believe the body positivity I was preaching
Today, I have the joy of helping amazing people realize just how amazing they are. I get to spend time getting to know them week after week, as we dig into their fears and dreams, and kick ED to the curb!
I get to teach students and interns about eating disorders, and healthy living.
I get to inspire the next generation to love themselves and ditch diets.
What a great career to be in.
My very favorite things are the moments of watching someone "get it," make change in their life, shift in their mindset, and ultimately work me out of a job (I know, weird - I want you to not need me). The texts and DMs, of how I made an impact in your life, make my day.
You all are amazing. Thank you for giving me my dream job!
Libby Parker, MS, RD
By: Jessica Cushing-murray
Though most people can understand the serious health consequences that can arise from a long term eating disorder, many are unaware of which problems are most commonly seen. One of which is called a Mallory Weiss Esophageal Tear, or Mallory Weiss Syndrome (MWS). MWS is defined as “tears in the lining of the esophagus,” which can often result from prolonged, severe vomiting, and is thus most evident in those suffering from Bulimia Nervosa.
So what exactly causes MW tears?
In people diagnosed with bulimia, the constant and continual act of forcing oneself to vomit (purge) their food after eating causes trauma to the esophagus (the tube that carries your food from your throat to your stomach). This trauma from vomiting can tear the lining of the esophagus, ultimately leading to people developing symptoms ranging from abdominal pain, to black/bloody bowel movements (blood in feces), to hematemesis (vomiting blood). None of these symptoms sound particularly pleasant, and they are worsened if the compulsive vomiting does not stop.
How can MW tears be fixed?
In people with bulimia who feel compelled to purge themselves through vomiting it can be unlikely that the Mallory Weiss tears in the esophagus will heal on their own. This creates an even more serious condition in which endoscopic therapy or even surgery may be required to resolve the symptoms. Left unhealed, MWS can lead to bad infections, as bacteria enter the open wounds in the esophagus. Though MWS can be the result of other trauma to the chest/throat, severe or prolonged hiccups, gastritis (inflammation of the stomach lining), it is a good example of a real and applicable consequence to people suffering from bulimia nervosa. However, it is possible that MW tears heal on their own, and a major part of the healing process is to stop purging behaviors.
For people with eating disorders (ED), it can become difficult to understand how their actions in their ED might affect them in the long run, so it’s important to learn and educate those around you about these kinds of conditions. Living with and recovering from an ED is difficult enough, it doesn’t need to be exacerbated by health issues such as MWS.
If you need help reducing your bulimia behaviors, including purging, make sure to reach out to an eating disorder registered dietitian for help. It can save your life (plus make food enjoyable again).
Can you help me change the industry by answering a few questions about eating disorder recovery services?
The questionnaire is 100% anonymous!
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Thank you so much!!
Something I hold back on is sharing about my struggles with food.
While I, thankfully, have been doing great for many years now, I did have an eating disorder end of high school/most of college.
And as most of you probably feel, it's hard to talk about!
I wonder if people will think I'm ok to help others.
I'd rather forget that part of my life.
But... It's important to break down the stigma and get the conversation going so others can feel empowered to tell their story and reach out for help.
So, I've been getting vulnerable and sharing my story.
You can hear parts of it in 3 places now:
My book, and the following video and article.
This video is both commentary on Taylor Swift's "Miss Americana" Documentary (the ED parts), and some of my story:
I was also asked to share some of my story, and tips for recovery, in a blog post for "Side by Side Nutrition," where I talked about eating foods that "don't count." Learn what I mean by reading the (short) article HERE.
You'r story is YOUR story. It doesn't have to look like anyone else's. If you are struggling with an eating disorder (or any health issues) you can get help. You don't have to wait until you are "sicker."
If you'd like to work with us, shoot me an email: Libby@notyouraveragenutritionist.com
You've got this!
Oh my; I get to go to NYC for work! ... and with theatre people....am I in a dream?
Nope, it's real. I'm headed to Broadway Con!
This conference is for theatre lovers, performers, crew, directors, and others involved in that world. I will be there promoting Not Your Average Nutritionist, along with The Body Positive Project (go check them out!). We are helping smash sterotyping roles and that any body can be a broadway body!
In honor of this theatre trip, this post is a round-up of my performance related articles, videos, and courses all in one place to help you have the best performing career you can!
Here we go...
My online health class for stage performers
(all the things you never learned):
"Whole Health for Performers"
OnStage Blog - Jan 2018 "Libby Parker: Making Performer's Health Their Top Priority"
On Stage Blog - Aug 2016 "Re-Igniting My Passion For Dance As An Adult"
What is the Dietitian's role on the dance sports medicine team?
Broadway BoPo - Aug 28, 2019 "The Broadway Dietitian" Interview. Nutrition and Wellness for Theatre Actors and Singers (video)
Stuck in a food rut? or eating disorder? Choreographing meals (video)
Why are dancers at a higher risk for eating disorders? (video)
Dance Nutrition with Emily Harrison, MS, RD, LD (video)
Our other services for perfomers
Follow my Instagram just for performance-related stuff: @The_Broadway_Dietitian
by Jessica Cushing-Murray
Anorexia, bulimia, obsessive-compulsive disorder. These are terms that are pretty universally known to the general population. But “orthorexia”? Not so much.
“Orthorexia” is defined by the National Eating Disorders Association (NEDA) as, “an obsession with proper or ‘healthful’ eating.” It is a fairly new term to describe those people you may know who are always looking at the nutritional labels on their food or can’t seem to eat food if they don’t know exactly what ingredients are in it. Orthorexia was coined only in the past couple of decades, and awareness of this term is increasing as the number of people concerned about “healthy” eating increases simultaneously. A deeper definition of the term originates from the man who coined the term himself, Dr. Stephen Bratman, who expressed, “Orthorexia commonly begins as an “exuberant” interest in healthy eating that escalates over time. What was originally a choice becomes a compulsion and the individual can no longer choose to relax their own rules. Eventually, the person’s restrictive eating starts to negatively impact both their health and social and occupational functioning; eating the right foods becomes increasingly important and squeezes out other pursuits.”
So why has orthorexia become a condition recognized by NEDA and important to us today?
It is an interesting phenomenon when a condition such as this one can be tied to society’s standards, as well as growing regulations put in place for nutrition in first-world countries. By this, I mean that all chain restaurants are now required to keep a copy of their nutritional facts in every restaurant for their consumers’ reference. Likewise, most places we eat have the calories, fat, and carbohydrate contents all directly on the menu, where these facts can sway anyone toward or away from certain meals based on the number of calories next to that food. In addition, there is a newer emphasis on vegetarian and vegan options, or a page of the menu that is classified “600 calories or less” and “lite meals.” All of these are ways that calories and nutrition facts are seemingly “thrown in our faces” everywhere we go, which certainly may correlate to the development of orthorexia.
In terms of treatment and diagnoses, Orthorexia is not specifically recognized as it’s own disorder in the Diagnostic and Statistic Manual (DSM) that health professionals abide by. This makes it very difficult to “diagnose” people as orthorexic. However, orthorexia itself is an obsession with healthy eating, so it is often thought of as combination of a classified eating disorder (such as anorexia) paired with a form of obsessive-compulsive disorder (OCD). Therefore, people who are be orthorexic may be constantly reading nutrition facts and ingredient labels, and may refuse to eat certain foods if the nutrition facts or other factors do not meet their ‘health’ standards. In addition to reading labels, someone who is orthorexic likely eats the same few foods or meals every day because they have deemed these specific foods as “acceptable.” People suffering from orthorexia may--in a similar way to those with eating disorders like anorexia-- completely cut out certain food groups from their diets. Things like “carbs” or “all meat” or “all animal products.” Or they may have other ways of deeming foods as acceptable such as if the food is grown organically or locally. They likely do this for a couple of reasons: the foods they are rejecting are not ‘pure’ or ‘healthy’ enough, but also because it makes it easier to continue with their orthorexic behavior in front of other people. Think about it: someone who randomly and completely stops eating meat looks suspicious, but if they can say to their friends that they have decided to adopt a vegetarian diet, now they have a reason to have cut an entire food group out of their diet without looking unhealthy. Lastly, another important sign of someone who may be suffering from orthorexia is someone who will become visibly distressed when there are no ‘healthy’ food options at an event, or if they are unable to find the nutrition facts or ingredients list for the food in front of them.
Orthorexia can look tremendously like a person who simply took the “eating a healthy diet” lifestyle to the extreme and is now obsessed with only eating very specific “healthy” foods. It is important to recognize and educate yourself on terms like orthorexia, because it has a likeliness to develop into other classified eating disorders, can lead to malnutrition based on the restriction and specificity involved, and can be very harmful to individuals suffering from it. Though orthorexia is not yet classified as its own official diagnosis (though it is currently diagnosed under “other specified feeding and eating disorders” in the DSM-5), the obsession our society has today with staying “fit” and “healthy” is sure to lead to increased prevalence of people becoming orthorexic. While reading this post you may have even had certain people in your life come to mind.
Awareness and education are powerful tools to utilize in helping people whose mantra of “living healthy” has ultimately become the dangerous opposite. The good news is: by reading this post, you just took the first step. See the links below for more information and signs/symptoms of people who may be suffering from Orthorexia.
If you need help recovering from Orthorexia, or another kind of eating disorder, reach out to our Dietitians today! Contact Dietitian Libby Parker HERE.
What are important things to know when thinking of performance nutrition for dancers (professional and pre-professional)?
Find out in this video interview with 2 dance-dietitians:
In this video: Registered dietitians, Libby Parker & Emily Harrison, chat about dancer nutrition/health, what to do if a director/choreographer asks you to lose weight, why diets are not a good idea, longevity (with quality of life), and more!
Emily Harrison, MS, RD, LD is a former professional ballet dancer, and has worked as the dietitian for dancers in seven countries, and with prestigious ballet companies. Emily frequently writes for dance publications, and published her own book/video series, Nutrition for Great Performances. Find Emily at: www.dancernutrition.com
By: Jessica Cushing-murray
Jessica graduated from UCLA in 2018 with a degree in Psychobiology and continued her education at University of Hawaii for a Masters in Nutritional Science. Though she loved her first semester studying nutrition, she realized that life is not always a linear process and made the decision to apply for medical school with hopes to be accepted this cycle in 2020. But, as a former collegiate distance runner, Jessica will always have a passion for nutrition and helping people struggling with eating disorders.
I probably have never met you, I don’t know what color your hair is, what your family is like, or where you live. And yet, I know you. A big part of you. The part struggling with an eating disorder, the part that has probably taken over your life and is consuming all your thoughts.
Before you roll your eyes and get ready for a lecture you’ve probably been hearing from your family and friends lately, you should know that I get it. Because I used to be you. You wake up every morning and go exercise and probably put off eating for as long as you can. The question constantly running through your mind is “to eat or not eat.” Some foods are acceptable, you’ve deemed them “healthy” in your mind; other foods are things you will not even consider eating. For me, a big “can’t” food was pasta. I used to love pasta: all kinds, spaghetti and meatballs, fettuccine Alfredo, mac and cheese, you name it, I loved it... But then my ED developed and I just couldn’t, it gave me so much anxiety.
You probably have a routine down filled with things like exercise, coffee, maybe even laxatives. Your friends are worried about you and you’re sick of hearing that “you should talk to someone” or “you need help” because you think you’re fine. I used to think that too.
So I have a question for you: what’s the goal? What’s the end point? Do you even know? How long have you been stuck and unhappy in your eating disorder? Is there an end in sight? I had a goal weight. An “if I hit this weight then I will be done and I will be proud of myself.” Here’s what I know: your goal--whether it’s a weight, a clothing size, a feeling--it won’t feel like you think it will. When I had exercised to the maximum and avoided all the foods I used to love, I hit my ‘goal’ - and I felt more empty and lost than I ever had, and I sure as heck didn’t feel any better about myself. When you’re stuck in an eating disorder, you are trapped in a cycle of dieting, cravings, and exercising, and it seems like there’s no way to stop. You might not even realize yet that life isn’t supposed to be this hard.
Two major things I learned in treatment:
1) Nobody can make you want to get better. You have to want it for yourself. And that’s the hardest part about navigating through an ED: the fact that you have to be the one who chooses recovery. Maybe you think that words like “recovery” and “treatment” sound like total BS things that you don’t need. That’s how I felt too.
But now let me tell you the 2nd thing I learned…
2) There are no shortcuts in life. Every decision you make in your ED is going to have real consequences that you probably don’t know about. I broke bones because of my ED. I have friends with permanent heart problems from their excessive exercise/binging/purging. I know people who’s repeated “I’m fine” and “I don’t have a problem” phrases left them hospitalized.
So yes, it’s your life. And it’s your choice to listen or not listen to the people around you. But it’s your life. Don’t you want to be around to live it and enjoy it? My psychologist once asked me, “Jess, what are some things you are unable to do now [because of your eating disorder] that you would be able to do once in recovery?” The long answer was: I could sleep better, have less anxiety, enjoy ice cream and going out to eat with friends, and again ICE CREAM!
But when I really thought about: what could I do when I finally accept recovery? The short answer was: anything and everything.
This is what I wish for you.
I'm speaking at the adorable local restaurant, Nourish SLO,
on July 19, 2019, and you are invited!
Get your ticket HERE they are going fast!
You can also contact firstname.lastname@example.org
Nourish SLO is excited to host registered dietitian and author, Libby Parker, for an evening of healthy discussion.
Join us at Nourish SLO with Libby Parker, MS, RD, for a Wellness Seminar on Intuitive Eating Friday, July 19 from 6-8pm.
In this seminar, you will learn:
-why you should ditch the tracking apps (never count calories or macros again!)
-how to check in with "what's eating you" before you eat.
-the difference between hunger and appetite, and that they don't always occur at the same time.
-about the physiological body systems that control our hunger and fullness.
-how to eat your favorite foods, and be healthy!
6:00-6:30 Meet & Greet w/ food from Nourish SLO
6:30-8:00 Intuitive Eating Seminar, followed by Q&A and book signing of Permission to Eat with Libby Parker (books will be available for purchase - $15)
Bring a notepad & pen - you're going to want to take notes!
Libby Parker, MS, RD, is a local Dietitian and author of "Permission To Eat: A practical guide to working yourself out of an eating disorder during college, while celebrating the awesomeness that is you!" Libby's private practice in SLO, Not Your Average Nutritionist, specializes in helping young adults and performers recover from eating disorders. Find her at www.NotYourAverageNutritionist.com or get social, @DietitianLibby
Libby is a non-diet Registered Dietitian focusing on eating disorder treatment and prevention. She approaches health from the inclusive standpoint that any "body" can focus on health regardless of size. She is a ally in diversity.
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Disclaimer: This website is for educational & informational purposes only,
it is not a substitute for medical or mental health advice or treatment.