I have been treating people with eating disorders since 1988.  This was around the time that Oprah  wheeled sixty pounds of animal fat onto her stage in a little red wagon, graphically representing the weight that she had lost on the liquid protein diet, “Optifast”.  Being in graduate school in Chicago at this time, where Oprah films, was fortuitous for me, as I was beginning my graduate career in Psychology.  I started facilitating groups for people committing themselves for the next several months to living, breathing, and drinking Optifast.  Every week I educated groups on nutrients, calories, fat, metabolism, and eventually, strategies to living with food in a healthy way.   We did not delve into individuals’ past hurts, wounds, struggles, abuses, or family dynamics, as this was not part of the program.  However,  I felt that while the “liquid” part of the program was a fairly drastic weight loss strategy, the maintenance part of the program was quite realistic, with food gently reintroduced.  The emphasis on behavior modification lent itself to members feeling greater control and ability to include even  favorite foods in their daily lives. I thought that Optifast group members were left with excellent informational and supportive materials and coping strategies.

Over the course of the next ten years, I  helped many clients recover from eating disorders of every kind:  obesity, anorexia nervosa, bulimia nervosa, compulsive overeating, etc.  Most of those who I saw during this time chose not to attempt a medically managed diet, such as Optifast, or other weight loss program such as Nutrisystem, Jenny Craig, or L.A. Weight Loss.  I worked with girls as young as nine who were so anxiety ridden about their weight compared to their peers’, that they were already limiting their caloric intake, and exercising in hiding.  Many of these women, adolescents and children recovered, and went on to work in the field of eating disorders in order to help others.  I had the pleasure of watching so many women and men change their lives as a result of losing weight and gaining self esteem.  Then I left private practice to rear my own children.  During the next ten years, I watched friends struggle with their weight before, during, and after pregnancy.  I had to face my own concerns and fear about my weight as I gained and lost an increasingly  larger amount of weight for each of three pregnancies.  I have watched standards change for womens’ weight and shape in the media.  I was frustrated when the actress,Tracey Gold, declared herself “recovered” on Oprah, when she filmed the T.V movie, “For the Love of Nancy”, in 1994.  She stated that she had only recently become well.  The recovery from an eating disorder takes years.  I knew that it was too early in her recovery for her to portray a girl in the midst of a full blown eating disorder.  At the same time, I was relieved to see actresses and models of normal weight being embraced by the media, and those “emaciated”, or “underweight” celebrities perceived in a more negative light than they had a decade prior.  I watched several fad diets come and go, along with the  diet pendulum, which swung from “no fat” to “no carbs”, to now, at least, an emphasis on balanced nutrition.

I began seeing clients again about one year ago.  So much had changed in the field of eating disorders, and weight management…or so I thought.  Since working again professionally with those who are struggling with food and body image issues, I realize that these will continue to be a major part of the American mental health culture.  I thought that with the anti-aging explosion, and the advent of drinks and foods rich in antioxidants, the emphasis was shifting from “thinner” to “healthier and younger”.  Everyone, it seemed, was now on a quest to remain young, and vibrant, as opposed to just maintaining a certain weight or jeans size.  Unfortunately, though, I have found this not to be the case.  Now I am seeing women and men who are not only trying to take years off their appearance through Botox and Restylane injections, plastic surgery, and yes, eating and drinking foods and juices made with the youth enhancing acai berry, but they are doing all that while still pursuing unrealistic weight goals.  What has happened?  What have we learned?  Surely, increased pressure on ourselves to uphold a standard of shape and weight is not where we thought we would be at this time.  This pressure, combined with the pressure to appear years younger than we actually are, is ironically, only serving to exacerbate the stress associated with aging.  The mental energy, obsessive thoughts, and compulsive behaviors associated with food and weight, continue to usurp the energy we should be spending improving the quality of our lives and bodies.  Adults of all ages, adolescents, and even children are putting unrealistic expectations on themselves regarding weight and size. This is in spite of how far we have come, and how much we know about aging, food, and health.

I love that the women in my community of Heathrow, Florida, play tennis for fun.  I love that boys and girls play sports, and are encouraged to be physically active all year.  I am dismayed to know that girls in third and fourth grade at a school in Lake Mary, Florida call themselves the “salad girls” because they limit themselves to only salad at lunch.  I will continue to do everything I can to facilitate the changes in public and self perceptions of body image that we know we can see.