Our current culture presents a confusing array of messages about eating and body image. We see media images which promote unrealistic (and generally unreal) bodies paired with headlines about obesity prevention programs; news stories about eating disorders alongside multiple supersize food options; push for perfection alongside marketing for indulgence.

It’s no wonder we have both increasing incidents of eating disorders, such as anorexia and bulimia, as well as increasing prevalence of binge eating disorder and rates of obesity.

Navigating this confusing world without falling into an eating- or weight-related disorder does require a return to some basic facts.

“The physical and emotional health of an entire generation and the economic health and security of our nation is at stake.” 
~ First Lady Michelle Obama at the Let’s Move! launch on February 9, 2010

Frank Bruni was a fat kid.  He was also the New York Times food critic from 2004-2009 and the best-selling author of Born Round: The Secret History of a Full-Time Eater.  In his deeply moving memoir, he explains the problems and perils of being fat and the emotional struggle food caused him as a child and an adult.  He said he wanted to write his memoir to show  “what food could do to trip people up.”

Apparently food can do a lot to trip you up.  Being obese can have a devastating impact on life. A child born in this century has a one in three chance of developing diabetes and an alarmingly high percentage will suffer obesity-related conditions such as cancer, asthma, high blood pressure and heart disease.  Those numbers go up dramatically in the Hispanic and African-American communities:  Right now 40 percent of these children are overweight or obese.

With these statistics, is it any wonder that Michelle Obama would introduce Let’s Move to combat childhood obesity?

If you’re obese and are at the end of your ropes looking for weight loss help, there’s good news from the U.S. Food and Drug Administration (FDA). The FDA in the past few months has approved two new weight loss drugs for people who struggle with obesity and being overweight — Qsymia and Belviq.

Both Qsymia (pronounced kyoo-sim-EE-uh and manufactured by Vivus Pharmaceuticals) and Belviq (pronounced bel-VEEK and manufactured by Arena Pharmaceuticals) have been shown to be effective in their clinical trials to help people lose significant amounts of weight.

Qsymia is composed of two generic drugs, phentermine (an appetite suppressant) and topiramate (a seizure and migraine medication). Belviq focuses on changing on how serotonin is processed by the brain. Qysmia will be on sale by the end of the year, while Belviq won’t be available until sometime in early-to-mid 2013.

Should you consider these drugs if you’re obese or seriously overweight?

Women’s National Health Week, an annual awareness event dedicated to all issues related to women’s health, was May 13-19 this year.

In honor of this year’s message, “It’s your time,” I want to draw attention to the link between how we see ourselves and how we treat our bodies.

Currently, 80 percent of women in the U.S. are dissatisfied with their appearance. And more than 10 million are suffering from eating disorders.

So the question I have to ask, Why all the self-hatred?

It takes continuous practice to maintain a positive body image. Think of it as a skill that needs attention and sharpening.

And that’s a great thing. It means that you can lift a low body image at any time. While it’s not easy, there are practical, concrete ways you can improve how you see your body — and yourself.

Below, Joyce Marter, LCPC, a psychotherapist and owner of Urban Balance, LLC, a multi-site counseling practice in the greater Chicago area, offers five ideas to do just that.

I live in a town where eating disorder treatment is almost nonexistent. Feeling in danger of a relapse, I decided it was time to see a therapist. She was a licensed psychologist specializing in eating disorders and women’s issues. I went voluntarily, not expecting what I received.

Everything was booked and set via email. My choice. I hate calling people. She mailed me all the paperwork from her office to bring with me on my first visit. What I loved when I first met her was that she didn’t even want to look at the filled-out documents during session; she was eager to get down to talking. I was nervous being there, naturally, it’s sensitive material being shared with a stranger. I remember which chair I sat in and how she sat on the couch.

Eager. Ready.

There is a strong correlation between trauma and eating disorders. A number of studies have shown that people who struggle with eating disorders have a higher incidence of neglect and physical, emotional and sexual abuse. In particular, binge eating disorder is associated with emotional abuse while sexual abuse has been linked to eating disorders in males.

So what constitutes trauma?

Trauma comes in many forms, including childhood abuse or neglect, growing up in an alcoholic or dysfunctional home, environmental catastrophes such as Hurricane Katrina, a serious accident, loss of a loved one, and violent attacks such as rape and sexual assault. What all of these experiences have in common is that they leave the individual feeling helpless and out of control.

Trauma isn’t the same as having post-traumatic stress disorder (PTSD). PTSD is a specific diagnosis with distinct criteria, involving a serious or life-threatening experience that results in nightmares, flashbacks, attempts to avoid situations similar to those that led to the trauma and a hyperactive startle response, among other symptoms.

Recently I had the chance to ask Margarita Tartakovsky, an associate editor at Psych Central, a few questions about eating behavior.  She blogs regularly about eating and self-image issues on her blog Weightless.

Q. Why doesn’t the current model of treating obesity — only telling people what and how much to eat — work for most people?

A. Great question, because the current model definitely doesn’t work. I can’t remember who said it, but there’s a saying that if you want to gain weight, go on a diet. Diets have a failure rate of about 95 percent. People may lose weight initially but then they usually gain it back and then some.

So this model doesn’t work for many reasons. For one thing, genetics plays a prominent role in our weight. This is why you can have two people who eat the same foods in the same quantities look very different. One may be thin; the other may be considered “overweight.” Our bodies are more complicated than the “calories in, calories out” equation assumes.

Integrative medicine can be defined as “a healing-oriented discipline that takes into account the whole person — body, mind and spirit — including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of both conventional and alternative therapies.”

Complementary and alternative therapies used in integrative medicine can include acupuncture, chiropractic, herbal medicine, dietary supplements and others that give the clinician a wide array of treatments for difficult conditions. This is particularly true in the integrative medicine approach to eating disorders.

Eating disorders have been documented in adolescents and adults for many years. More recently, there is evidence that these disorders can also affect young children.

The cornerstones of an integrative medicine model for eating disorders includes some components that are found in every approach to the treatment of eating disorders, but may be used in a unique manner. Others are more specific to the use of complementary and alternative medicine (CAM) therapies. The most important difference in this model when compared to other treatment strategies is the philosophical underpinning of integrative medicine — that is, the belief in the self-healing nature of body, mind and spirit.

Are you a moderator or an abstainer?

In honor of many people’s New Year’s resolutions — “Eat more healthfully,” “Cut out sweets,” “Lose weight,” and the like — I’m re-posting this quiz, to help you determine whether you’re a moderator or an abstainer. When I figured out that I’m an “abstainer,” it helped me tremendously in terms of eating better.

Often, we know we’d have more long-term happiness if we gave up something that gives us a rush of satisfaction in the short-term. That morning doughnut, that late-night ice cream.

A piece of advice I often see is, “Be moderate. Don’t have dessert every night, but if you try to deny yourself altogether, you’ll fall off the wagon. Allow yourself to have the occasional treat, it will help you stick to your plan.”

I’ve come to believe that this is good advice for some people: the moderators. They do better when they try to make moderate changes, when they avoid absolutes and bright lines.

Food likes and dislikes are often thought to play a huge role in eating behaviors.  The pleasure we derive from food may be one of the most — if not the most — important factors contributing to food intake (Eertmans, et al., 2001; Rozin & Zellner, 1985; Rozin, 1990). 

Interviews with customers in supermarkets and restaurants have shown that people consider the sensory properties of food as an important value influencing their choice of food purchased (Furst, et al., 1996).  If food is not perceived as appealing in terms of appearance, smell, taste, and texture it probably will not be eaten (Hetherington & Rolls, 1996). 

Although food preferences are by no means the only influences on eating behavior, likes and dislikes are very important factors. This article will briefly discuss the influence food preferences have on eating behavior.  

It has been suggested that we are often unaware of external factors that influence eating behavior (Wansink, 2006; Vartaninan et al., 2008).  There is a substantial body of research that shows external factors have a robust influence on eating behavior (Epstein et al., 2009; Remick et al., 2009; Rozin et al., 2003). 

These external factors include things such as portion size, labeling, variety of food we eat, and how much attention we pay when we’re eating (or whether we’re distracted by socializing, for instance). Even the plate size can affect how we eat.

Now, some researchers have suggested that external factors may play a larger role in eating behavior than internal factors, such as hunger, satiety, flavor, macro-nutrient content, and so on (Wansink et al., 2007; Levitsky, 2005; Wansink, et al., 2005). 

What’s behind these external or environmental factors and their role in how we eat?