I would rather have lofty dreams that are never fulfilled than lowly goals that are easily accomplished. - - Jim Watkins

The National Eating Disorders Association (NEDA) conference was held this weekend in Austin, TX. When I am at NEDA, I can't help but feel moved by the family and friends of loved ones with eating disorders who are there to seek comfort and regain strength and encouragement. I also feel invigorated by the many changes that are taking place on a societal level, especially when I'm not very confident that the factors contributing to and maintaining eating disorders and body image concerns will be eradicated in my lifetime. One such change that was brought to my attention was the "Body Peace" Project promoted by Seventeen magazine. Although the magazine still focuses on fashion, appearance, fitness, and other teen issues, they are making efforts to promote body acceptance/peace through special blogs, articles, and even a treaty for young girls and their mothers. Some of my favorite vows from the youth treaty are:

I vow to . . .
• Never blame my body for the bad day I'm having
• Notice all the amazing things my body is doing for me every moment I walk, talk, think, breathe . . .
• Remind myself that what you see isn't always what you get on TV and in ads - - it takes a lot of airbrushing, dieting, money, and work to look like that
• Know that I'm already beautiful just the way I am

Click here to read all of the vows in the Body Peace treaty, and here to see what vows are available for moms too! Work toward adopting body peace for yourself and for everyone in your family.

Last year, I worked with two colleagues at the University of Minnesota (Jayne Fulkerson, PhD of the School of Nursing and Dianne Neumark-Sztainer, PhD, MPH, RD of the Division of Epidemiology and Community Health, School of Public Health) to understand the probable prevalence of full threshold and subthreshold eating disorders, as well as body image concerns, among teenagers. Using the Project EAT (Eating Among Teens) dataset which includes 4,746 students from Minnesota public middle and high schools, we found that 43% of girls and 34% of boys reported some significant level of disordered eating and/or body image concerns.

Even though the rates of full threshold eating disorder diagnoses were low (2.3% for girls and 0.5% for boys), an alarmingly high percentage of youth reported binge eating, self-induced vomiting, laxative use and/or excessive exercise (16.0% girls, 15.4% boys) not meeting criteria for a full threshold eating disorder. An even higher proportion reported severe body disparagement without disordered eating behaviors (25.1% girls and 17.7% boys).

Our findings are concerning. There are many youth who report disordered eating behaviors and body disparagement severe enough to warrant treatment but not (yet) meeting criteria for an eating disorder, and who may have difficulty accessing treatment due to how diagnostic criteria inform insurance coverage and access to specialized treatment. We are missing a substantial opportunity to provide primary prevention, and certainly early intervention, to these vulnerable youth because it is currently difficult for them to access specialized care. As a revision to the Diagnostic and Statistical Manual is underway and anticipated to be published in 2011, we hope that these findings will be taken into consideration so that more affected individuals can access specialized treatment before developing a full threshold eating disorder.

This article can be accessed through the International Journal of Eating Disorders (Int J Eat Disorder 2007; 40: 409-417).

There are times when clients tell me that they are afraid to express their feelings, under the belief that if they start to release their feelings, the feelings will never stop. Yet when feelings aren't released, they build up and build up, kind of like being cooked under pressure.

Picture what happens when you are cooking something liquid on the stovetop with the heat on high and the lid on fully. After awhile, the heat is so great that the boiling liquid will sneak out of the top of the pot underneath the lid and run down the side of the pot - it has to escape!

Feelings are kind of like liquid in a pot. Trying to contain our feelings when we're "hot" creates too much pressure, thus creating a situation where our feelings can "leak out" in an uncontrolled manner. But releasing the steam of our feelings on a more regular basis can help us avoid an explosion and attain better health. Keep this in mind when you find yourself full of feelings: the regular release of feelings to a trusted person can allow feelings to flow more freely and under better control, thus making you feel better without stuffing your feelings down.