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Session 7

Body Image and Healthy Eating

Session 7

Breaking free from diet culture

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Normal eating or disordered eating?

Drag and drop the sentences into the correct bubble below...

Disordered eating

    This is correct

    Normal eating

      Incorrect! Try again

      Do you think the statements below are normal eating or disordered eating?

      Drag the sentences into the correct bubble

      Sometimes overeating and sometimes undereating

      Avoiding whole food groups due to food rules (all carbs are 'bad')

      Food and weight occupying most of your waking thoughts

      Allowing food to have moral value (eating a specific food makes you a bad person)

      Measuring and weighing food

      Choosing desired foods without guilt

      Eating regular balanced meals and snacks of normal portion (e.g. 3 larger meals and small snack or multiple smaller snacks)

      Meeting nutritional needs through varied diet

      Ignoring your bodies hunger signals

      Being able to maintain a healthy body through regular and relaxed intake

      Answers

      What does "normal"
      eating look
      like?

      Includes
      social foods

      Includes having
      varied food
      groups

      Variable in the
      amount and type

      Usually comprises of
      3 main meals
      and 2-3 snacks, however,
      this can vary based
      on many factors
      e.g. how active
      you are, your appetite,
      the environment
      etc.

      Flexible

      Listening to hunger
      and fullness cues.
      Eating regularly is
      the best way to
      manage appetite

      Enjoying your food

      Sometimes
      eating
      fast food or
      takeaways

      Using some
      restraint in your
      food selection
      to get the right
      balance
      of foods

      What affects our ability
      to eat 'normally'

      Take a moment to list some ideas:

      What we read on social
      media, magazines,
      internet

      The eating habits
      observed or learnt
      from childhood

      Pressures from
      peers and society
      to look a certain
      way

      Our knowledge of food and
      what is normal eating
      behaviours

      The Diet Culture
      we live in

      Diet Culture

      A system that values weight, shape and size over health and well-being!

      What does diet culture mean to you?

      Labelling
      foods

      Ignoring body
      cues

      Associating
      worth with
      how you look

      Equating thinness
      with health

      Associating
      worth with what
      you eat

      Food rules

      Food anxiety

      Avoiding foods
      too high in fats,
      carbs or calories

      Food label gives
      you permission
      to eat

      Eliminating food
      groups

      Food Guilt

      Examples of
      diet culture!

      Avoiding
      situations
      because of food

      Feeling or need
      to justify eating

      Exercise for
      punishment

      Diet talk

      Complimenting
      weight loss

      Scale dictates
      happiness or
      worth

      Believing you must
      take supplements
      for health

      What causes and maintains diet culture?

      The way we speak >>

      It's my cheat day!

      This is so bad for you

      I start my new diet tomorrow

      What influences diet culture?

      Advertising!
      The UK diet industry is worth $2 billion a year

      Competition & comparison

      Things to bear in mind

      Anyone can call themselves a "nutritionist"

      It is not a legally protected title – an Instagram “nutritionist guru" may have no qualification

      Research reveals social media influencers give bad diet and fitness advise

      Breaking food rules
      His

      Stop comparing your food choices to someone else’s

      Hers

      It’s okay if you eat more than someone else, man or woman!

      Do you have any rules around how you eat or the foods you eat?

      Do you have any deliberately avoided foods?

      Make some notes below ?

      Most days

      Eats a mix of both

      Also no food rules

      having grapes for dessert because it’s what you want

      Some days

      Eats mostly processed foods

      Other days

      eats mostly 'whole' foods

      Most days

      Eats a mix of both

      Mental

      Not physically hungry but have a craving for some chocolate

      Hunger

      Totally okay, eat mindfully to identify satisfaction and enjoy without guilt

      Using your list of rules and avoided foods. Cut these up into individual papers and fold to place in a jar.

      Choose one or more out the jar to challenge each week.

      You can challenge that rule as frequent as food daily or as little as once in the week.

      Challenging food rules
      and avoided foods

      Consider where this rule came from:

      Is it based on evidence and a credible source?

      Is it relevant to your age group?

      Is it relevant to your gender?

      Is it designed for a healthy population of for medical purposes?

      Consider the impact of the rules or avoided foods
      to other parts of your life:

      Does this rule or avoided food stop you being able to do social activities?

      Does it stop you attending social events?

      Does it impact your mood negatively?

      Does it negatively impact your physical health? – fatigue, illness,
      dizziness, weight, energy levels etc.

      Note: It will likely take more than one attempt, so consider placing them back in the jar for another attempt

      The harm of diet culture

      Harmful to health

      Normalises disordered eating

      Dominates your thoughts

      Promotes eating disorders

      Steals joy from life

      Waste of time

      Waste of money

      Increases guilt and shame

      Makes digestion worse

      Increases risk of physically ill health

      Hurts relationships

      Exercise becomes punishment

      What are your take home messages about diet culture?

      Why Diets don’t work

      Diets are usually short term interventions focused on rigid, strict and restricting food plans with aim
      of losing weight.

      Physiological and Psychological effects:
      Diets are often overly prescriptive in the deficit of intake that leads to semi-starving of the body and physical body feeling deprived. Physiologically and psychologically, the body starts to increase it’s signalling to get what it needs … food.

      - Young people may feel like they are constantly thinking about food, preoccupied by making food choices or have a building sense of craving food.

      - This deprivation of brain and body can lead to overconsumption of food intake and poor food choices, which can undo the aims of the initial diet.

      - Following overconsumption, young people may then feel guilty about eating too much and feel a need to restrict further to make up for the overeating. Leading to a vicious cycle.

      Creation of Food rules: Diets usually promote labelling foods into categories ‘good foods’ and ‘bad foods’.

      Psychologically, this can lead to over restriction of the ‘bad foods’ and significant guilt if a young person gives in and eats a ‘bad food’. Eating a bad food or banned food, can make a young person feel like they have failed in their diet.

      This can trigger thoughts that they might as well eat as much as they can since they failed anyway, with view of then going back to denying themselves the food in the future.

      Diet culture influence

      Diets are usually short term interventions focused on rigid, strict and restricting food plans with aim
      of losing weight.

      In the body image sessions, one task was to complete two self-worth pie charts. One chart focused on aspects currently
      highlighted as influencing your self-worth, and the second pie-chart focused on how youwould like their future self-worth pie chart to look (based on goals, values, beliefs and desires).

      In a blank pie chart, draw out how much space dieting, or controlling what you eat and how you look takes up.

      Are there other aspects of your life that have been neglected due to your focus on diet and image?

      How would you like your pie chart to look in regard to what you hold important?

      Some Ideas...

      Build Awareness

      Begin to notice the messages around you that are from diet culture.
      This includes conversations about weight, body shape and dieting

      Know the facts

      Recognise the unhelpfulness of diet culture. Know that skinny doesn’t always equal healthy. Remember why fats and sugars are ok, and even needed, in our diets

      Walk away from diet culture

      When you see it say “no not today” to diet culture

      It’s ok to leave these conversations – or even call them out! Talk about something else

      Do something else – engage in hobbies, voluntary work or learning something new

      Surround yourself with anti-diet culture messages.

      Listen to podcasts and follow social media around intuitive eating and body kindness

      Find friends that have similar beliefs as you

      Empower others to break free of diet culture

      Create a diet culture free zone

      Clean up your social media feeds

      Avoid diet products – food & drinks, supplements, books, magazines

      Healthy relationship to food not based on a restrictive diet

      You are awesome as you are

      Don't go on a diet

      Superfoods don’t exist All food is neutral

      Challenging Diet Culture

      How can we challenge diet culture?

      Can you think of a good magazine or news headline to challenge diet culture?

      My worth is unrelated to how I look

      Know our boundaries

      it’s ok to say no and prioritise mental health

      Feel amazing

      stop comparing yourself to unrealistic standards

      Move because it feels good in your body and head but don’t forget to rest!

      Don't exhaust yourself just to get visible abs!

      Try to choose what you genuinely want.
      Think about how hungry you are, remember some of mindful eating and intuitive eating ideas discussed in the previous presentation

      Try not to order based on any food rules
      you have or diet culture influences

      Task

      Ordering off a menu

      What would you like to order today?

      The pad thai because
      they like the cuisine and
      peanut taste

      Task

      What did you order and why?

      Examples from other young people:

      The quesadilla
      because they love
      cheese

      The Souvlaki because it
      reminded them of a
      holiday in Greece

      Reflections

      image
      image
      image

      Acknowledgements Body Image & Eating

      Content created by:

      • Module Lead: Dr Erica Cini - Consultant Child and Adolescent Psychiatrist ELFT
      • Module Team:
        Alex Bell - Senior Specialist Paediatric Dietitian
        Emily Bland - Assistant Psychologist
        Elliott Lee - Assistant Dietitian
        Phoebe Bainbridge - Assistant Psychologist
      • East London NHS Foundation Trust Community Eating Disorder Services (CEDS) and Eating Disorder Services (EDS)

      The CEDS Body Image and Normal Eating Group is a CBT psychoeducation series ofsessions based on the manual developed by Hampshire CEDS, consultation and published body image manuals (Fairburn, 2001; Collins-Donnelly, 2014) such as Cognitive Behaviour Therapy and Eating disorders and Banish Your Body Image Thief.

      Meisel, Georgia & Chounkaria, Michelle & Cini, Erica. (2021). The Developmentof a Body Image and Normal Eating Group for Adolescents in an EatingDisorders Service. 10.13140/RG.2.2.29915.28965.

      Wilson, Ruth & Iredale, Catherine & Fialko, Laura & Rumball, Katrina & Cini,Erica. (2018). Group Interventions in an Eating Disorder Service for Children &Young People: Development of a ‘Learning to Live in Your Body’ Group.10.13140/RG.2.2.32896.12807.

      Image references available upon request, stock images provided by Adobe stock images, Shutterstock and Freepik. For any copyright questions or concerns please contact our web development service provider Infused Media Ltd.

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      My Notes

      Supporting Videos

      The Fight, Flight, Freeze Response

      If you could change one thing about your body, what would it be?

      Mindful Eating