By Ani C. Keshishian
2nd Year Graduate Student
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The COVID-19 pandemic has changed daily life as we know it and has had an enormous toll on mental health. Stresses related to the pandemic and increased isolation have led to a rise in depression, anxiety, and other mental health problems. Eating disorders are also on the rise. In 2020, the National Eating Disorders Association (NEDA) reported a 70% increase in calls and inquiries compared to 2019. Studies show that many with eating disorders are experiencing a worsening in symptoms. There are several factors that have contributed to the increase in and worsening of eating disorders. Pandemic related stressors leave many struggling to cope. Don’t despair! There are small things you can do to make sure you stay on track with eating disorder recovery! Here are steps you can take to maintain your mental health and manage your eating disorder.

1. Eat regularly. Make sure you are eating at regular intervals (approximately every 3-4 hours). Unemployment, working and schooling from home, and quarantining have left many lacking structure and feeling stressed. However, it is important to maintain the nourishment your body needs to survive and thrive, especially during stressful times. Eating regularly can also improve awareness of body cues, such as hunger and fullness.
2. Sleep regularly. Good sleep hygiene can improve your energy level and mood, while reducing feelings of depression. The National Sleep Foundation recommends adults need between 7 and 9 hours of sleep per night. Too little or too much sleep can have negative impacts on your well-being, contributing to depression, anxiety, and fatigue. Develop a consistent sleep schedule. Go to bed and get up at the same times each day, even on the weekends. Being consistent with your sleep times can help you maintain daily routine and structure.
3. Engage in enjoyable activities. COVID-19 has left many with a lot of free time spent alone. You don’t need to spend the extra time learning a new language, writing a novel, or re-organizing your closet. Spend time doing the things that bring you joy, whether that is reading a book, playing a game, building a puzzle, listening to music, taking a short walk, or sitting outside. Find the activities that make you happy and commit time to engaging in them, even or especially when you are feeling stressed.
4. Limit social media usage. Social media usage has also been associated with anxiety, depression, poor sleep, and low self-esteem. Being confined to your home can leave you vulnerable to increasing your social media usage. Social media can create a climate of social comparison and preoccupation with appearance. Especially during the pandemic, fatphobic messages – such as the growing usage of terms like the “quarantine 15” – can contribute to fear of weight gain. Limiting your social media usage, taking a social media break, removing triggering content, and following body positive content can help promote your mental health.
5. Practice gratitude. Take time to recognize and appreciate the things you are grateful for every day. It can be simple ordinary things such as noticing the sun shining, sensing the breeze on your face, watching a child play, listening to a bird sing, or taking note of a stranger’s kindness. There are many negative things we can focus on during these stressful times. But focusing on the positive things you are thankful for can reduce your stress levels and make you feel more connected to others.
6. Stay connected. Social distancing and quarantine have led to increases in social isolation and loneliness. It is important to take active steps to stay connected with the ones you love and care about. Positive social supports have been shown to be a powerful resource on the road to recovery. Communicate with your family, friends, coworkers, or classmates. Even though in-person contact is limited, you can still connect with a text, phone call, facetime, skype, or zoom. Feeling connected to others can reduce loneliness and improve your overall well-being.
7. Reach out for professional help. It is important to maintain both your physical and mental health. If you are experiencing symptoms of an eating disorder, it is vital that you seek professional support. If you are already in treatment, make sure you stay connected with your treatment team and ask for additional support if you need it. If you need more support, there are eating disorder organizations that can help you navigate the process of finding help, such as NEDA, the National Association of Anorexia Nervosa and Associated Disorders (ANAD), and Project Heal. Don’t hesitate to reach out for help.

 
It is undeniable that COVID-19 has changed our way of life. But it is important to remember that this is temporary. This too shall pass!

By: Cheri A. Levinson, PhD | EAT Lab Director

1. Food will not hurt you. In fact, food is your route to healing. 

2. Your anxiety, fear, guilt and other emotions will not hurt you. Embrace your emotions and you will start to break free.

3. Your size does not matter. It does not matter. It does not matter. Size does not define who you are or what you can do with your life.

4. Becoming thinner will not make you happy. Running more will not make you happy. Restricting more will not make you happy. Letting go of your eating disorder is the only pathway to happiness.

5. You can and will survive if someone judges you. When it comes down to what matters, people do not care about how big, thin, fat etc. you are. People worry more about themselves than other people. And if they do judge you on how you look, first, it won’t impact your life and second, you probably don’t want to be around them anyway.

6. The more you eat the more energy you will have. The more energy you have the more you can actually enjoy life.

7. You are a unique and special person who does enough and is enough just by being you.

8. Everyone deserves to eat. That voice in the back of your head telling you otherwise is wrong.
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9. Diet culture is an illusion steeped in patriarchy. It’s society’s way of holding you back. It profits large corporations and a corrupt wellness industry. Don’t let it win.  Fight back.

By Caroline Christian, M.S. 
3rd Year Graduate Student 

In our society, there are codes for how we treat one another. Imagine you are watching as someone walks up to a stranger and says, “Oh my gosh, you are so fat, there is no way anyone will ever love you.” What would your reaction be? Shock? Horror? Disbelief? You may even feel the need to walk up to the person and let them know that is not acceptable, or to comfort the other person. Or imagine saying to a friend, “Ew, your body looks gross today. You shouldn’t leave the house.” Or imagine if a friend said to you, “You need to lose weight, let’s not eat today.” What would your response be? These are examples of statements you would likely never say, or probably even think, about another person, because it would be rude, hostile, and may even end relationships. So why do we accept these statements when they are said to us by an eating disorder?

Individuals with eating disorders experience urges to engage in maladaptive behaviors, which are often driven by eating disorder thoughts. As discussed in the book, “Life without Ed”, by Jenni Schaefer, eating disorder thoughts often feel like another voice or entity (Ed) living in your head, chiming in on how you eat, socialize, and view your body (if unfamiliar with the eating disorder voice, you can read more here). The examples, “you are so fat,” “you shouldn’t leave the house today,” and “you need to lose weight” are just a few Ed thoughts that individuals with eating disorders may feel constantly bombarded with, especially around meal times, social gatherings, or situations involving seeing one’s body. Even if you don’t have an eating disorder, you likely still hear thoughts like this from time to time when looking in the mirror, trying on clothes, comparing yourself to friends, or eating at a restaurant. Although not typically accepted towards others, having critical thoughts about one’s own body and eating habits is so engrained in our society. We are taught that these self-critical thoughts are there for a reason: to motivate us to be “healthy,” to be the best version of ourselves, to be liked, and to have the most friends. These myths leading to shame, unhealthy weight-loss behaviors, and the impossible pursuit of perfection can hold us back from self-love and living life to the fullest. We are told we need to hate ourselves in order to motivate positive change, but in reality, the best motivator to want to take care of yourself is to love and accept yourself exactly as you are.
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Below are tips from evidence-based therapies for eating disorders, anxiety, and obsessive-compulsive disorder that may help you respond to these intrusive eating disorder thoughts that people of all backgrounds experience. The severity of these thoughts may widely differ for all people, but these tips can be helpful for folks that are young and old, men, women, and gender minorities, and people with and without eating disorders. For individuals at various stages of eating disorder recovery, we hope this is a helpful supplement or refresher, but strongly recommend working with an eating disorder specialist to practice responding to Ed thoughts. Resources for seeking treatment are included the very bottom of this page.
 
1. Practice logging thoughts to notice when Ed thoughts come up. The first step in responding to unhelpful thoughts is to notice when they arise. Starting a log or diary of thoughts can help identify when thoughts come up, if there are patterns in what triggered the thought, and how these thoughts impact your day. For example, you may notice you have self-critical thoughts about your body when you look in the mirror, and that these thoughts contribute to shame and make it harder to focus at work. Even just building this awareness can help you reclaim your life from Ed thoughts. It can also help you decide if and when it may be most helpful to use the other skills below.  
 
2. Telling Ed “maybe, maybe not.” One quick response to Ed thoughts is, “Maybe, maybe not.” This skill comes from acceptance-based and exposure-based therapies, and stems from the idea that you can accept uncertainty without having to respond to it with anxiety or unhealthy behaviors. For example, if Ed says, “Nobody will like you because you look fat,” you can say “Maybe nobody will ever like me, but maybe they will.” This dismission of Ed prevents the thought from spiraling and can help you become comfortable with the discomfort of uncertainty. For example, in reality, there may be people in society who judge others based on weight, but ruminative thoughts about the past and worried thoughts about the future don’t have to dictate how you feel in the current moment.
 
3. Treat yourself like you would treat a friend who heard Ed thoughts. Treating yourself like you would treat a loved one is the primary tenant of self-compassion. As exemplified in the first paragraph, many of us would never say the things Ed tell us to a friend or accept such comments from a stranger. Self-compassion is a great tool to use all the time, but especially when 1) you’re going through a hard time or 2) you feel like you’ve made a mistake. Self-critical thoughts about food and body can be especially loud during these times, so when you hear those thoughts (e.g., “you aren’t good enough”; “you shouldn’t have eaten that”), try to respond to yourself like you would a friend going through that same tough time. For example, if your friend is having Ed thoughts about her body after looking in the mirror, you may compliment her, remind her of other things you like about her, give her a hug, or invite her to do something fun or relaxing. Many people rarely afford the same compassion to themselves. Start to practice directing this kindness inward and see how it may change your outlook.
 
4. Challenge Ed thoughts. Another tool for responding to these thoughts comes from cognitive-behavioral therapy. Most self-critical thoughts have logical fallacies in them, like assuming something is black-or-white, exaggerating possible negatives, trying to predict the future, or assuming you know what another person may think. If you notice you have a thought that is based on a myth or misconception (try noticing them in the examples above!), you can challenge the thought and replace it with a rational alternative. You can challenge a thought by putting it on trial, and listing evidence (facts, not feelings) that support the statement is true, as well as evidence that contradicts the thought. For example, there probably isn’t much evidence that your friends think you are fat, but a lot of evidence that your friends like you for who you are! Writing out this evidence can help you see the reality of the situation; not just what Ed sees.
 
5. Let Ed thoughts come and go without changing behaviors. Importantly, self-critical thoughts are usually accompanied with something you should do or change, including unhealthy weight loss behaviors. It can be hard not to let these thoughts motivate you to do things that may be harmful or hurtful. However, there are several skills you can use to let these thoughts go, without giving them power or feeling like you must engage in behaviors. One example is the “leaves on a stream” meditation. In this meditation, you picture yourself in a wooded area by a stream. You picture the leaves from the trees around you as they fall from the trees, land on the stream, and slowly get swept away. When doing this meditation, as thoughts come up, especially unhelpful Ed thoughts, you can acknowledge the thought, place it on a leaf, and slowly watch it float away. There are also versions of this meditation where you put your thoughts on clouds, or a conveyor belt – whatever is best for you! The idea behind this meditation is that you can experience thoughts without valuing or buying into them, and that the thought does not have to continue to stay in your mind. Practicing this meditation can help you get better at letting go and saying no to Ed thoughts.   
 
6. Model these skills for loved ones. It is important to note that most people have self-critical thoughts and varying levels of practice responding to them. When interacting with friends and loved ones, it can be helpful to spread positive messages about food and body image and be mindful of saying things that enhance other’s Ed thoughts. Even saying critical thoughts about yourself, like “Do I look fat in this dress?” is a form of fat talk that can influence other’s perceptions of themselves. Instead, try to be self-compassionate, present-focused, and nonjudgmental of thoughts even when you are around others. By doing this, you may help others that have similar struggles with self-criticism or intrusive Ed thoughts. You can read more about how to spread positive food and body messages in this blog!
 
Responding to these self-critical thoughts about food and body image is not easy at first, whether you have an eating disorder or not. However, being aware of and responding to these thoughts can give them less power in your life, opening you up to a fuller life with self-compassion, self-acceptance, and present-focused awareness. As thoughts like, “I should lose weight so people think I am attractive,” or “I look so bloated and gross right now” come up in real life, let yourself replace these thoughts with rational thoughts, like, “My loved ones care about me, not my weight” and “It is normal that my body shape fluctuates.” Even though it may feel difficult at first, I encourage you to practice these responses and find the ones that are most helpful for you.
 
Resources for seeking treatment:
https://www.edreferral.com/
https://www.nationaleatingdisorders.org/help-support/contact-helpline
https://map.nationaleatingdisorders.org/
(for those in Louisville or Kentucky) https://www.louisvillecenterforeatingdisorders.com/

By Claire Cusack, B.A., Lab Manager
 
“If you would only stop thinking, you would be much happier”
―Pavilion of Women, Pearl S. Buck
 
Individuals with eating disorders are often bombarded with negative thoughts, both eating disorder specific and general. Some thoughts may resemble worry and others rumination. Yes, there is a difference between worry and rumination! Though worry and rumination are similar negative thinking patterns (Fresco et al., 2002),
 

• Worry refers to an uncontrollable, sequence of negative thoughts, whereas
• Rumination refers to brooding about negative thoughts and feelings (Ellis & Hudson, 2010; Papagerogiou, 2006).

 
Worry is usually repetitive negative thoughts about the future, and rumination is usually repetitive negative thoughts about the past.  In other words, worry is characterized by “What if’s” and rumination is characterized by “Why’s.”
 
What if I fail? Why did I say that?
What if I gain weight? Why can’t I eat normally?
 
At some level, everyone worries and ruminates, even those without eating disorders, and worry and rumination may be adaptive! For instance, concern about an upcoming test may motivate you to study, to reflect on a time that things didn’t go as well as you hoped, or may help you do things differently next time. However, for individuals with eating disorders who also show anxious and depressive symptoms, the thoughts may become unhelpful (Smith et al., 2018). This is where you may get stuck. Have you ever kept circling over an event and have gotten nowhere?
 
Have you asked yourself things like:
​

​Repeating these thoughts may make them seem true or like your fears are inevitable. The good news is that 93% of worries do not come true (LaFreniere & Newman, 2020). When worries do come true, it’s often because we make them come true or what happens turns out to not be as bad as we thought it would.
 
For example, before you know it, you’ve spent so much time thinking that you haven’t checked in with your friend about how they actually interpreted what you said. Or, you’ve spent so much time worrying about failing, that you didn’t study for the test. These sorts of behaviors in response to thoughts may actually cause a rift in the friendship or a low grade. Indeed, it is easy to get trapped in these cyclical negative thought patterns and believe them. These thoughts may make it more difficult to concentrate, do daily activities, or focus on the present (Paperogiou, 2006). Moreover, you may believe that these thoughts are valuable (Behar et al., 2009) and help you (Ellis & Hudson, 2010), such as by avoiding weight gain, or make you feel better (Schmidt & Treasure, 2006). What makes rumination even more insidious is it doesn’t always appear like “negative” or brooding thoughts. Reflecting on food, weight, and shape can lead to eating disorder symptoms just like brooding does (Cowdrey & Park, 2012). An example may be writing down food intake, thinking about it, and analyzing it (Cowdrey & Park, 2011). Though not obviously problematic, this type of behavior encourages repetitive (and unrealistic) negative thinking that takes you out of the present moment.
 
How do I know if my thoughts are helpful or not?

“Yes” to these questions may suggest your thinking patterns are not serving you. When worry and rumination become unmanageable, people often engage in corrective responses (Rawal et al., 2011). These responses may look like seeking reassurance (e.g., weighing or body checking) and attempting to avoid the negative thoughts (Cowdrey & Park, 2012), which ultimately increases eating disorder symptoms (Rawal et al., 2011). The reverse may be true too, where eating disorder symptoms trigger worry and rumination, thus circling back to more eating disorder behaviors (Smith et al., 2018). The repetitive negative thoughts, eating disorder behaviors, and management of both are exhausting.

​So, what can you do about it?
 
While you may currently be in the throes of an endless loop of worry, depression, and symptoms, you can put a pin it and break the cycle. It may seem counter-intuitive, yet approaching and accepting your thoughts can help you find a way out. This means inviting curiosity into your thoughts. When a thought (or series of thoughts) pops into your head, instead of accepting them as fact, notice them, acknowledge them, and try saying “Maybe, maybe not.” This lessens their power. You might wonder, “Why do I need to approach my thoughts and emotions when I am already constantly thinking?” Certainly, worry and rumination can be near constant and thus, may not seem like avoidance. Ironically, they are forms of avoidance. So, how do you approach a thought or feeling when you feel like you’re already doing that, and in fact, can’t avoid thinking? Surprisingly, this does not involve changing the content of your thoughts, but rather changing the thought processes (Ellis & Hudson, 2010; Watkins et al., 2007). Simply put, you don’t have to change what you’re thinking about, but how you’re thinking about it. Here are some suggestions when encountering repetitive negative thoughts:
 

• Acknowledge and Accept. Try noticing the thought and emotions; acknowledge them; and watch them pass without engaging in an eating disorder behavior. For instance, if the thought is “What if I get fat?” Acknowledge the feeling: “I feel scared.” Reframe how you are thinking: “I notice that I am scared.” Instead of avoiding food, approach food by eating the meal or snack anyway. Cycling through a litany of “What if’s” is a strategy to avoid the fear of weight gain.

 

• Take a step back from the thoughts, take a step into the feelings. Entertaining an endless list of “What if’s” or pondering an equally exhaustive list of “Why’s,” may lead you to get lost in the details and forget the purpose. It’s challenging to see the big picture with that level of scrutiny. Taking a step back may provide you with room to acknowledge the feelings. For example:

 
When giving a presentation at school or at work, you might slip on your words. If you catch yourself wondering “Why did I do that? Did they notice? Everyone must think I’m incompetent,” you can take a step back from the thoughts by acknowledging them. “I think that others think less of me because I made a mistake.” Taking a step into the feelings may look like, “I feel embarrassed.” Remembering the big picture could look like, “Even though I messed up a few words, the audience was still able to follow my presentation. Everyone makes mistakes.”
 

• Tune in to your body. This does not mean evaluate and judge your body, but instead to listen to your body (Park et al., 2011). It may be helpful to consider this as a shift from “doing” (e.g., ruminating and worrying) to “being” (e.g., how do you feel in this moment). As worry is typically future driven and rumination is typically past-driven, it can be helpful to focus on the present moment. Taking an inventory of the five senses may be a place to start. What can you see, hear, feel, taste, smell right now? Other activities that have been found helpful for worries include relaxation skills (Hoyer et al., 2009), meditation (Course-Choi et al., 2017; Eberth & Sedlmeier, 2012), and yoga (Zoogman et al., 2019).

 
Here are three take-aways: 
 

1. Not all of your thoughts are facts.
2. Most of your worries are not likely to come true.
3. You can create peace with your thoughts.

 
This doesn’t mean you won’t think negative thoughts or experience uncomfortable emotions. This is a hope that by shifting the way you think, you can not only face uncomfortable emotions, but you create room to feel the happier ones, too.

​Brenna Williams, B.A.
 
“To be beautiful means to be yourself. You don’t need to be accepted by others. You need to accept yourself.” – Thich Nhat Hanh
 
When you look in the mirror, what do you think about your body? How do you picture yourself in your mind? Do you feel comfortable with your body shape, or do you feel self-conscious about the way your body looks? Do you think you have a realistic perception of your body, or is the way you see your body distorted? The way you answer these questions represents your body image.
 
Body image is formally defined as how we feel about our own bodies and our physical appearance. People with a positive body image have realistic perceptions about their bodies. They also accept their bodies or feel comfortable in their own bodies. On the other hand, people with a negative body image have distorted perceptions of their bodies, and they feel shameful, anxious, or self-conscious about their bodies. In other words, people with a negative body image do not see their bodies realistically and they are dissatisfied with their bodies. If you have a negative body image, you’re not alone! Most people have a negative body image, with up to 72% of women and 61% of men report being unsatisfied with their bodies (Fiske et al., 2014). Having a negative body image can impact our mental health. For instance, body dissatisfaction is related to lower self-esteem (Tiggeman, 2005), depression (Keel et al., 2001), and disordered eating (Goldfield et al., 2010).
 
The good news is that body dissatisfaction and negative body image do not have to be permanent, and we do not have to change our bodies to like them. Furthermore, you don’t have to like or love your body to have a positive body image! Having a positive body image can involve simply accepting our bodies as they are in the present moment and not letting how we feel about our bodies get in the way of doing the things we enjoy. We can learn to accept and appreciate our bodies as they are right now. Loving or liking our bodies is not necessary. By changing our behaviors and our perspectives we can promote a positive body image in both ourselves and society.
 
Promoting a Positive Body Image in OURSELVES:

• Focus on the healthy ideal, rather than the appearance ideal. The healthy ideal is how your body looks when all of your health needs are met, including physical, mental, emotional, social, spiritual, and intellectual health.
• Focus on your body’s functions. Remind yourself of all the things your body does that you are grateful for, such as “I like my hands because they help me draw.”
• Practice self-compassion. When you notice you are feeling badly, instead of criticizing yourself, practice self-kindness. Try saying to yourself, “I accept myself as I am today” when you don’t feel good about your body.
• Notice when you are comparing yourself to others. We usually compare ourselves to others who we perceive as “better” than us (i.e., taller, thinner, more muscular), rather than those we are “better” than.
• Focus on the positives. Remind yourself of the physical characteristics that you do like. List them out, “I like my eyes. I like the color of my hair. I like my legs.”

 
Promoting a Positive Body Image in SOCIETY:

• Listen for and challenge body shame talk. When you hear other people talking badly about their own body, or other’s bodies, try calling out their behavior.
• Notice any of your own negative body talk. Make a pact with a friend or family member to stop talking negatively about your own or other’s bodies, and become aware of how you may talk about your own and other’s bodies.
• Start a “body acceptance” campaign or project. Put up positive body image quotes on Post-It notes in your home, school, campus, workplace, or town.
• Raise awareness. Read and share resources about media literacy, body diversity, body positivity, and Health at Every Size (HAES).

 
Positive Body Image Resources

• Health at Every Size
• National Eating Disorder Association
• The Body Project
• The Body: A Home for Love

 
Please share your own ideas of how to promote a positive body image in both ourselves and society in the comments. We would love to hear your suggestions!

By Caroline Christian- Second Year Graduate Student 
There is a lot of misinformation and misunderstanding about eating disorders in our society, which can make it difficult to get accurate information about what eating disorders are, and what they look like. Stigma, stereotypes, and poor communication from eating disorder specialists have led to a lack of awareness of the reality of eating disorders. Getting educated about eating disorders can help one learn how to best support a loved one with an eating disorder, help individuals stay motivated in recovery, or help with speaking out against institutions and policies that are harmful for individuals with eating disorders. Here I provide and discuss some statistics and facts about eating disorders based on empirical research, both in the United States broadly, and in my home state of Kentucky. 
 
Eating disorders (and disordered eating) are prevalent.

• About 6-20% of individuals in the United States will suffer from an eating disorder at some point in their life (Favaro, 2003).
• At this rate, in the city of Louisville there are roughly ~200,000 individuals with an eating disorder and in the state of Kentucky there are roughly ~900,000 individuals with an eating disorder.
• 91% of college women have reported engaging in dieting to control their weight (Kurth et al., 1995).
• 75% of women reported concerns about weight and shape interfered with their happiness (Reba-Harrelson et al., 2009).
• Eating disorders affect everyone, not just women, including men and ethnic and sexual minorities.

 
Eating disorders are (increasingly) prevalent in adolescents.

• Eating disorders commonly develop during adolescence and early adulthood (Stice et al., 2013).
• 15-19 years of age has been labeled a “high risk” group for eating disorders (Smink et al., 2012).
• Most eating disorders (>90% develop by age 24)
• Eating disorders affect 13% of females by the age of 20 (Stice et al., 2013).
• Children and early adolescents today are reporting higher rates of eating disorder behaviors compared to older generations who went through adolescence in the 1990s and 2000s (Favaro et al., 2009).

 
Eating disorders are chronic.

• Approximately 50% of individuals with anorexia nervosa and bulimia nervosa do not achieve full recovery in treatment (Herzog et al., 1993).
• Of those who do recover, over one third with experience at least one relapse.
• Anorexia nervosa has the second highest mortality rate of any psychiatric illness (only after opioid use disorders).
• Individuals with anorexia are 12x more likely to die than women their age without anorexia nervosa.
• Without treatment, 20% of people with from anorexia will prematurely die from eating disorder related health complications.

 
Eating disorders frequently co-occur with other mental and physical health problems.

• 80-97% of individuals with eating disorders have another psychiatric disorder, primarily anxiety and mood disorders (Blinder et al., 2006).
• Individuals with eating disorders are at much greater risk for attempting suicide, engaging in risky behaviors (e.g., substance misuse), and having other comorbid mental health conditions (Pietsky et al., 2008).
• Individuals with eating disorders are at significant higher risk for physical health complications, such as cardiovascular symptoms, obesity, chronic pain, and infectious diseases (Johnson et al., 2002).

 
Eating disorders are difficult to treat.

• Eating disorders are hard to detect and youth frequently don’t perceive these behaviors as problematic and unhealthy, leading to more difficulty in early identification of eating disorders (Walsh et al., 2000).

• Only between 1 in 5 and 1 in 10 individuals with a diagnosed eating disorder will seek treatment (Hart et al., 2011).
• Treatment is even less common among underrepresented populations.
• Inpatient and outpatient treatment for eating disorders cost more than treatment for other conditions, such as OCD, and many individuals in treatment are at a lower level of care than recommended, due to treatment costs and lack of resources (Streigel-Moore et al., 2000).

 
Eating disorders are underfunded.

• The National Institutes of Health allocates only 93 cents towards research funding for every person diagnosed with an eating disorder.
• This ratio can be compared to $88 for every person diagnosed with Alzheimer’s disease and 81% for every individual with Schizophrenia (National Institutes of Health, 2011).

 
Eating disorders are a silent epidemic in Kentucky crucially in need of resources.

• Based on data collected in the Kentucky Youth Risk Behavior Survey in 2013:
• Rates of eating disorders in Kentucky are significantly higher than the national average.
• 33% of high school students perceive themselves to be overweight, 47% are currently trying to lose weight, 13% fasted to lose/maintain weight in the past month, 7% took pills or supplements without a doctor’s advice to lose/maintain weight in the past month, and 6% vomited or took laxatives to lose/maintain weight in the past month.
• Approximately 1 out of every 10 Kentucky high school students reported engaging in 3 or more disordered eating behaviors.
• Students reporting more than three eating disorder behaviors were 5 times more likely to report feeling depressed in the past year, 6 times more likely to report suicidality in the past year, and 4 times more likely to report being bullied or cyber-bullied in the past year.
• The first and only eating disorder specialty clinic in Kentucky opened in Louisville in 2016.
  • This clinic does not offer residential level of care.
  • The closest eating disorder facility that offers residential care is in Missouri.
• Eating disorder behaviors are just as common, if not more common, than many other risky behaviors (e.g., substance abuse) that are currently prioritized by the Commonwealth.
• There are many screening and early intervention protocols in place in Kentucky schools, primary care, and other community-based service settings to detect substance use and mental health problems, but eating disorders behaviors are rarely, if ever, included in those standardized assessments.

 
These statistics and facts reflect the rather bleak current state of eating disorders. But there is hope! If you are feeling helpless or pessimistic about eating disorders, there are things you can do to help change enact positive change!

1. Call your legislators. If you live in Kentucky, Senate Bill 82 is currently being discussed, which would establish an eating disorder legislative council for the state of Kentucky. To support this bill becoming a law, you can Call 1-800-372-7181, and leave a message for your lawmakers, the Senate Health & Welfare Committee or Senate Leadership. When you call, you can let them know why this is important (You can use all the reasons above!)
2. Learn about eating disorder specialists near you that are doing empirically supported practices. Treatment outcomes are much better when therapists are using evidence-based therapies for eating disorders!
3. Talk to your friends and family members (especially kiddos) about the importance of body acceptance and engaging in healthy eating behaviors (e.g., eating enough food, eating a balanced variety of foods, and eating regularly throughout the day). Research shows that open discussions about and modeling of these healthy behaviors can have a huge impact (e.g., Eliassen, 2011).
4. When you are spending time with friends and family, and especially when engaging in this open dialogue about weight, shape, and eating, try to avoid “fat talk” statements. See our blog on why positive body talk is so important in preventing eating disorders!
5. Spread awareness by talking and posting about eating disorders and the harm that eating disorder stigma and stereotypes can cause. Sharing this message widely will allow us to educate policy-makers, therapists, medical and health providers, eating disorder survivors, and their loved ones about how serious and important eating disorders are. Spreading factual information about the real issues can help us build a huge network of people all fighting eating disorders together!

​While many individuals hope their summer is filled with once-in-a-lifetime adventures, summer is the perfect time to spend dedicated time gaining valuable experiences. Whether this is volunteering in a research lab, interning in a field related to your future career, or planning ahead and doing intensive seminars and preparatory courses, there are many ways for you to take advantage and get ahead. Personally, I did a combination of the three, and this has provided me with invaluable experiences that have shaped my future career interests and helped me to prepare for graduate school. As summer applications begin to open, I have a few pieces of advice, and suggestions for maximizing your summer-break opportunity:

1. Start Early. One of the biggest suggestions I have for anyone interested in participating in summer programs is to do your research early. Many of my programs had applications that opened in late fall, and were due around Christmas. To avoid missing out on the perfect opportunity, know where you would like to apply and keep a log of when all the components are due. Even if they are not due immediately, fall and winter breaks are the perfect time to dedicate to finishing these applications. This way, you can make sure you don’t forget to submit during the busiest times of the semester.
2. Be adventurous. While working all summer may not sound the most fun, there are opportunities across the globe. Whether you become a visiting student in a new city in the U.S., or participate in a summer program abroad, there are a multitude of opportunities to explore a new place. Summer is a great time to do a short program abroad, getting not only internship experience and course credit, but also developing your independence and cultural competency. Many colleges have scholarships or partnership experiences that help you obtain these experiences while maintaining a college budget.
3. Know your financial limits. Because internships are invaluable experiences that primarily benefit you, many are either volunteer or stipend positions. Particularly if you are planning to move to a new city, verify that you have the resources available prior to beginning your adventure. As previously stated, there are many scholarships available through universities to help fund these experiences. It is important to balance experience with budget so that you maintain your financial cushion for the semester. In my experience, I spent two summers receiving a stipend from my internship experience. I also spent one summer doing research part-time while also working part-time. This enabled me to still get my experience while also saving for tuition and other costs.
4. Document your experiences. Keep good notes of your roles in your positions. When applying for graduate school or later positions, you will want to have a careful record of what you worked on and how you contributed. This is a pain to do months after the program ends and you may not remember the details. My advice is to keep a journal or log of your daily/weekly tasks, which you can then consolidate and revise for your CV or interviews. Particularly for clinical psychology graduate programs, you will want to talk about your past experiences in depth throughout your application essays, so it is important to have careful documentation of your projects.
5. Follow your passions. This is the most important advice I have for anyone looking for internships or programs. If you are not interested in a field, you will not be able to maximize your experience. Your time is a valuable resource, so why spend it pursuing something you are not interested in? While looking for programs, do some self-reflection to find out what you really want to do. Use the summer to rule out programs or test out new career paths. Let this summer guide you and shape your focus. Most importantly, whatever you do, pursue the goals you love, and they will guide you into a rewarding career.

 
In conclusion, summer is the perfect time to get ahead. By starting early, you can prevent the April stress of not having a plan and be better prepared to take on your future career. As Sophia Loren once said, “Getting ahead in a difficult profession requires avid faith in yourself. That is why some people with mediocre talent, but with great inner drive, go much further than people with vastly superior talent.”