Tuesday, 24 March 2015

My Life After College... (By: Emily Jokisch, MS, RD, LDN, CSCS)

As a registered dietitian, I feel like I have spent the majority of my life after college working with people on their diet. Whether it’s for weight loss or for a disease state, I feel like I have a pretty good understanding of what “healthy” is.  Of course, I try to put my knowledge into my own lifestyle, try to get in at least an hour workout most days of the week, try to eat right, and drink plenty of water.  But the thing I always find myself questioning is: do I have a healthy mind?

It is all over the media right now, the importance of proper diet and exercise, but what I struggle with is the idea that this will then make you happy.  Sure, proper diet and exercise helps keep your body in its naturally healthy state, and exercise releases endorphins, but does it truly make you happy?  I think it can definitely help.  Major studies have been done that show a direct correlation between exercise and reducing depression, and I think that’s fantastic.  However, the one thing I hate is the other side of the coin, the side where society and people relate negative feelings and words with state of being and the word “fat”. 

I think from a young age, especially woman, we are taught that being thin means “beautiful”, “successful”, happy, etc. and we carry that with us throughout our lives, and I truly believe that is just not the case.  I know plenty of women who are “thin” and unhappy, and plenty that are “fat” and happy.  I think that it is a matter of being confident in your body, who you are, and what you are supposed to be.

Starting at a very young age, I joined gymnastics.  I loved it.  I just loved learning new things, the athleticism of it all, and the competition.  I don’t think I was ever told anything about needing to be a certain size or anything ever.  Not by a coach, not by parent. But somehow, it was still there.  In the comments from teammates, watching the bodies of the other elite gymnasts, these thoughts somehow formed in my head.  The idea of a perfect body formed, and all before I was even a teenager.  When I got to high school, I quit gymnastics to start competitive cheerleading.  This sport became the love of my life.  Again, I loved learning new skills, taking what I had learned in gymnastics to a new format, my teammates, the flying high, the competition—I loved it all!  Again, I was never told I needed to be a certain size, but with this sport, even more than with gymnastics, you knew that there was some kind of expectation.  If you wanted to fly, you had to be small.  Thin.  If you wanted to excel, you needed to be small, thin, strong, and athletic.  And fortunately, I had the genetics to help me get there.  I never really focused on diet and exercise much in high school.  I was small enough naturally, so I didn’t need to focus on it.  But the pressure was definitely there.  Again, I was never told I needed to be small, ever, not by a coach, definitely not by my parents, but it I did hear it more in little teammate banter.  I mean, it’s high school.  Kids can be mean in high school.  But I successfully made it out of competitive high school cheerleading without too much of a blow to my body image, still feeling pretty good and confident about myself.

After high school, I got a full scholarship to college for competitive cheerleading.  I was ecstatic.  I loved cheerleading in college.  Again, I loved everything about it.  The intensity, the long 4 hour practices, the conditioning, the uniforms, the competitions, and the games, everything.  But somehow, it got to me in college.  I got into great shape in college.  We practiced in sports bras and spandex shorts.  Our uniforms were short skirts and cropped tops.  Everyone could always see your body, and you knew and heard the judgments that were being made about you, and each and every one of your teammates.  I still carried myself with confidence, but I started going through extreme lengths to get my body where I thought it needed to be.  Cutting down my food intake, watching everything I ate, exercising beyond the 4 hour practices, and the conditioning workouts. Going above and beyond seemed to show my dedication, and was not a sign of insecurity.   Even after I transferred over to a new school, which had more conservative views on practice gear and uniforms, there was still the underlying pressure to be small:  weigh-ins at try outs, having to stay within 5 pounds of your tryout weight, being paired with a stunt partner, knowing your partner was related directly to how heavy you were, and the overall atmosphere of the sport of cheerleading.  Standing at 5’4”, I was the tallest female cheerleader on my coed cheerleading team, and the feeling of needing to be “thin” and small was definitely present at this point.  I worked very hard to keep my body where I thought it needed to be for the sport.  Unlike high school, coaches on the college level definitely express their feelings about your weight and the weight of your teammates.  You know exactly what is expected of you.  Going through this sport in college for many years, I never saw a problem with it.  I worked hard, and was rewarded for it, both through having the body I thought I needed, and being successful with the sport and in competitions.

What I never expected to come from doing these sports is the judgment I would learn to have on my body once my career with these sports had ended.  Through these sports I have taught myself the adjectives of “success” and “happiness” are correlated with a body like I had in college.  A body I obtained through hours of exercise and practice.  A body that, now having a desk job, is not easy to have.  Even though I no longer parade around in sports bras and spandex shorts, I found myself disappointed in my aging body, disappointed by looking in the mirror, thinking to myself that if I just worked a little harder, I could get my old body back.  There was a feeling that if I didn’t get my six-pack abs back, that I was a failure.  And what can I say?  The media doesn’t help.  With every Pinterest board flaunting the easy way to get in shape and quotes like “fit is the new thin”, it wasn’t just me knowing where my body was as an athlete and having these expectations for myself, I also felt society wanted me to be there as well.  And so it started— the comments to myself when I looked in the mirror, the poking fun at the areas of my body that I didn’t like, the attempt to eat perfectly, and the daily intense exercising.  But even when I got back into better shape, better still wasn’t good enough. I still picked apart the things I didn’t like, or areas I thought weren’t perfect.  After a long time of my brain housing a secret insecurity in my body, I had a realization.  Something that I talk to my patients about all the time, but somehow it slipped past my own self talk…that happiness will not come from some form of my body.

So it is a daily thing now, trying to become confident in who I am, realizing that a certain body type does not make you happier.  I need to understand that some ideal body type that I taught myself to believe I needed in college does not make me successful or more desirable.  True happiness and comes from who I am, not what I look like.  This is something that I think many people struggle with, but I especially see it in former athletes.  I see it in people who have a desire for what used to be.  But we all need to remember that change is good.  Aging is beautiful, both in wisdom and our bodies.   I challenge this to you: Look in the mirror today and don’t berate yourself.  Instead engage your thoughts in your uniqueness and beauty.  If we change the way we view ourselves and in our own self talk, hopefully that change will translate to the way society communicates back to us as well.

“Enjoy your body.  Use it every way you can…..don’t be afraid of it, or what other people think of it, it’s the greatest instrument you’ll ever own.” – Baz Luhrmann lyrics to Everybody’s Free

About the Author

Emily Jokisch is a Registered Dietitian from Madison, Wisconsin, now residing in Nashville, Tennessee. She went to the University of Tennessee where she graduated with her Bachelors in Dietetics and Psychology, and her Masters in Dietetics and Exercise Science. Emily is also a Certified Strength and Conditioning Specialist. She currently works in corporate wellness as a Wellness/Engagement Consultant for Humana. In addition, she spends time writing and blogging for local wellness websites and works as a nutrition and exercise science guest writer for a cheerleading magazine.  Emily enjoys volunteering around the Nashville area, including the mentor program at the YMCA, Habitat for Humanity, the Make-A-Wish Foundation, and now the Eating Disorders Coalition of Tennessee.

Posted on 03/24/2015 10:53 AM by Emily Jokisch

Monday, 23 February 2015

"What is Reverse Anorexia?" (By: Megan Dottermusch)

Disclaimer: “Reverse anorexia” is not a medical, diagnosable, DSM-V term, but rather vernacular to describe an obsessive mindset.

Reverse anorexia is a type of body dysmorphic disorder in men and women that can lead to severe physical and emotional consequences. National Eating Disorders Awareness Week is Feb. 22-28, but the entire month provides an opportunity to inform people that eating disorders affect both genders. I once thought body image issues were something that only women struggled with, but I’ve since discovered that men also wrestle with these demons.

Leigh Cohn, President of N.A.M.E.D. (National Association of Males with Eating Disorders), was instrumental in helping me understand the struggles men have with eating disorders. I discussed this problem with him to find out how we can educate the public and work to end the stigma surrounding body dysmorphia.

What is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) is an image disorder that causes the affected individual to have an altered sense of their appearance. According to Cohn, BDD is often generalized and referred to as “reverse anorexia.” Of course, almost all of us have some body part that we would change if we could, but we don’t become obsessed over it. Someone with BDD is so consumed with fixing an imperfect body part — or the part that they perceive is imperfect — that this obsession negatively affects their ability to live a normal life. They consider their imperfections, which in reality may be so slight that they’re not noticeable, to be so obvious to others that they withdraw from friends, family, and school, and may even go so far as to seek plastic surgery.

We typically see BDD develop in adolescence, affecting men and women at roughly the same rate, although Cohn says it is likely higher in men. While experts can’t pinpoint the exact source of this disorder, some people have a genetic predisposition to developing BDD. One explanation is that their brain may be unable to adequately process serotonin, the neurotransmitter that determines a person’s mood or disposition. Other risk factors include damaging experiences, such as bullying, emotional trauma or a negative family environment. It is not unusual for individuals with BDD to also have obsessive-compulsive disorder, social anxiety disorder, additional eating disorders, and depression.     

Reverse Anorexia

Anorexia nervosa can best be described as an obsessive fear of gaining weight. In people with this condition, regardless of how thin they become, their mind insists they are overweight. Although it is thought that men have lower rates of this condition, this may be the result of misdiagnosing the condition in them. As awareness increases, anorexia nervosa may be recognized more in men, and therefore treated in greater numbers. 

However, reverse anorexia is a type of BDD, primarily affecting men, in which men want to be bigger or more muscular. Reverse anorexia is sometimes referred to as bigorexia, or muscle dysmorphia.

Cohn explains, “Whereas someone with anorexia would look at a little flab under their arms and think, ‘I’ve got to lose weight,’ someone with reverse anorexia would look at their muscles and think, ‘Those need to be larger … those aren’t big enough ... my abs aren’t defined enough.’ ”

What are the signs and symptoms?

It’s important to know the symptoms of reverse anorexia so you don’t assume everyone lifting weights at the gym has this body image issue. According to Cohn, “Males with reverse anorexia obsess about taking supplements and steroids, and steroid use is a really big problem among people with BDD.”

In addition to anabolic steroid use, symptoms include an obsession with working out, building muscle and decreasing body fat. In fact, these individuals place such a high priority on working out to the exclusion of other activities, such as school, work or hanging out with friends, and are agitated when they have to miss a workout session. They also adhere to an overly strict diet that focuses on eating protein (to build muscle), and excludes carbohydrates. Other warning signs include weighing themselves more than once in the course of a day, and spending a considerable amount of time in front of a mirror examining their muscles. However, sometimes this condition may also cause men to avoid looking at themselves in the mirror at all or they may wear baggy clothes in public because they feel that their bodies are inadequate. 

Seeking Treatment

Left untreated, BDD can be an emotionally debilitating and paralyzing condition that can also have serious physical consequences. Research has shown that steroid use can adversely affect the body, and limiting one’s diet to the exclusion of other foods that provide nutrients can lead to malnutrition. Combined with the emotional and mental turmoil that those with reverse anorexia suffer, along with their social isolation, it becomes apparent that these individuals cannot lead a normal life without intervention. 

While the public is pretty knowledgeable of the dangers of anorexia among women, we need to raise public awareness that body dysmorphic issues, which predominately affect men, are just as dangerous. It’s important to understand that women are not the only people who struggle with eating disorders, and equal attention should be given to men so we can identify and treat these problems across the board.  


If you suspect that you have an eating disorder, or think that you know someone who does, please seek professional help for a proper diagnosis and clinical counseling. Mental health assistance in the form of treatment and counseling has proven to be effective in combating eating disorders in both women and men. For more information on help and support, visit the websites of N.A.M.E.D., the Eating Disorders Coalition of Tennessee, and the National Eating Disorders Association.

About the Author

Megan Dottermusch is the community manager for Counseling at Northwestern, the masters in counseling program offered by The Family Institute at Northwestern online. She earned her B.S. in Business Marketing from the University of Maryland and was an active member in Kappa Delta Sorority. While serving as Risk Manager on her chapter’s Executive Board, Megan was a confidant and resource for its members seeking help for personal and emotional issues. As a result, she has become passionate about combatting mental health stigmas, promoting wellness through proper nutrition, fitness, and everyday mindfulness.


Posted on 02/23/2015 12:53 PM by Megan Dottermusch

1 2 3 4 5 Next Last
sun mon tue wed thu fri sat
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31