Gary Snapper

Helpful Suggestions: Road Trip Tips

     This article was written by Gary Snapper, LPC, LLP, an active SMEDA Board member.  He is a licensed Professional Counselor and a Limited License Psychologist who founded Cognitive Behavior Solutions in Kalamazoo. He specializes in the treatment of eating disorders, anxiety disorders, and personality disorders.

 

Road Trip Tips


     The end of summer is the time for road trips. Whether we are visiting family on the other side of the state, traveling to the beach, forest, or mountains, or simply packing up and going somewhere new, we need to eat during the trip.

     Eating during road trips brings its own set of challenges. Boredom can lead to eating more than we typically do. Apparent lack of healthy options can lead to eating more “junk” food. Escaping our day-to-day routine when leaving home can trigger additional escape urges, including escaping our healthy eating routines.

     A handful of simple strategies can help us cope with these and other food -related challenges that we face during summer road tripping:

  1. Packing some portable healthy foods and snacks can help us stick to the routines that we have worked hard to adopt at home. Some examples are trail mix, bagged vegetables, and hummus.
  2. Planning occasional stops at grocery stores can allow us to restock those healthy items during our travels.
  3. Eating frequently and in smaller amounts can address boredom, reduces the risk of binges, and helps ensure that you use up the food that you bring on the trip.
  4. Limit or avoid substances that are more likely to make us feel bad such as alcohol, deep fried foods, and refined carbohydrates.
  5. Choose water as your primary source of fluid during the trip. Many drinks on the market today provide little nutrient value and are overflowing with sugar, caffeine, alcohol, or synthetic sweeteners, none of which our bodies are designed to process effectively. These additives may diminish our sense of well-being.
  6. Don’t forget to enjoy the journey along the way. Prioritize physical-activity breaks several times per day while on the road. Packing Frisbees, soccer balls, and/or walking shoes help you to engage in light activities at rest stops or parks along the way.  Activity helps our bowels function, increases our metabolism, and increases absorption of the nutrients that food offers us.
  7. When you choose to sample local fare, make it worthwhile. Mindfully focus on the value of the foods chosen for flavor or novelty, and try to avoid food choice just due to convenience.
  8. Don’t be so rigorous in your food choices that you forget to have fun on the trip.  Be kind to yourself if you do opt for some unhealthier items while on the road.  Remind yourself that perfection is not the goal, but mindful eating is.


 

May 2016 - May 2017 SMEDA Projects and Activities Completed

May 2016-May 2017 SMEDA Projects and Activities Completed

Compiled by

Lindsay P. South, MA/LPC, RPT-S
President, SMEDA

Ø  Development and Design of SMEDA logo

 

Ø  Website Redesign and Launching (Angela Morris and Peter Butts)

o   Blog Posts on topics such as Holiday Eating, Yoga and Eating Disorders

o   PayPal attached

 

Ø  Monthly publication of SMEDA Newsletter (now posted on-line as a blog), coordinated by Laura Smidchens.   Articles on topics such as Dialectical Behavior Therapy for Eating Disorders” and “Men and Eating Disorders” (both by Gary Snapper, LLP/LPC).

 

Ø  SMEDA Facebook Page posts with links to current research on eating disorders (Laura Smidchens & Vinay Reddy, MD)

 

Ø  Parent Support Group Reconceived into face to face parent meetings, online and telephone support and Parent Mentorship program (Angie Morris, Community Board Member and parent)

 

Ø  Free Monthly Support Group meeting for adults struggling with ED (Trina Weber, RD).  Approximately 7 adults attend regularly.

 

Ø  Dewpoint, support groups for adolescent girls and women with eating disorders at Well of Grace Ministries, Stevensville, MI (Flori Mejeur, SMEDA Lakeshore)

 

Ø  Outreach to local K-12 schools:  classroom presentations on Intuitive Eating, Eating Disorders Prevention, and What to Do if you Suspect Someone Might Have an ED (Moorsbridge Elementary, West Middle School and Portage Northern High School) (Trina Weber, RD)

 

Ø  October 2016 Co-sponsorship of and participation in St. Joseph Mercy annual eating disorders conference

o   Discounted rates for SMEDA members to attend @ $25 a person.

o   Info on SMEDA presented at table

o   (Trina Weber, RD, Deb Frisk, RD, Kris Gibson, MD, Lindsay South, MA, Sheryl Lowzowski-Sullivan, PhD, Cathy Cook, LLPC) SMEDA Professionals and 1 community board member (Angie Morris) attended.

 

Ø  Art Hop- Friday, February 2, 2017 at WMU’s Homer Stryker School of Medicine (Laura Smidchens)

 

Ø  Coffee Tasting Fundraiser-Saturday, February 11, 2017 ( 5 Coffee Roasters and at least 8 Companies involved)(Angie Morris, parent)  Profit:  $2,407.77

 

Ø  Public Speaking and Outreach:

 

1)      Brief presentation at Rambling Road Pediatrics clinical staff meeting -August 2016, (Lindsay South, LPC) this led to cultivation of new relationships with Dr. Dodich and Dr. Dobson, two female pediatricians at Rambling Road Peds.

2)      Panel Presentation to Dietetics Association in Battle Creek-September 27, 2016 (  Jillane Mofitt-Bernacki, LMSW, Danielle Seabold, parent/community board member)

3)      Presentation at Grace Health, Battle Creek on “Food Relationships and Identification of Disordered Eating Behaviors” during the monthly behavioral health staff meeting, February 17 , 2017 (Cathy Cook, LLPC, TLLP, RD)

4)      Lunch and Learning presentation to Potawatomi Reservation, March 15, 2017. ( Jillane Mofitt-Biernacki, LLMSW, Danielle Seabold, parent SMEDA board member)

5)      Article on the problems associated with dieting, (Title?), February 2017 Good News Gazette

6)      Article on eating disorders, “When Dieting turns into a Disorder,” South Haven Tribune, February 8, 2017. (Interview with Kristin Fiore, SMEDA Community Board Member and Susan Katz-Scheinker, RD, Flori Mejeur, LMSW)

7)      Radio interview with Lori Moore during Eating Disorders Awareness Week,  February 2017(Kris Gibson, MD and Angie Morris, parent)

8)      Panel Discussion at WMU after “Food Prisons,” a play about ED (Trina Weber, RD and Kris Gibson, MD)

9)      TV interview about eating disorders, February 2017 (Kristin Fiore, Community member/Down Dog Yoga)

10)   Panel Discussion on eating disorders, Kalamazoo College.  (Kris Gibson, MD, Deb Frisk, RD and Jillane Mofitt-Biernacki, LLMSW)

11)   Meetings with local representatives in Lansing to spread awareness for eating disorders. Representative Hoadley read a resolution on the House floor to support eating disorder awareness at 11:36 a.m. , February 22, 2017 (Jillane Mofitt-Biernacki, L LMSW and dietetic students)

12)   SMEDA Lakeshore mailed out over 100 letters to medical practices, counseling offices, and school counseling centers in Berrien County to raise awareness about ED and highlight SMEDA as a resource (March 2017, Flori Mejeur, Abby Black, RD)

13)   On March 28, 2017 SMEDA Lakeshore highlighted a presentation by Dr. Stephanie Style at Lakeland Regional Center.  The presentation was live streamed and was watched by over 600 people.  SMEDA members were present and offered resources and referral information.

14)   Guest Lecture, Introduction to Eating Disorder at WMU for Amy Getman’s undergraduate dietician course. March 13, 2017 (Danielle Seabold, parent SMEDA board member)

15)   Presentation at DeVos Children’s Hospital Conference entitled, “Adolescent Eating Disorders:  Early Detection and Treatment,” an Eating Disorders Interprofessional Teaching Event for third year medical students, undergraduate nursing students, Masters level dietician students and psychology PhD candidates, April 26, 2017.  Kristine Gibson, MD, WMU Stryker School of Medicine.

16)   Panel representation in Kalamazoo College’s Abnormal Psychology class discussion on eating disorders, May 24, 2017 (Jillane Moffit-Biernacki, LLMSW)

 

 

Ø  Monthly Case Presentations on eating disorders at SMEDA general meetings (Gary Snapper, LLP/LLP, Lindsay South, LPC, Trina Weber, RD, Cathy Cook, LLPC, TLLP, RD)

 

Ø  Topical Presentations for SMEDA general meetings:  “How to Cope with Therapy Interfering Behaviors” and “Evidence Based Treatment of Binge Eating Disorder” (Gary Snapper, LLP/LPC)

 

Ø  Conference for professionals on Eating Disorders and Substance Abuse coordinated with Castlewood Treatment Center, St. Louis in planning stages for Fall 2017 (Gary Snapper, LLP/LPC)

 

Ø  Formation of SMEDA’s Instagram Group, a new commitment to reaching young people about eating disorders.  First meeting:  Saturday, May 20.  Sawalls Health Food, second floor restaurant. (Angie Morris and Emily Marre)

 

Back to Basics: Men And Eating Disorders

     This month’s article was written by Gary Snapper, LPC, LLP, an active SMEDA Board member.  He is a licensed Professional Counselor and a Limited License Psychologist who founded Cognitive Behavior Solutions in Kalamazoo. He specializes in the treatment of eating disorders, anxiety disorders, and personality disorders.

 Back to Basics:  Men and Eating Disorders

     Most people associate eating disorders with women; women with anorexia, women who binge and purge their food, women who binge eat. Many are surprised to learn that men are also susceptible to eating disorders.  Examples of men struggling with disordered eating have appeared in medical records over the centuries. The earliest recorded example of a man with anorexia is a commonly considered case from 1689. The English physician Richard Morton described the case of a male adolescent who began fasting at 16 years of age.   Dr. Morton described the trigger for the fasting as “studying too hard,” along with “the passions of his mind.”  Dr. Morton told the adolescent to abandon his studies, move to the country, take up riding and drink plenty of milk.  This change in lifestyle led to the young man recovering, “his health in great measure.” If only all treatments of anorexia could be accomplished so directly.

     Today, males are estimated to represent up to 25% of cases of anorexia, with only 5% of these seeking treatment.  As with females, stigma contributes to treatment avoidance in males with ED.  One study concluded that being labeled gay or feminine can act as a stigma in male eating disorders, preventing some males from seeking treatment.  Another source of stigma is the pervasive female focus in the literature, support services, research, and treatment options.  One survey concluded that over 99% of books published on eating disorders assume a female bias in pronoun, as well as in the topic focus. Males who start to search resources for ED treatment are likely to observe these biases, and may be reluctant to continue their exploration.

     Comparative analyses between male and female eating disorders are needed, including manifestations, treatment options, outcomes and stigma.  Initial studies suggest a number of gender-specific trends in eating disorders.  For example, mortality of eating disorders may be higher in men.   Another trend is that males with ED tend to have a higher incidence of overexercising than do females. A study comparing results between 108 men and women receiving residential treatment for eating disorders, identified that men scored lower (less intense) on questions regarding body dissatisfaction, bulimic behavior and drive for thinness. This supports the hypothesis that assessment tools may be more effective if created to be gender specific. Similarly, further research might help steer the development of gender- aware treatment protocols to enhance effectiveness of therapy options. 

     Unfortunately, as with treatment of eating disorders in women, men with eating disorders have limited options for evidence-based treatment.  For adolescent males and females with Anorexia, there is a research-supported treatment option termed Family Based Therapy (or the Maudsley approach).  This therapy approach includes three phases of treatment.  Phase I is focused on refeeding at home, with parents encouraging the teen to eat more food per meal with the goal of weight restoration. Phase II focuses on client empowerment, giving more control back to the teen and decreasing parental supervision over time. Phase III focuses on establishing a healthy adolescent identity (increased autonomy, developing healthy boundaries toward and from parents, and fostering increasing independence over time). Studies suggest that weight restoration occurs in 70-90% of both male and female participants, with 5-year weight retention.

     For adults of both genders, research continues to support the use of Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), and Interpersonal Psychotherapy (IPT) as treatments of choice for Bulimia Nervosa, Binge Eating Disorder, and Anorexia Nervosa (mildly effective).  Unfortunately, as with all eating disorders, even the most effective treatments are not as effective for individuals with more intense symptoms of each type of eating disorder. Underfunding for research of treatments for eating disorders is yet another challenge to overcome.

     In summary, despite centuries-old records of males with eating disorders, research on males with eating disorders is and has always been limited.  The available research suggests that although current evidence-based treatments may be equally effective for both genders, males’ symptoms manifest differently and are less likely to be diagnosed than those of their female counterparts.  Males also avoid seeking treatment for different reasons than do females.   Attention to these differences and a more inclusive support environment are needed to help males get the treatments currently available that might benefit them.

References:

1)      Stanford, S.C. Volume 20, 2012 - Issue 5: Males and Eating Disorders. A Clinical Comparison of Men and Women on the Eating Disorder Inventory-3 (EDI-3) and the Eating Disorder Assessment for Men (EDAM). The Journal of Treatment and Prevention.

2)      Striegel RH, Bedrosian R, Wang C, Schwartz S: Why men should be included in research on binge eating: results from a comparison of psychosocial impairment in men and women. Int J Eat Disord. 2012, 45 (2): 233-240. 10.1002/eat.20962.

3)      Striegel-Moore RH, Leslie D, Petrill SA, Garvin V, Rosenheck RA: One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: evidence from a national database of health insurance claims. Int J Eat Disord. 2000, 27 (4): 381-389.

4)      Zhang, Chengyuan. Journal of Eating Disorders 2104 2:138. What Can We Learn From the History of Male Anorexia Nervosa?

 

ED Therapy - DBT?

This month's blog article was written by Gary Snapper, LPC, LLP, a member of the SMEDA Board and a founder of Cognitive Behavioral Solutions in Kalamazoo.  http://www.southwestmichiganeatingdisorders.org/directory/

DBT History

Marsha Linehan, creator of DBT therapy, described DBT as “a multimodal cognitive-behavioral treatment originally developed to treat chronically suicidal individuals meeting BPD criteria.”  Since DBT’s inception in the 1990s, researchers and clinicians have experimented with broadening the application of DBT to multiple mental-health disorders including OCD, Bipolar Disorder, Substance Abuse Disorders, Depression, and Eating Disorders.

 DBT Components

DBT is a high-intensity treatment program that combines aspects of Cognitive Behavioral Therapy with the concepts of Dialectics and Mindfulness.

 Dialectics is the concept that two apparently polar opposites can be true concurrently.  Dialectics help clients to avoid all-or-nothing thoughts and actions. For example, a person can be doing the best they can AND need to try harder.

 Mindfulness is associated with Eastern Religions, and portions of it have been described in most major religions.  Mindfulness is the nonjudgmental awareness of one’s internal and external experiences and states. This also can be explained as follows:  Attempting to be aware of one’s focus and gentle re-directing of the mind to the present when one notices one’s mind drifting towards judgmental thoughts or over-focusing on past or future worries.   Research has shown Mindfulness helps to reduce anxiety and to increase a sense of balance.

 DBT implements these concepts through a comprehensive regimen that requires all of the following:  1) Individual therapy, 2) Skills training,  3) After hours skills-based phone support, and 4) Weekly DBT team consultation meetings.

 DBT Theory and Eating Disorders (ED)

A cornerstone of DBT theory is that emotion dysregulation contributes to many disorders, including EDs.  Difficulty regulating intense emotions can lead to avoiding  “emotion experiencing”.  Emotions that are avoided may lead to ED symptoms, including food restriction, binging, purging, and over-exercise. DBT provides specific skills to cope with intense emotions in tandem, with a forum to learn, practice, and apply the skills.  This helps the client to replace ED behaviors with effective coping strategies. In essence, DBT teaches the ED client a new language that allows for skills-based emotion regulation in place of ED behaviors.

 Along with new coping strategies, DBT’s use of Mindfulness techniques, Dialectics, and after-hours Coaching, all apply to the treatment of ED’s, and has become a comprehensive approach for treating Eating Disorders.

 Although none of the researched eating disorder treatments are as effective as we would like them to be, research suggests that DBT rivals and/or surpasses the effectiveness of traditional CBT, which has been considered the Gold Standard for treatment of eating disorders in adults.

 A simple 8-minute video describing DBT for Adolescents can be found at: https://youtu.be/Stz--d17ID4?list=PLV9RJQek2bix34tBuHaOp12gt-sHf32yV  .

 Sources:

 Linehan, Marsha, M., (1993).  Cognitive-Behavioral Treatment of Borderline Personality Disorder.  New York: Guilford Publications.

 Linehan, M. and Chen, E. (2005). Dialectical-Behavior Therapy for Eating Disorders. In Freeman, A. Encyclopedia of Cognitive Behavior Therapy. (pp168-171). New York: Springer.