National Eating Disorder Awareness Week 2015

February is usually the most hectic month for me – more hectic than even the holiday season! Between my husband’s birthday, my birthday, AND our wedding anniversary, there’s plenty of celebration to be planned (and enjoyed), but it’s also the time of the year when perhaps the gusto with which I attack each January starts to catch up with me. Like, tell me again why I planned to start training for a half marathon while juggling a half dozen private clients, a brand new nutrition group, five public yoga classes a week, two non-profit jobs, and the mounting of a cabaret? In the dead of winter?!

No complaining here though. I feel invigorated, if a little frazzled, and I’m taking it one day at a time, one breath at a time, one break from the computer at a time — and always keeping an eye out for my MBP Daily Three.

NEDAwareness_2015_Shareable_IllusionsFebruary 22nd through the 28th is National Eating Disorder Awareness Week, in which people across the country come together to “put the spotlight on the seriousness of eating disorders and to improve public understanding of their causes, triggers and treatments.”

One of my favorite offerings from NEDA so far this week is this Media Literacy Toolkit, which includes, among other awesome info, a quiz to help you determine your digital body image and examples of how to send your feedback to advertisers.

Also included in the toolkit is a pledge designed to “let people know where you stand on picture-perfect body images in the media.”

What do you think — would you take the pledge?

NEDA’s Body Positive Pledge:

  • I promise to move beyond society’s ideal body standards and embrace my own body.
  • I promise to tell myself one positive thing about my body every time I look in the mirror and appreciate that I am original and there’s only one me.
  • I pledge to respect my body and not try to fit media’s image of attractiveness.
  • I promise to keep a healthy and active lifestyle for myself and no one else.
  • I pledge not to judge people based on their body shape and size, especially if they do not fit the cultural body ideal.
  • I pledge to be proactive about negative body images and challenge unrealistic and demeaning body talk.
  • I pledge to advocate for positive body image messages—that includes not to buy from companies or support organizations that use unrealistic and unattainable body ideals to sell a product or promote a cause.
  • I pledge not to retouch my photos in order to enhance my appearance online.
  • I pledge to become more media literate and think critically about what I see, hear and read, especially on social media.
  • Finally, I pledge to love my body unconditionally.

If I’m totally honest with myself, holding to this pledge in its entirety would be a serious challenge. This is not easy stuff here, folks; we’re talking about reversing years of negative conditioning. But what a goal to work towards! Which of the above pledges will you work towards this Eating Disorder Awareness Week? Let me know in the comments below.

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Why I’m Giving Up On My Dreams

A stage; a.k.a. "home"

A stage; a.k.a. “home”

When I moved from San Francisco to New York City, I definitely imagined myself on a stage in front of hundreds of people. After all, I had been doing it my whole life. I was the lead in an opera before I was ten years old. In 2010, just before leaving the Bay Area, SF Weekly readers generously voted me San Francisco’s Best Stage Actor. So I knew I’d make my way to a New York City stage eventually.

I just couldn’t have guessed what kind of stage.

Last Sunday morning I took the subway down to New York City’s Foley Square, right across from City Hall. The fountain had been turned into a stage, and I waited on it as hundreds of people crowded around to listen to an opening ceremony. It was the day of the annual New York City NEDA Walk, raising money and awareness for the mission of the National Eating Disorders Association, and after raising nearly $150,000.00, this huge group was about to walk the Brooklyn Bridge.

Then I heard my name:

Sarah Kit Farrell is a yoga teacher and health coach who recently celebrated 6 years of recovery. She is a program facilitator for mentalfitness, inc., an organization that builds mental fitness in all youth through arts-based awareness and prevention programs…

It was time for me to take the mic, though I wouldn’t be singing. Instead, I spent the next several moments leading all those hundreds of people in a yoga-inspired warm-up.

Just a slice of the immense crowd in Foley Square

Just a slice of the immense crowd in Foley Square

Lemmie tell ya – I wish I had been asked to sing, ’cause I wouldn’t have been nearly as nervous. Singing I know how to do. But playing the part of an inspirational yoga teacher? Now that made me shake in my running shoes.

Performing is in my heart and it always will be, but a few years back I stopped spending the bulk of my free time on preparing for auditions and memorizing monologues. I basically stopped living the “actor’s life”. It just sort of happened. And when I realized that it was happening, I used every weapon I could think of to punish myself for my transgression.

How could you? I thought to myself, everyone will think you’re giving up — you ARE giving up! Have you wasted your entire life trying to perform only to find that you’re not good enough? That you don’t have what it takes? Or maybe you are good enough and you’re just too lazy to make it. If that’s the case, then you deserve to fail. You’re worthless, in fact. You’re a goddamn disgrace. Get it together, SKF!

Wow, right? Um, self-abuse, party of two?

But no matter how many times I told myself to get back on track, how I should be doing this and that, I just didn’t. The truth was, I didn’t want to. It wasn’t enjoyable to me. That lifestyle wasn’t making me happy.

All the while, little by little, I was giving in to these interests and activities that have fascinated me all along: nutrition, mindfulness, yoga, eating disorders… and I felt awful about it. Each time I gave attention to one of these alternative areas, a little gremlin in my head told me I was betraying my destiny, betraying my true “purpose” in coming to NYC, betraying the goals set out for me by my younger self.

For a while now, I’ve made an effort not to “should” on myself (I should do this and I should have done that). But if I’m honest with myself, for the last few years, my life has essentially been one big SHOULD. I’ve been clinging to this idea that my life was supposed to go one way, and refusing to accept that it might go somewhere else.

This all reminds me of a metaphor used by author Esther Hicks, who says that life is a swift-moving river and we’re all conditioned to think that we’ll be rewarded by fighting to get upstream. But in all actuality, nothing that you want is upstream. In fact, the stream itself is a stream of well-being, and the second you accept the current of your life and learn to move with it, to sway with it, to go with the flow, joyful things begin to happen — and they happen fast.

With my amazingly supportive friends at the 2014 NEDA Walk

With my amazingly supportive friends at the 2014 NEDA Walk

So on the one hand, I’m flabbergasted that I, of all people, would end up leading stretches for this year’s NEDA Walk, but on the other hand, I’m not surprised at all. It’s the same reason that I was hired at the very first yoga studio I applied to, the same reason my coaching practice took off the moment I decided take it seriously.

Because the current of my life is headed that way. The more I trust that current, and the more I can let go of my preconceptions about how my life in NYC should turn out, the farther I’ll be able to go.

Of course I’ll never stop performing, don’t be silly; it’s in my bones. In fact, I’m planning a New York City debut of my one woman show about food, body image, and appetites unchecked. But it may not be the most important thing. As far as those earlier dreams go, the ones in part constructed by a thirteen year old Sarah, consumed by her eating disorder, rigid in her perfectionism, and desperate for approval, well… maybe I don’t need those specific dreams anymore.

I think I passed that fork in the stream a long time ago. And thank goodness.

So what about you? Are you swimming upstream against the dominant current of well-being in your life? What do you think would happen if you stopped fighting in order to go with the flow?

6 Years Recovered

Practice self-care, loves; this post may be triggering to some.

six candles recovery anniversary | MindBodyPlate

Today is a special day for me – one of my favorite days of the year. September 3rd is my recovery anniversary, and today marks 6 years since the last time I binged and purged.

I blogged about my recovery anniversary last year, but a lot has changed since then. Last year I started the day by taking my favorite yoga class; this year I woke up at 5:30 AM to teach a yoga class.

Last year I thought that self-care was something extra you made time for every day; this year I’ve learned that every facet of life and every choice you make is an opportunity for self-care (self-care isn’t the frosting on the cake, it’s the cake itself).

Last year my ideas about what I should be doing with my life were getting in the way of the actual doing; this year I have a private practice which offers nutritional coaching, private yoga sessions, and peer coaching for those in recovery from eating disorders, and I’m in the early stages of planning the New York City debut of my one woman show about food and body image.

The long view almost always highlights growth — I think that’s why I like anniversaries. Because, individually, most of the last 365 days felt like nothing was happening, like I was getting nowhere. But the sum is greater than its parts, as they say.

peanut loves maple syrup | MindBodyPlate

I want you to know that ‘6 years recovered’ does not mean I have a perfect relationship with food. Just yesterday, for example, I was so frustrated with the logistics of setting up my new laptop that I ended up eating a ramekin full of peanut butter mixed with maple syrup… with a spoon.

…and then I went back for seconds.

Emotional eating at its finest, folks. Were there elements of a binge there, where I felt out of control? Sure. The difference is that after it was done I didn’t throw up my hands and say, “Well, now that I’ve totally blown it, I better eat everything else in the kitchen.” The difference is that I didn’t want to purge or punish myself at the gym. The difference is that I knew a little bit too much peanut butter would not send my weight or my body image spiraling out of control. The difference is that I didn’t beat myself up.

Sarah Kit Farrell laughing | MindBodyPlate

Squished on the subway and loving it!

Actually, I had a bit of a chuckle. I mean, we all get frustrated sometimes — let’s be real, especially when setting up new electronics. Of course I lost a bit of control as my brain became overwhelmed. Of course my body tried to comfort itself. And of course it chose the path of least resistance (dietary fat and sugar!!!).

That I can hold yesterday’s mini-binge with empathy, love, and a bit of humor is the real sign that I am recovered.

Just as all of the changes in one year may not be apparent until the year is over, the hundreds and thousands of mini-steps towards recovery may not be apparent day-to-day. That’s how it is with overcoming anything, I think. We relish when we can look back and feel pride in our accomplishment, now abundantly clear. But the good stuff is happening with every mini-step, every choice to incorporate self-care, every day, every moment, every bite.

Good Food / Bad Food

New York Magazine recently featured a piece on orthorexia nervosa, the unhealthy obsession with eating only healthy or “correct” foods. The term isn’t officially recognized by the American Psychiatric Association, and some are skeptical that it has diagnostic criteria unique enough to warrant a separate designation, but I think it can be helpful in describing a specific kind of extreme attitude towards healthy eating.

beet leaves | MindBodyPlateWhile the behaviors of orthorexia may overlap with anorexia or bulimia, it’s the motivation behind the behaviors that are different. In the case of anorexia or bulimia, the underlying desire is to achieve thinness or weight loss; in the case of orthorexia, the desire is strictly (and paradoxically) to achieve optimal health.

So it doesn’t surprise me that those who are recovered from eating disorders are particularly susceptible to orthorexia. After overcoming a dangerously rigid set of unhealthy eating behaviors, it makes sense that one might get caught up in an equally rigid set of “healthy” ones.

there are no bad foods | MindBodyPlateWhether it’s in the DSM or not, I’m glad orthorexia is getting this kind of attention in the mainstream media. Ferocious commitment to dietary health is widely accepted and even encouraged in our culture, especially as we become more and more preoccupied with the “war on obesity”. As such, it’s important that we encourage mindfulness and dietary moderation with equal fervor.

The slippery slope of orthorexia is exactly why I spend ample time with my clients exploring how we improve our health & wellness and make more positive food choices without relying on the labeling of certain foods as inherently ‘bad’. As soon as we label foods good or bad, we enable the kind of extreme thinking that can lead to orthorexia.

foods are not inherently bad | MindBodyPlateWhat are your impressions of orthorexia nervosa? Should it be considered its own eating disorder? I’d love to know what you think.

The Pendulum Effect

Foucault pendulum hanging in Milan’s National Museum of Science and Technology. Photo courtesy of Ben Ostrowsky.

Foucault pendulum hanging in Milan’s National Museum of Science and Technology. Photo courtesy of Ben Ostrowsky.

I find myself talking about pendulums pretty frequently. Why pendulums? That Foucault could use one to demonstrate the earth’s rotation is pretty cool, but I usually reference them because they serve as the perfect metaphor for so much of what I talk about with my clients. “For every action there is an equal and opposite reaction.” Newton was talking about the physical laws of motion, but I find it interesting to view our mental, behavioral, and even physical shifts through this same lens.

The universe is always seeking balance, often in ways beyond our control and outside our periphery.

When you pull a pendulum really far in one direction and let go, what happens? You can bet that it will swing really far back in the other direction. A big shift begets another big shift. And we can find this rule of balance playing out in our day to day (or month-to-month, as it were)…

A Tale of Two Months

February was an extremely stressful, obligation-filled month for me, jam-packed with intense emotional growth and periods of distressing uncertainty.

In 28 short days, I turned 30, celebrated my partner’s birthday, celebrated our fourth wedding anniversary, juggled multiple jobs alongside 20 hours a week of yoga teacher training, hosted my parents during their visit from California, became a certified yoga teacher, braved the New York City rental market to find us a dream apartment (after our first one fell through), packed up our lives in boxes, moved to a whole new borough, and then unpacked those very same boxes, all amid freezing weather and one winter storm after another.

Needless to say, by the time March rolled around, I felt tired. In fact, I found myself struggling to stay motivated. Midway through the month, I even started to get a little down on myself. What was happening to me? Why did I feel so lazy? Then it hit me:

Well, DUH.

Of course I feel like I’m swimming upstream against a current of relentless lethargy. Of course it’s all I can do to go through the motions and cover the essentials. Of course all I want to do is eat and drink and enjoy the casual company of good friends. Of course my immune system is compromised. Of course I watched all three seasons of The Borgias in two weeks.

This is my body’s way of creating balance, of carving out a period of rest and recovery. This is my body’s response to February. This is the pendulum effect in action.

Macrobiotics* and the Yin-Yang of Food

Have you ever had too many salty foods in a short period of time and found yourself wrestling with intense cravings for sugar not long thereafter? This is your body seeking balance through appetite, and it’s a pretty obvious example of that pendulum swing.

Turns out, there’s an entire dietary approach that concerns itself with balancing the energies of food. The Macrobiotic diet pulls from ancient Chinese philosophy, asserting that every food item falls somewhere on a spectrum of energy, from yin to yang.

Different foods may be more yin (as in sugar) or yang (as in salt). Some foods exist near the extremities of this spectrum, containing high amounts of one kind of energy (red meat, for example, is strongly yang), while other foods fall towards the center and have a more balanced composition (leafy greens, for example, are faintly yin, and root veggies contain just a hint of yang).

yin yang food chart

Someone who follows a Macrobiotic diet seeks to balance out the yin and yang energies on their plate. The best way to do it? Not to swing the pendulum too far in either direction; in other words, to eschew the foods with extreme yin or yang energies, choosing instead those items which are relatively balanced: fruit, sea vegetables, leafy greens, round veggies, root veggies, beans, legumes, grains, and white-meat fish.

I don’t follow a strictly Macrobiotic Diet, but I do dig the idea of seeking harmony on my plate, and I definitely know what it’s like to experience a balance-seeking backlash in my relationship with food.

The Inevitable Backlash of Deprivation

According to researchers at UCLA, the average person who diets for six months will lose five to ten percent of their starting weight. Great! Except that’s not the whole story. Within five years, one-third to two-thirds of those who lost weight on a diet will regain more weight than they lost. There’s that pesky pendulum effect again.

Your body is a finely tuned, highly functioning machine, but it’s not always in cahoots with your intellect. For instance, when you decide to try that fashionable juice cleanse, your brain consciously acknowledges that you’ll be dramatically reducing your caloric intake for a short time. You’re fully aware that you’ll probably get a little hangry or euphoric, but that it’ll all be over in a matter of days. Everything will be fine! It’ll be more than fine – you’ll be glowing by the time you’re through!

But the thing is, your body doesn’t necessarily get the memo. As far as your body is concerned, you were going along fine, enjoying your abundant 21st century menu, when – all of a sudden – your caloric intake was cut in half, there’s no fiber coming in, what happened to the healthy fats, and ohmygod, this can only mean one thing: FAMINE!

Do you know how the human body responds to famine? To semi-starvation? It shuts down any nonessential activity to conserve energy. Immune function? Forget it. Reproductive capacity? As if – we can’t make a baby when there’s hardly enough fuel for one! Moreover, when your body is faced with semi-starvation your metabolic rate drops. It slows. And when you begin eating regularly again, it doesn’t necessarily speed back up. The pendulum has already swung to the other side.

Keep in mind that this juice cleanse example is a bit of an exaggeration. The effects of caloric deprivation take a few days at least to register in the body as an emergency situation. In fact, some research suggests that intermittent fasting may benefit overall health. But for chronic dieters or those suffering from eating disorders, this is no exaggeration.

I suffered from anorexia nervosa for a period of time around the age of 12, then began binging and purging a handful of years later. I had pulled the pendulum of deprivation to such an extreme, that by the time I was in college I felt helpless in the face of my compulsive urge to consume everything around me.

My particular brand of deprivation, so indicative of the “fat phobic 1990s”, was that I denied myself any form of the macro-nutrient fat. Many years later, a nutritional counselor asked me what type of food I binged on the most during my struggle with bulimia. “I don’t think there was one type,” I answered, “I feel like I binged on everything: ice cream, cheese, creamy pasta, doughnuts, pesto crepes, and peanut butter.” She stopped me. “Don’t you see? Those foods do have something in common: fat.” She was right. They were all foods high in fat. How’s that for a pendulum swing?

the cosmic pendulum

Not Quite Equilibrium

So how do we mitigate the destructive arc of the pendulum effect? How do we find balance in the areas of appetite, energy, and mood?

Well, let’s look to the metaphor for answers: a pendulum is never completely still. Even at rest, it is always moving, ever shifting, oscillating back and forth, but imperceptibly so. Just like the pendulum, we never seek to make our lives static, to be happy all the time, or relaxed all the time, or militantly controlling of our diets so they never stray from “perfect” equilibrium. We welcome these shifts, because they a part of being alive in a human body.

And yet, we wish to minimize the extreme swinging back and forth. Which is why we turn to mindfulness. The more in-tune we can become with the subtleties of our moods, patterns, and habits, the more likely we’ll be to notice a swing before it gets too extreme. And we can take a further cue from the Macrobiotic camp: if we aim to steer clear of extremes altogether, we automatically limit the extent to which those appetite, energy, and mood swings can get out of hand.

So let’s take another look at the way my February and March went down: what’s clear is that I have a tendency to push myself too hard until I reach a breaking point, at which time I go through a period of lethargic withdrawal. If I can integrate more mindfulness moving forward, perhaps by scheduling a 10 minute meditation break in the middle of every single work day (no matter how much there is to do), I’m less likely to burn out by the end of the week. And if I can limit my overall obligations and be more realistic about what I can get done in, say, a 28-day period, I’ll be even less likely to crash.

Basically, it’s about being kinder to myself and becoming more successful in the process. After all, two months of working at approximately 78% productivity is better than one month at 98% and the next at 2%. I’m not looking to eliminate my natural ebb and flow, I just want to keep the massive swings to a minimum.

In what ways do you experience the pendulum effect in your own life? Have you noticed it in others? How often do you stop to notice your dominant tendencies, and what would it mean to consciously cultivate a little bit of the opposite? Let’s take a cue from the universe and strive in the general direction of balance, whatever that means for us. After all, the other shoe is going to drop eventually.

scales

*Mine is a crude representation of the rich and wonderful world of Macrobiotics. For more information, check out The Hip Chick’s Guide to Macrobiotics by Jessica Porter.

References:

http://www.kushiinstitute.org/what-is-macrobiotics/
http://newsroom.ucla.edu/portal/ucla/dieting-does-not-work-ucla-researchers-7832.aspx
http://archive.unu.edu/unupress/food2/UID07E/UID07E11.HTM
http://en.wikipedia.org/wiki/Minnesota_Starvation_Experiment
http://www.scientificamerican.com/article/how-intermittent-fasting-might-help-you-live-longer-healthier-life/

I Wear Purple

I wear purple because

February draws to a close this evening, and with it, Eating Disorder Awareness Month. If you’re looking for some inspiration, head on over to the facebook page for The Purple Project, a month-long event beautifully orchestrated by an organization called Where I Stand. All month, people from all over the world have been submitting pictures of themselves wearing purple, standing up for eating disorder awareness, recovery, and prevention. The whole project has been quite moving, and I’d like to congratulate Where I Stand for such a successful endeavor!

When Full Means Fat and Fat Means Bad

Bowl of Almonds

When full means fat and fat means bad,
nourishing your body is a treacherous task.

When full means fat and fat means bad,
an extra helping can make you feel like your own worst enemy.

When full means fat and fat means bad,
Thanksgiving dinner is like navigating a minefield.

When full means fat and fat means bad,
you’d rather miss your best friend’s birthday party than feel bloated in public.

When full means fat and fat means bad,
you can never truly appreciate a shared meal with loved ones.

When full means fat and fat means bad,
the world is a dark, scary place, and recovery seems nearly impossible.

But full is not fat. And fat is not bad.

Full is a signal: my body has had enough. How grateful I am for that satiety cue! How miraculous that I can communicate with my own body in this way, with the trillions of cells which comprise its form. Full can be uncomfortable, but full goes away. So I sit with it. I give it time. I say, “Thank you for the message; I hear you loud and clear.”

Fat is a macronutrient essential to my body’s functioning. It helps me digest and absorb many important vitamins and delivers essential fatty acids that my body can’t make by itself. It helps my cells do their various jobs, promotes healthy skin and hair, maintains my body temperature, allows my neurons to communicate, protects my organs, and helps combat disease.

My body also creates fat as a form of emergency energy storage. What a blessing that my body knows how to care for itself in this way! Sometimes, my body may go a little overboard, but I will never remedy this by depriving myself. Instead, I will help my body feel nourished and balanced. Only then will my body stop preparing for the worst case scenario. So I accept it for what it is. I say, “Thank you for protecting me in this way; there’s no emergency here.”

Sometimes I need to be reminded that being full isn’t the same as being fat, and that “fat” is a term which has been demonized beyond recognition. After all, these are ideas that I learned a long time ago, and those kinds of ideas can be the hardest to change. But if I’ve proven anything to myself it’s that I am capable of remarkable change. So thank you, Fullness. Thank you, Fat. I hear you loud and clear, but there’s no emergency here.

SKF at Window

5 Years Recovered

Practice self-care, my friends; this post may be triggering to some.

Journal Entry on Recovery

When I wrote the above journal entry I had been in recovery for two years. It would be another two years and 8 months before I binged and purged for the last time. The road was long, grueling, messy, and confusing, but I made it, and today I celebrate five years recovered from an eating disorder that took 12 years of my life.

This old journal entry really captured my attention, because it sums up what was most challenging about my recovery process: sitting with the discomfort. Of course, at times, “discomfort” couldn’t begin to describe what I was feeling, the skin-crawling, nail-biting, heart-wrenching, head-pounding agony of living in my own skin after eating. I used to imagine digging my fingernails into the couch cushions, into the walls, into anything that would anchor me down and keep me out of the bathroom. There were times when I wanted to die, because it all seemed too painful to bear.

Looking back, it’s no surprise that I had trouble sitting with discomfort, with distress. Studies show that low levels of distress tolerance paired with high levels of urgency can predict bulimia nervosa (Anestis et al., 2007). The paradox of this life-threatening disease is that immediately following a binge/purge episode, bulimics experience a rapid drop in stress and other negative emotions along with a corresponding increase in positive emotions (Smyth et al., 2007). In other words, purging is an effective coping mechanism that makes sense… in the short-term. These reinforcing factors are part of what makes it so hard to beat.

And yet, it’s possible. I’m living proof.

This is not to say that my day-to-day is without struggle. A better marker than years for recovery would be the number of times I’ve felt physical discomfort or emotional pain and chosen to do something other than binge, purge, or restrict my food intake. What a number that would be! That’s how ‘five years recovered’ happens: sitting with one uncomfortable urge at a time.

Dr. G. Alan Marlatt, who was the director of the Addictive Behaviors Research Center at the University of Washington, called this practice “urge surfing,” and he used it with patients suffering from all kinds of addiction, from drugs, to sex, to food (Taitz, 2012). But you don’t need an addiction to use urge surfing; everyone can benefit from mindfully observing the rise and fall of a craving. We all struggle with urges that satisfy us in the short-term but might not be in line with our long-term goals. That makes us human.

Luckily, the intensity of my struggle has diminished with time and practice. I’ve gained a great deal of insight studying Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), mindfulness, and yoga. Each in their own way has helped me cultivate self-empathy and nonjudgmental awareness. I find when I’m able to slow down, notice what’s happening in the present moment, and accept the moment for what it is, I am free to create more beneficial patterns of thinking and behaving. And that is what recovery is all about.

So how do I plan on spending my big day? Well, I’ll start with my favorite yoga class, and I’ll probably end with a meal at my favorite New York City restaurant, Pure Food and Wine. A massage might be in order. More importantly, I’m dedicating this day to embracing each emotion as it comes, the good, the bad, and the not-conventionally-beautiful. Because if I can embrace those emotional waves and ride them with loving kindness, there’s nothing that can stop me.

5 Years of Recovery

References:

  • Anestis, M. D., Selby, E. A., Fink, E. L. and Joiner, T. E. (2007), The multifaceted role of distress tolerance in dysregulated eating behaviors. Int. J. Eat. Disord., 40: 718–726. doi: 10.1002/eat.20471
  • Smyth, J., Wonderlich, S., Heron, K., Sliwinski, M., Crosby, R., Mitchell, J., & Engel, S. (2007). Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75 (4), 629-638 DOI: 10.1037/0022-006X.75.4.629
  • Taitz, J. L. (2012). End emotional eating: Using Dialectical Behavior Therapy skills to cope with difficult emotions and develop a healthy relationship to food. Oakland: New Harbinger Publications, Inc.