How to navigate Halloween candy as a parent.

As a parent, you might feel some anxiety around Halloween approaching. There’s candy…everywhere… and your kids want it all. Or at least that’s how it may feel.

So how do you navigate allowing your child to eat candy? Many parents worry their child will eat too much.

Here’s some sweet food for thought:

• Treat candy the SAME as any other food, even vegetables.

  -Why? Because this will reduce the forbidden or “special” label on it. As humans, we like special things, limited time offers, forbidden treasures, and novelty items. By putting candy on the same playing field as veggies, it’s no longer this special it to be desired after.

• Allow your child to eat as much as they want.

  -If they eat too much, then they’ll get a stomachache and learn to eat less next time. Self regulating the amount they eat will help them feel satisfied and confident in their abilities to eat.

• Encourage your child to eat it as a part of meal or snacks.

  -This will ensure your child eats a variety of foods. This will also reinforce the first 🍭point. It also teaches that food isn’t something that needs to be earned (ex. If you eat your veggies you can get dessert).

More questions about this? Meet with our dietitian nutritionist!

Call the front desk to schedule an appointment.

Other Signs of Hunger

When we think of hunger signs we commonly imagine the classic sign of a growling stomach. Yet, there are a variety of hunger sings, some more subtle than others.

1. Headache or Mental “Fog”

   1. When you haven’t eaten in 3+ hours your body will experience a gradual dip in blood sugar levels. This can lead to a headache or lack of mental clarity. You might find it difficult to focus on a task or notice yourself continually zoning out.

2. Tiredness

   1. If the body is running low on energy, then we will likely feel tired. This can be one sign that it’s time to eat again.

3. Food Thoughts

   1. Are you constantly thinking about food or drawn to pictures of food? We are biologically wired to seek food when our body is hungry. This might show up as obsession with cooking, food pictures, grocery stores, or planning food.

4. Anxiety or Fidgeting

   1. While anxiety can have many origins and influencers, one of those can be related to hunger. When the brain is malnourished or hungry, it can produce an anxious state. Scientists suspect the anxiety might be a biological drive to make us more alert for food sources.

5. Irritation or Hangry

   1. Hangry is the mix of hunger and anger. When you notice your irritated (especially if its for no reason) check in with yourself. When was the last time you ate? Was it enough? Perhaps try eating something.

6. Feeling shaky or weak

   1. When the body is running low on energy, you might feel physically shaky or weak. Physical exertion, such as lifting weights, running, etc. may become more difficult than usual. This is a sign that your body doesn’t have enough energy.

7. Nausea or Stomach Pains

   1. This one may seem counterintuitive, however, nausea can sometimes be a symptom of hunger. This can occur due to the acidity of stomach acid, in addition to taking certain medications (ex. NASIDS) or supplements (ex. multivitamin) without food.

While this isn’t an exhaustive list of hunger signs, it hopefully provides you some guidance on navigating your less obvious hunger cues. Questions or want more? Contact us to meet with our nutritionist!

Five Nutrition Tips for Travelers

Traveling can make eating tricky with limited access to food, new foods, chaotic schedule, etc.

It’s important to stay nourished while traveling that way you’re energized and healthy. Take a look at the images below for tips on how to stay nourished while traveling!

Diets Don't Work

FACT: Research shows that diets are proven to fail long term (~5-10 years post start of the diet). The research that shows weight loss diets “working” is all conducted within the 5 years time or less.

Why do diets not work?

Well, first of all, your body is WAYYY smarter than any diet program. Your body recognizes “oh crap, I’m not getting enough energy; there is a limited amount of food…guess I should slow things down.”

You’re body doesn’t know the different between purposeful restriction and unintentional /environmental restrictions. And let’s be real, it all has the same outcome of reducing the body’s ability to repair, move, think, grow, and heal.

Now you’re probably thinking “okay, great, what do I do now?”

Eat like you did as a young child. Eat in a way that respects your physical and emotional needs. Become attuned with your body, listen to it, and nourish it.

If you feel really detached from with body’s needs, that okay. You’re not alone.

Working with an ED-informed or intuitive eating specialist can be really helpful in rebuilding a healthy relationship with food.

Note: this post is not meant to replace individualized healthcare recommends. Information has been simplified for the purpose of making a brief post.

Reclaiming Your Binge Foods

What does it mean to reclaim “binge foods?”

First, a “binge food” can be any type of food and it is specific to the individual. It’s a food that tends to be eaten in a binge. For some individuals they may have specific foods while others don’t.

When recovering from binge eating disorder (BED) you might be tempted to want to completely cut out all foods that you usually binge on. They may feel like triggers or scary.

Yet by cutting them out this is reinforcing restriction, and science shows us that (mental or physical) restriction often fuels binging.

Reclaiming that food means learning to eat it in a way that respects your emotional and physical needs.

For example if you usually binge X food, then reclaiming it would mean that you’re eating X food when desired until you are emotionally satisfied and physically comfortably full. You are reclaiming that food from the eating disorder.

The eating disorder has likely made it an “all or nothing” food, and by eating it in a self-attuned mindful way you are creating a middle ground.

This can be really scary and/or hard to do and should be done with the help of an ED-informed therapist and/or dietitian.

Contact us if you are interested in learning more!

When is your child's picky eating TOO picky?

“My kid is such a picky eater! I’m afraid they arent getting enough.”

Ever heard or said this phrase? Or perhaps you’ve said it before. It’s common for kids to go through a picky eating phase when they’re young. But….

How do you know when it becomes TOO PICKY?

• they become emotionally distressed when told to have a food they dislike (e.g. crying, screaming, running away from table, etc)

• they’re gagging on foods they don’t like

• they will only eat VERY specific foods

• their variety is severally limited

• they aren’t growing sufficiently

This isn’t a diagnostic list but it gives an idea of the difference between simple food preferences and a type of disorder eating, called Avoidant Restrictive Food Intake Disorder (ARFID).

ARFID is typically first noticed in young children and can persist into adulthood if not addressed.

It frequently includes severe texture, taste, smell, and temperature preferences, resulting in a very limited diet and anxiety around food.

How to approach treatment?

• Work with a trained ED-informed dietitian or therapist that provide in-person sessions

• they will likely have your child do controlled food exposures with feared / disliked foods

• these food exposures will likely need to be replicated and repeated at home

• understand that these feared / disliked food may be very distressing for your child… AND that don’t mean they can’t grow distress tolerance to them

Interested in treatment? Message us through our website portal!

Eating During the Holidays

Oh, the holidays….what a love, hate relationship they can create. The holidays are a wonderful time for fun festivities, reconnecting with loved ones, and enjoying good food. Unfortunately, the holidays may also bring about a number of stressors for many individuals, specifically in relation to food. 

In the U.S., late fall and winter hold four popular holidays that largely revolve around food, that being Halloween, Thanksgiving, Christmas or Hanukkah, and New Year’s Day. While holiday foods can be exciting, enjoyable, and a social aspect for many individuals, others may find themselves anxious about being surrounded by candy, rich desserts and dishes, and alcoholic beverages. As a registered dietitian nutritionist at Potomac Behavioral Solutions, I have several clients that express increased concerns during the holidays relating to the fear of weight gain, the fear of specific desserts or dishes at an upcoming holiday, and the fear of eating in social settings. Ultimately, they all ask the same question of “how do I survive the holidays?” 

While the answer is much more complex and individualized, there are some basic nutrition-related tips that can help! Please note, that your individual providers recommendations are primary and this is not a substitute for any medical or therapeutic advice. 

Meal Frequency

Source:https://www.boredpanda.com/cats-eating-weird-things/?utm_source=google&

utm_medium=organic&utm_campaign=organic

I commonly hear people planning to restrict most or all meals Thanksgiving Day, until dinner time and they eat to the point of feeling “stuffed.” Whether you are struggling with recovery from an eating disorder or just wanting to improve your relationship with food, swinging from starving to stuffed is not optimal for overall well-being. 

Restricting your intake can bring on feelings of irritability, depression, anxiety, dizziness, food obsession (aka food consumes your thoughts), and eating disorder related thoughts. Constrastingly, eating till you’re “stuffed” is frequently associated with feeling tired, sluggish, guilty, disgust, anxiety, depression, and a need for compensation (e.g. “I need to go for a run to compensate for this meal” or “I promise my diet starts tomorrow”). 

Meal frequency means to eat a meal or snack in a normalized and appropriate frequency to ensure that you are eating enough calories and nutrients throughout the day. This typically looks like three to four meals and one to three snacks per day (your registered dietitian can help you individualize this). Normalized meal timing typically includes meals/snacks every two to five hours, with the average being three to four hours. Therefore, try to regularly eat meals, even during the holidays. 

Balanced Meals

Source: https://www.lovethispic.com/image/81760/a-balanced-diet

Generally speaking, a balanced meal includes a protein, a starch, a fruit and/or vegetable, and a fat source. A protein source includes plant proteins, meats, seafood, poultry, eggs, and dairy. Starches include anything that is an adequate source of carbohydrates, such as rice, potatoes, bread, pasta, pastries, grains, crackers, and cereal. Fat sources are a little more tricky to identify sometimes because they can be baked into the dish, but some common sources are salad dressing, oil or butter, animal fats, nuts, full-fat dairy products, creamy sauces, oil-based soups or sauces, and dark chocolate. Fruits and vegetables provide important micronutrients (e.g. vitamins and minerals) and fiber for your body. All these components are important in a balanced diet because they allow you to feel energized and satiated, and help with mood stability, muscle recovery, growth, and cognitive abilities. 

Hydration 

Source: https://memegenerator.net/instance/73156790/dried-up-spongebob-i-need-water

In the famous words of Spongebob Squarepants… “I NEED WATERRRRRR!” Staying hydrated during the holidays seems like a “duhh” topic. However, with all the festivities, increased work, and busy schedules many people forget to hydrate themselves with water. Caffeinated and (non-) alcoholic beverages, and sweet holiday themed beverages are wonderful, but don’t forget to also drink water. Staying hydrated can help with energy, focus, mood stability, digestion, and hunger and satiety. As a rule of thumb, your urine should look like lemonade. If it looks like apple juice, then go grab your water bottle! 

Sleep

Source: https://knowyourmeme.com/photos/52251-reaction-images

Sleep is important for all aspects of your well being, including nutrition. Being sleep deprived is associated with increased levels of cortisol hormone and anxiety, which can increase your hunger, decrease digestion, alter bowel movements, shift food preferences and cravings towards high fat, sugar, and salty foods, reduce your metabolism and (over time your) alter biochemically lab levels. Therefore, sleep is greatly important for your health, especially during this hectic holiday season! 

Mindfulness

Source: https://me.me/i/why-yes-im-a-bit-stressed-why-do-you-ask-20288589

Try to schedule some time to reconnect with yourself, more specifically your hunger and satiety cues. I often tell my clients to pick three random times per day, and then check in with themselves to gauge “What is my body trying to tell me?” Questions to ask to bring mindfulness to your meals may include:  How hungry/full are you on a scale of one to ten, with one being starving and ten being stuffed to the point of nausea or pain? Are you feeling tension anywhere in your body? Are you hungry for a snack or a meal? If you are noticing hunger, try to think about why types of foods or flavors sound good to you. In addition, when eating a snack or meal, try to notice the smell, taste, and texture of the food. 

Self-Compassion 

Source: https://www.instagram.com/p/B-UOXuPHcsU/

Practicing self-compassion is not easy for many people. Afterall, we are our own worst critics! However, most people can agree they want the best for their loved ones and that they deserve care, love, and enjoyable things in life. Well, you are no different! You don’t have to love yourself to respect and take care of yourself (although if you do love yourself that is an added bonus). Just like the puppy (see picture above above), doing relaxing and enjoyable activities can be a form of self-compassion. Self-compassion encompasses taking care of yourself from a physical, emotional, spiritual, mental, and nutritional perspective. This means eating regular and balanced meals, hydrating with water, reducing anxiety, and staying mindful during eating experiences. It can also mean eating that extra slice of cake or having a salad, or sleeping in or hitting the gym - it’s all based on what is needed for you in that moment (aka listening to your body’s needs). Also, don’t forget to cut yourself some slack, because the holidays can be difficult and you’re doing your best! 

Coronavirus and Eating Disorder Concerns

Check out below for a message from our nutritionist on the connection between COVID-19 and eating disorders. Thanks for your input, Jennifer!

If you or someone you care about struggles with an eating disorder, this time of social isolation and the associated anxiety could exacerbate their symptoms.  Uncertainty can increase feelings of powerlessness and tendencies to engage in destructive behaviors; social distancing can create challenges in maintaining a support network; difficulty in procuring food and household items can lead to anxiety and drive one to unhealthy coping skills. Here are some things to be mindful of during this time.

* While staying safe at home and grocery shopping less frequently, a person might experience the inclination to ration food, which could lead to food restriction.  At the same time, stockpiling and hoarding food could increase vulnerabilities and lead to binge eating.

* News and social messaging could influence thoughts regarding eating “immune boosting” or “virus defeating” foods and supplements, possibly supporting orthorexia.  It’s worthwhile to note that none of these claims are scientifically proven.  Rather, a balanced diet of fresh or frozen fruits, vegetables, and whole grains is rich in antioxidants, fiber, and flavonoids, all of which naturally support the immune system. 

*With gyms closed and sporting events cancelled, someone who leans toward excessive exercise can experience panic and increased negative body perceptions. 

All of these lay the groundwork for obsessive thinking about food, weight, and body image, which are all hallmarks of eating disorders. During this challenging time, the best way to maintain a balanced diet and physical health is to stick to the basics:  strive for a wide variety of colorful fruits and vegetables, whole grains, and lean meats, minimize sugar and processed foods, and get the recommended 30 minutes of moderate exercise daily.

If you notice the above symptoms developing or increasing in yourself or a loved one, please reach out for help.  The Eating Disorder Team at Potomac Behavioral Solutions is here to support you. We are open and using telehealth during this time, so please reach out to our admin team at (571) 257-3378 to schedule an intake call with our clinical coordinator. 

 Jennifer Moore, MS, CNS

Nutritionist

Potomac Behavioral Solutions Partners with Local Child Services Act Program to Expand Impact on Community

Potomac Behavioral Solutions (PBS) is happy to announce reaching a contract agreement with the local Child Services Act (CSA) program in order to provide therapy services to eligible youth and families!  CSA, a law enacted in the state of Virginia in 1993, provides state and local community funds to help match at risk youth and their families to public and private services that effectively meet their assessed needs.  Owner of PBS, Dr. Joanna Marino says, “We are so excited to be partnering with our local CSA program.  This provides PBS the opportunity to connect with folks who otherwise may not be eligible to receive the mental health services that we provide.  Our partnership with CSA allows us to reach a larger community to promote awareness of emotional health.” 

PBS will be providing dialectical behavioral therapy, medication management, nutrition, and consultation services through their contract with CSA.  Research shows that providing early mental health interventions in youth helps to prevent or mitigate mental health concerns later in life, which is why Dr. Marino was passionate about partnering with CSA when they reached out to PBS.  “I think it is essential to teach skills that help youth regulate and understand their emotions,” said Marino.  “Providing evidence-based treatment and teaching skills to youth and their family is a significant factor that could help prevent further mental health concerns down the road.  I am thrilled we have the opportunity to expand our impact on our local community!” 

For more information on CSA, please visit their website.  

The Downside of Missed Periods

Sam Tryon, MS, RD

For some, the idea of not having their period might be cause for celebration.  No cramps, bloating or having to worry about keeping tampons or pads on hand; awesome right?! Unfortunately, not getting your period could be cause for concern.*

If you are 16 years old and have not yet started your period or if you have missed at least 3, you could be diagnosed with amenorrhea.1 Amenorrhea can be caused by a variety of factors including genetic abnormalities, gland problems, and certain gynecological conditions.1  Amenorrhea may also be due to what you eat and how active you are.

The roles of nutrition and activity

Low energy availability is one cause of amenorrhea.  Energy availability is a measure of the energy left for bodily functions (i.e. heart beating, digestion, breathing) after subtracting for energy used during exercise and other activities of daily living (i.e. vacuuming, walking to work, gardening).  Low energy availability means that there is not enough energy for body functions and exercise.

Low energy availability can be a result of not taking in enough fuel (A.K.A. not eating enough) and/or using too much energy for exercise.  Among other effects, the lack of energy left for bodily functions leads to decreased production of gonadotropin-releasing hormone, a hormone important in reproduction, which causes decreased production of estrogen and progesterone and disruption of the menstrual cycle.2

Amenorrhea and Bone Health

Both low energy availability and reproductive hormone changes have negative impacts on bone density.  In addition to not having the available energy and nutrients to maintain bone mass, lack of estrogen is associated with bone loss.  In a healthy body, our bones are constantly being broken down to release minerals like calcium and then rebuilt.  Without estrogen, there is increased breakdown without rebuilding which leads to decreased bone density.  This can progress to osteopenia and osteoporosis, putting a person at risk for fractures.  

Studies have found that up to 95% of people with Anorexia Nervosa have osteopenia and as many as 40% have the more severe osteoporosis.3 Weight gain is associated with return of menstruation and possible reversal of at least some bone loss.

Amenorrhea and bone loss are especially concerning in adolescents as peak bone mass is reached during this time. Bone loss from low energy availability during this stage of life may prevent patients from reaching a normal peak bone mass. This can put them at increased risk for fractures later in life.

Next Steps

If you have missed 3 or more periods, an appointment with your general physician can help to determine the cause of amenorrhea.  They may recommend a bone density test to look for possible bone loss.  

If the cause is found to be nutrition related, a dietitian can help you change your diet to make sure you are taking in enough energy to fuel your body. Amenorrhea can occur with or without disordered eating and a dietitian can also help assess for any disordered eating behaviors.  If disordered eating is a problem, a therapist may be added to the team to best tackle these concerns and get you back to the activities you love.  

*The content of this article is for informational purposes only and does not constitute medical advice, professional diagnosis, or treatment.  See your healthcare provider before making any healthcare decisions or with any questions you have regarding a medical condition.  

References:

1. Amenorrhea. Eunice Kennedy Shriver National Institute for Child Health and Human Development; [accessed 2017 May 31]. https://www.nichd.nih.gov/health/topics/amenorrhea/Pages/default.aspx

2. Mallinson, R and De Souza, M. Current perspectives on the etiology and manifestation of the “silent” component of the Female Athlete Triad. Int J Womens Health. 2014; 6: 451–467

3. Mehler, P and MacKenzie, T. Treatment of Osteopenia and Osteoporosis in Anorexia Nervosa: A Systematic Review of the Literature. Int J Eat Disord. 2009; 42: 195-201