A Moment for Vets

This Memorial Day, let’s take a moment to honor our fallen service members.  Many have died in battle to protect us and provide us our freedoms, but sadly, too many have also died here at home.  May is Mental Health Awareness Month and it is the perfect time to shine a light on how many Veterans return home from service and require so much more than they are given. Nearly 1 in 4 active duty members showed signs of a mental health condition, according to a 2014 study in JAMA Psychiatry.

Between Post Traumatic Stress Disorder, Traumatic Brain Injuries and Depression, many of our veterans face a fiercer battle when they attempt to fit back in to civilian life.  According to the Department of Veterans Affairs, in 2014 an average of 20 veterans committed suicide each day.  The United States has two holiday’s to honor those that have served, but there’s so much more that we can do every day:  http://bit.ly/2qtdqL7

We thank you for your service,

The Staff at Southlake Counseling


EMDR Therapy: Healing from Disturbing Life Experiences

By Maria Russell, MACC, LPC

Hi. My name is Maria Russell, and I am a therapist at Southlake Counseling. I have recently returned from an intense 3-day EMDR training workshop, and I am excited to share my experience with you.

120810 - eyeYou may be asking yourself, “What is EMDR?” EMDR stands for Eye Movement Desensitization and Reprocessing. This therapy was originally designed to alleviate symptoms associated with traumatic events. However, after years of research, it has been discovered that EMDR is also an effective intervention in traditional psychotherapy. During a session, EMDR therapy can be used to enable an individual to heal from symptoms of emotional distress that are the result of disturbing life experiences – the type of experiences that are common for many individuals to encounter, not only extreme traumatic events (http://www.emdr.com/faqs.html).

The training has really opened my eyes to many new possibilities of how to treat my clients. Through using EMDR, I can more effectively decrease anxiety and panic attacks, rid clients of phobias, help clients process feelings of sadness, frustration and anger, and also improve a client’s self-esteem and self-worth.  This EMDR intervention also works very well for children who are struggling with sadness or anxiety, or for those who are exhibiting behaviors and feelings that they may not fully understand.

120810 - eye1I am very excited to begin using EMDR therapy because this intervention can be so effectively woven into other forms of psychotherapy (including DBT and Equine Therapy). This treatment has such positive results, and fortunately it can be applied to almost any client, no matter what issues the client may be experiencing.

If you are interested in learning more about EMDR or scheduling a session, please call Southlake Counseling at 704-896-7776.

4 Things to Know About Communicating With the Opposite Gender

If you are a female, communication is likely second nature to you.

As a female, you communicate without even thinking about it. You use every faculty at your disposal to communicate and take great pleasure in doing so. You understand – without giving it your conscious attention – the complex interactions that can take place between body language, facial expression, tonal nuance, word choice, eye contact, and other particulars in your extensive toolkit of human communication skills.

If you are male, however, these skills may come more dearly.

120709-older-couple-walkingAs a male, you may prize directness at the expense of nuance, or confrontation over conciliation. You may find yourself getting frustrated with linguistic flourishes, and have little awareness of or patience for the need to “warm up” your audience or find “just the right words” before launching into a challenging topic.

The good news here is that these differences in communication skills and preferences are only to be expected once the unique genetic coding in the female and male brain is factored in.

Louann Brizendine, M.D., author of “The Female Brain” and its twin bestselling volume, “The Male Brain”, points out that while 99 percent of the genetic code in male and female brains is identical, there is approximately one percent that could not be more different. It is here that problems often arise in learning to communicate effectively and enjoyably with the opposite gender.

Since nearly all of past research into human brain structure, biology and function has been conducted on male brains, researchers’ understanding of female brain structure, usage, and genetic coding is more recent. As more of this information is obtained and shared, the genders can finally begin to mend shattered verbal fences and build satisfying communication bridges, and then turn around to pass along their hard-won knowledge to the next generation of men and women in turn.

In addition to basic communication skills, there are four things to know about communicating with the opposite gender that can be helpful under any conditions – in the workplace, in a friendship, in a romantic relationship, between family members, with peers or acquaintances, and even among total strangers.

Communication Basics But first, it can be helpful to review communication basics. These six essential skills can pave the way for successful communication whether gender differences are involved or not:

1. Remain calm: Speaking when you are angry or feeling any strong emotion risks the message getting lost in the expression of the emotion itself. If you want someone to really hear what you want to communicate, wait until you are feeling calm to speak. 2. Choose your words concisely and carefully: Everyone has had the experience of laughing over a choice bit of movie dialogue, or feeling tears well up from an especially moving literary turn of phrase. But while flowery language may do very well for artistic endeavors, in human-to-human communications, careful and concise language serves you best. If the communication is somewhat difficult or emotional, this rule is even more critical to follow. 3. Take your turn: While speaking your mind may not provide the resolution you are hoping for, it is a sure bet that not saying anything will deliver a less than satisfactory result. Whether someone else is hogging the conversation, or you simply feel too timid to speak up, be sure take your turn. It is yours – you deserve to speak every bit as much as anyone else. 4. Do not interrupt: Have you ever had a conversation with another person that was so one-sided that all you did was listen? And then at the end of the “conversation”, the other person announced that they enjoyed speaking with you so much that they hope to do it again soon? Everyone loves a good listener. Just as it is important for you to take your turn to speak, when your turn it is over, it is equally as important to listen attentively to what the other person has to share. 5. Try to stand in the other person’s shoes: While in most cases, women are more easily able to access and display empathy than men are, everyone has the ability to communicate in a way that conveys “we are in this together”. In sales, in service, between lovers and best friends, or even between two strangers, a genuine expression of mutual empathy is the communication trait that is most likely to pave the way to happy conversational results for both parties. 6. Know when to stay and when to walk away: Sometimes, and especially if the communication is particularly difficult, more than one conversation may be necessary to obtain resolution. Sometimes, no resolution will be possible. When entering into any communication, be aware that there is a time to stay and a time to walk away. If the conversation is becoming unproductive, it is often best to simply “pause” it and resume again when calmer waters have returned.

These six skills lay a firm foundation upon which to become a communications expert. As you practice and master each basic skill in its turn, you can then proceed forward and use this next set of four skills to build on what you are learning.

Gender Communications Because of the one percent of the brain that is different between the male and female brain, gender communications require the development of an additional skill set for optimal results.

Part of this skill set comes from a willingness to learn about the opposite gender’s genetic difference as the basis for a corresponding difference in communication style and preferences. The rest of the skill set comes from learning to communicate to play to the strengths of the other party, which may change depending on whether the conversation taking place is happening between a male and a female (inter-gender), two males or two females (both intra-gender).

These four skills can enhance your gender communications and provide for more enjoyable and satisfying conversations regardless of age or level of prior familiarity.

1. Pay attention to your word count and conversational speed: According to Dr. Brizendine’s research, females on average will use about 20,000 words per day, while males come in at a mere 7,000 words per day.  In addition, females tend to speak faster than males on average. This means that if the communication is happening between a male and a female, some word count sensitivity and speed can smooth inter-gender communications. a. Helpful tips: Females, try to choose your words with care, and slow down when you speak them. When speaking with a male, use less words and a slower pace than you might normally choose in your intra-gender conversations and see if your communications results improve. Males, think about conversation as a three-phase process: “warm up”, “game time”, and “cool down”. Since your communications likely normally consist of “game time” words only, add in some “warm up” and “cool down” communications when talking with the opposite gender to smooth the path. 2. Balance listening with action: Because males have a more direct, “fix it” oriented brain, while women have a more well-developed ability to read subtle nuances into even the most casual statement, the ability to balance listening with action is critical to success in inter-gender communications. a. Helpful tips: Males, if you are unsure whether she is asking you to help her fix or solve a problem or if she simply needs you to listen, then ask her. It is respectful to ask what she needs from you, and this will also help you to feel more satisfied in the exchange as well. Females, if you feel frustrated that he doesn’t “talk to you” or “share” more, understand that for many males, no news means good news. If he isn’t talking, chances are he doesn’t have anything to say or he isn’t ready to say it. When he is ready to speak, he will. 3. Remember your inverse needs: For females, cuddling and intimate conversation can frequently meet their needs for physical connection. For males, however, there is a near-continual drive for physical consummation. Because these needs are hard-wired into the brains of females and males, respectively, being part of a couple means balancing these needs so that each partner feels they are getting their basic physical intimacy needs met. a. Helpful tips: Females, there are some very real physical discomforts for males that are associated with too infrequent consummation. And because males on average are less verbal, physical consummation forms an important communicative bridge that males crave. Also, the common phenomenon of males falling asleep right after consummation is more biological than environmental, according to Dr. Brizendine and other researchers. Males, she needs cuddling just as much as you need consummation. If you do tend to fall asleep immediately after consummation, be aware that you haven’t lost your opportunity to show her attention and to cuddle later on. 4. Respect different tolerances and preferences for conflict: One of the most important gender brain differences recently uncovered by Dr. Brizendine and other scientific researchers points to differences in tolerances and preferences for conflict versus congruence in interpersonal connection. Whereas males are often quite confident and comfortable with conflict, females often do whatever they can to avoid conflict. There are hormonal and biological reasons for these differences in preferences for conflict. The differences in large part relate to the different roles males and females take on when it comes to fostering family and community relationships and raising children and are hardwired into male and female brains, respectively. a. Helpful tips: Males, remember that most females do not enjoy nor seek out conflict or competition in their intimate personal relationships. Since there are often several ways to approach even the most difficult communications, whether in the work place or in the home, remember it can be helpful to “dial it down” when having an inter-gender conversation. Females, remember that males are not conflict-avoidant and are not biologically programmed to seek congruence in relationships and communications. Take a few steps back before overreacting to inter-gender communications that appear strongly worded or overtly conflict-oriented. Train yourself to take a few deep breaths before responding, and remember that as negative as conflict feels for females, it can feel equally and inversely positive for males.

“The Female Brain” and “The Male Brain” by Dr. Brizendine offer many more valuable insights into the mechanics of intra- and inter-gender communications. With these basic communication skills in hand, coupled with newfound understandings and knowledge about gender brain differences, scientists and researchers are paving the way for more productive and satisfying communications for both genders.


About the Author: Kimberly B. Krueger, MSW, LCSW is the Founder and Program Director for Southlake Counseling and Southlake Center for Self Discovery. She has dedicated her career to helping people of all ages “say yes to life” and overcome their life challenges with compassion, professional guidance, and caring support. Southlake Counseling offers the most comprehensive counseling services in the Southlake area with a focus on eating disorders, mood disorders, nutrition and fitness, wellness, Dialectical Behavioral Therapy, addictions, equine therapy, and a full range of one-on-one and group therapeutic services. Learn more at www.southlakecounseling.com.


What is IFS?

The Internal Family Systems (IFS) model of therapy has been developed over the past two decades by Richard Schwartz and is based on the concept of self-leadership as the ideal. IFS relies on a client’s own intuitive wisdom and therefore offers a safe, nonpathological, and empowering approach to psychotherapy. Schwartz believes that any client can benefit from the techniques used in IFS therapy, but that it is particularly helpful for the client who has been humiliated and feels worthless, or for those who have suffered loss or been devastated by trauma.

The basic premise of IFS is that internally, an individual is constantly listening to many different voices and is engaged in various thought patterns and emotions, which are similar to complex external relationships he may have with other people. When a person believes himself to be “thinking,” he is often having an inner dialogue with one or more of his parts. As people develop, their parts develop and form a complex system of interactions among themselves, and the functioning of this internal system can be examined using the systems theory. The IFS model posits that each individual is composed of many internal parts, and that the Self is the true core of each individual. The Self is not only viewed as separate from the other parts, but the goal of IFS is to for the Self to be recognized and respected as the leader of the other parts. Schwartz uses a board room analogy to illustrate the ideal role of the Self at the head of the table and in the position of chairman, with the parts in the chairs around the table. The parts are all respected and important in their roles, but the chairman (Self) does not give up his seat at the head of the table to any of them.

IFS also contains spiritual components in reference to the Self as being similar to the soul of a human being. Schwartz promotes that all individuals have at their core a true Self that innately possesses qualities such as curiosity, compassion, calmness, confidence, courage, clarity, creativity, and connectedness – natural leadership qualities. As individuals go through life and experience various events which their system perceives as traumatic, or other extreme emotional consequences, their true Selves become obscured by these new emotions and beliefs, which become their parts. IFS assumes that the intention of each part is something positive for the individual, such as protection or motivation, therefore there are no “bad” parts. The goal of IFS therapy is not to eliminate the parts, but to help them find less extreme roles. The goal for the individual is to be able to separate his true Self from the parts, view the parts with compassion and curiosity, and regain his innate sense of calmness, confidence and clarity.

The parts in the IFS model of therapy are those separate internal characteristics of an individual that are not qualities of his true Self. They could be emotions or beliefs such as anger, fear, shame, or distrust, which have been programmed into a person by external events or messages, and they all have a reason for being there or an ingrained role to play. For instance, if a girl grows up in an abusive environment, she may eventually come to believe that she is worthless and is not deserving of being treated with kindness and acceptance. Through IFS therapy, her worthless part can be separated from her true Self and be seen as only a part of her. Then perhaps her true Self can be curious about how the worthless part came to be, what it is telling her, and how she can develop compassion for it. In this way, her true Self can come to acknowledge and respect the worthless part, and either unburden it of its feelings of worthlessness based on the abuse she suffered, or give it a more helpful role to play in protecting her. Schwartz believes that after an individual’s true Self becomes curious about one of his parts and begins to acknowledge and respect it, he can begin to have compassion for its purpose in his internal world.

One of the most important aspects of the IFS model of therapy is the safety of its use with the client, and the safety the client feels in referring to any undesirable emotion or characteristic as only a part of him. In IFS parts sessions, the client is in control of which parts to address and to what depth, so the therapeutic process is safely client-driven. Likewise, most clients are more accepting of referring to an undesirable trait as only part of them, and not their true Self. For instance, the woman who was abused as a child may be more comfortable saying, “Part of me is still very angry at the person who hurt me when I was a little girl,” rather than, “I am still very angry at this person.” The difference is that while it is healthy to acknowledge the anger and hurt, it may be liberating to accept that the adult woman is not obligated to carry it around with her and allow it to affect every aspect of her life if it is only a part of her, and not her true Self.

Debbie Parrott, MSW, P-LCSW

Southlake Counseling

The Dangerous Downside to the DSM-IV

For many who suffer from deadly eating disorders, the Diagnostic Standards Manual (DSM-IV) has become a bible of sorts.

Let me explain.

The DSM-IV is the official diagnostic tool that standardizes how to diagnose and address certain sets of symptoms for healthcare professionals the world over. So, for instance, if you are diagnosed with anorexia nervosa in Nevada, but then travel to Singapore, the healthcare professionals in Singapore will be able to reference your diagnosis and treat you appropriately. And if you then travel on to Canada, the healthcare professionals there will be able to take up where your Singapore team left off.

This is the upside to the DSM-IV.

However, as I write this post, the DSM-IV is once again undergoing scrutiny and tremendous revision, and a new version is anticipated by May 2012. While revision to the DSM is normal and does happen every so often when new information becomes available and our knowledge of mental illness increases, for those of us with eating disorders, and those of us who treat eating disorders, the revisions simply cannot come fast enough.

If you have an eating disorder, or suspect you have an eating disorder, you are likely all too familiar already with the stringent diagnostic criteria the DSM-IV outlines to categorize the severity of your illness and the impact it is likely to have on your overall health and wellbeing. For instance, a diagnosis of anorexia nervosa comes only when the individual can meet the following criteria:

Refusal to maintain body weight at or above a minimally normal weight for age and height (weight drops beneath 85% of ideal or fails to achieve expected body weight for age and growth rate)
Intense fear of gaining weight or becoming fat, even though underweight
Undue influence of body weight or shape on self-evaluation or denial of the seriousness of the current low body weight
Amenorrhea (the absence of at least three consecutive cycles), with periods reappearing only with hormone administration

From the very first bullet point we can see where the problems begin. Insurance companies look to the DSM-IV to determine whether they are required to pay for care, and how much care they must pay for. Doctors cannot provide care (for the most part) without the promise of reimbursement, and they frequently must rely on insurance coverage for that reimbursement. So an individual suffering from restricting-type disordered eating is literally forced to lose 15% of his or her body weight before being eligible for care! Furthermore, it is very common for individuals suffering from restricting-type to label themselves as “not sick enough” to even reach out for help or support until they can meet all four of these diagnostic criteria.

After my own eight-year battle against an eating disorder and almost two decades treating individuals for disordered eating and eating disorders, I can assert with utmost authority that eating disorders come in all shapes and sizes, and that eating disorders can be deadly at any stage of illness…and the dangerous downside to the DSM-IV is that current standards do not reflect that*.

I will give you just one final example to prove my point. The DSM-IV currently lists the following criteria as a prerequisite for a medical diagnosis of bulimia nervosa:

Recurrent episodes of binge eating: Eating, within any 2-hour period, an amount of food that is definitely larger than most people would eat under similar circumstances; A sense of lack of control over eating during the episode; Inappropriate compensatory behavior in order to prevent weight gain (vomiting, laxatives, diuretics, enemas, fasting, excessive exercise, etc.)
The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months
Self-evaluation is unduly influenced by body shape and weight
The disturbance does not occur exclusively during episodes of anorexia

Yet there have been documented instances of death due to cardiac arrest after only three purge incidents. The DSM-IV criteria gives individuals who suffer from purging – and their insurance companies – free rein to assume that they are not in need of critical care until they have been purging at least twice a week for 3 months.

Some individuals who suffer won’t make it that long.

If you are suffering from any level of disordered eating, if food has taken a place in your life beyond simply giving your body the nutrition it needs to function, if you feel trapped or imprisoned by your food-related thoughts and behaviors, and if you know, deep down on the inside where no one else but you can see or hear that you are struggling regardless of what the DSM-IV criteria are, then you need to get help.

You deserve help. Life is too short to live with an eating disorder as your constant companion. And life is too precious to lose it to an eating disorder when help and hope is available.

Here at The Southlake Center, we know what it feels like to live through an eating disorder. We know how dangerous eating disorders are, and how deadly they can be. If you will let us, we can help you say a permanent “no” to your eating disorder, and say YES to your own unique and precious life!

Be Well.


* There is a diagnostic category in the DSM-IV called “eating disorders not otherwise specified (EDNOS)” that allows for less severe symptoms that do not fit into the three major categories of eating disorders (anorexia, bulimia, binge-eating disorder). However, many insurance companies have been slow to recognize this category and incorporate it into coverage provided to policy-holders.

Infertility: When to Say When?

Most couples facing infertility treatment never expected to have difficulty conceiving a baby. Month after month of trying leads to a trip to an infertility specialist and before you know it you are in the midst of infertility treatments. You begin with monitoring your basal body temperature then move into taking some medication and before you know it you are making difficult decisions about things like surgery and using donors. It can all come at you very quickly and make you feel out of control. Dealing with infertility on a daily basis can take an enormous toll on you physically, emotionally and financially.

Which treatments to try, for how many cycles and how much money to spend? All are very difficult questions. The answers are different for each couple. What may feel right for one person might feel very wrong for another. It is important to honor your individual circumstances. No one has walked in your shoes, and though loved ones and medical professionals may give you advise, you are the only one that can decide when the time is right to grieve your reproductive loss and move on to explore the other options that may be available for building your family.

Struggling through all that comes with infertility can leave even the most grounded person feeling that they have lost control over their life. It can help to take a step back and have a conversation with your partner about your goals, ethical beliefs, physical and emotional stamina and financial situation in order to put you in a proactive mode instead of feeling that you are always reacting. Some topics worthy of discussion include:

Ethical Beliefs – It may be that you are ok with IUI, but IVF doesn’t feel right, or perhaps you are comfortable with IVF and a donor egg, but surrogacy is pushing the envelope for you. Think ahead as to what could be coming down the road so you will be prepared when the next option is presented.

Financial Investment – As much as you may hate to put a price tag on a child the reality is that infertility can be a very expensive endeavor with no guarantee of a successful outcome. Most people have a limit on what they can spend. It is wise to set a budget early on with an agreement not to go over it without additional discussion. As much as you may dread it you should also discuss what your contingency plan is. It may be that if you are not able to have your own child that you might consider some form of adoption in the future which may have a significant financial cost as well.

Time investment – Life can feel like it is at a stand still when you are going through infertility treatment. Your whole schedule is planned around injections, blood draws, ovulation, etc. Things like vacations are difficult to plan, not knowing if you will or won’t be pregnant. Again, it can be helpful to set a time table for yourself knowing that you will reevaluate your feelings when you reach that point. It is also important for women who are getting older to realize that some of their other family building options such as adoption may be threatened if they wait to long.

These are difficult decisions to make as an individual; they become increasingly complicated when trying to make them as a couple. It is rare for a couple to always be in agreement. Infertility can take an emotional toll on even the strongest of relationships which is why it is important to talk through these issues early on and to continue to communicate throughout the process. If you are really having trouble coming to a consensus get some assistance. Some couples find it helpful to work through these decisions in counseling with a therapist specifically trained in reproductive health issues (you can locate qualified Infertility Counselors at  www.ASRM/MPHG.org)

In the end only you will know when “enough is enough” and you are ready to move on. Trust in your judgment and expect that you may second guess your decisions in the future. “If we had just tried one more cycle…? If you do decide to walk away from infertility treatment be prepared to mourn the loss of the dream you had for yourself. Acknowledging the loss will allow you to grieve so that you can move on and explore other options such as adoption, fostering or deciding to live child free.

Erin Clark is a therapist who specializes in working with women and couples struggling with issues related to infertility, pregnancy loss and adoption. If you found this article helpful you can reach Erin through from our Contact Page

Supporting a Loved One Struggling with Infertility Can Be Confusing

How Do I Support Her Through Infertility?

Supporting a loved one struggling with infertility can be difficult. How do I help? What do I say? When your spouse, friend or daughter is struggling through the ups and downs of infertility it is hard to know how to help.

For the woman who is struggling with infertility the emotional toll, to say nothing of the physical toll, can be immense. Every month brings the opportunity for new hope and despair. It is difficult to accept the fact that there is nothing you can do to fix the problem or to stop the hurt, but there are things that you can do to help:

Offer to lighten the load: Trying to juggle work and home responsibilities in the midst of infertility can often feel overwhelming. Be specific with your intent. Instead of saying, “Let me know if there is anything you need.” Offer to bring over a meal for her on a day that you know will be particularly trying, such as after an IVF treatment.

Ask her about her treatment: Most women are consumed with thoughts about their infertility and would appreciate the opportunity to talk about what they are going through. If she is not in the mood to talk she will likely let you know, but she will be glad to know that you will be there when she is ready to talk.

Keep asking: Unfortunately for many women the infertility struggle can be a long one lasting many months and sometimes even several years. As time wears on the emotional strain deepens. Try to avoid questions like, “Are you pregnant yet?” which can make her feel like a failure if the answer is no, and opt for something more supportive like “How are you holding up? It is helpful to know that you have people that will be there to support you regardless of how long it takes.

Don’t minimize her feelings: A platitude such as, “Well, at least now you know that you can get pregnant.” or “There’s always next month.” doesn’t erase the fact that she is hurting now. What may seem like a small set-back to you could feel huge to her. Don’t assume you know how she feels, even if you have struggled with infertility yourself. Each person’s reproductive story is unique.

Run interference: For a woman trying to have a baby it seems that everywhere she goes there are babies and everyone she knows is pregnant. Handling situations like family gatherings and holidays where it is likely that the focus is going to be on children can be especially painful. Try to anticipate people or places that might be difficult for her. Help her to steer clear of those things or give her an outlet if she needs to escape.

Be present: Sometimes empathy is the only tool in your arsenal. Being a shoulder to cry on or crying with her will help her through her grief and let her know that you care.

You may not always do or say the right thing to your special someone who is struggling with infertility, but what really matters is that you let her know that you love her unconditionally and will be there to support her whenever and however she needs.

Erin Clark is a therapist who specializes in working with women and couples struggling with issues related to infertility, pregnancy loss and adoption. If you found this article helpful you can reach Erin through from our Contact Page

Food Allergies on the Rise

More than 12 million Americans suffer from food allergies.  Young children make up the highest percentage by age, with about one in 17 children under the age of 3 (5.6% of that age group) currently dealing with a food allergy.  Children aged 1 to 18 represent about 4% of cases and adults represent a slightly lower 3.7% of cases, according to the Federal Register.  And, while no cure has been officially found, there is new hope with current research that cures will be found in the near future.  Duke University, for instance, is having good results with therapies to eliminate peanut allergies.  And, luckily for many, most milk, egg, soy and wheat allergies are outgrown with age.

As a dietitian, I am seeing more and more clients trying to manage a food allergy…and it seems there is more to the story than just a higher diagnostic rate.  There actually seems to be an increasing number of individuals developing food allergies.  The CDC reports food or digestive allergy increased 18% among young people between 1997 and 2007.  And, between 1997 and 2002, childhood peanut allergies doubled.

Theories about why food allergies are on the rise include (but are not limited to):

  1. genetic susceptibility;
  2. the “hygiene hypothesis”(overuse of antibiotics, vaccinations and antibacterial cleaners leaves our immune systems open to attack other perceived toxins, such as foods);
  3. a lack of vitamin D, which plays a role in the immune system;
  4. an imbalance of omega-3 fatty acids to omega-6 fatty acids;
  5. and, the way foods are heavily processed.

Food allergies occur when the body mistakenly identifies a particular food as a health threat.  Unlike a food intolerance which causes a digestive response, an allergy involves a complex immune response.  Ranging from mild to life-threatening, the severity of a food allergy differs depending on the individual.  For some, a minute amount of food ingested or inhaled (perhaps if a child smelled a nut) can cause a reaction – even anaphylaxis (multi-factorial body response that can be fatal).  For others, it takes a larger volume of allergenic food for a reaction.

Food allergy causes about 30,000 ER admits and 150 deaths annually, according to the FDA.  Peanut and tree nut allergy represent the leading causes of fatal and near-fatal allergenic reactions.  And, although there are more than 160 foods that can cause an allergic reaction in humans, the top eight allergenic foods include peanuts, milk, eggs, tree nuts, wheat, soy, fish and shellfish.  The top eight cause about 90% of reactions.  New evidence points towards sesame as the 9th most allergenic food.

Sensitive individuals may react with hives or an eczema flare from skin contact.  In others, eating an allergen could trigger runny nose, coughing, wheezing, cramps, diarrhea, nausea, vomiting, a drop in blood pressure or a change in heart rate.  If someone has asthma, it increases the risk of a severe response.

Although there are different types of immunological responses, one of the most common causes the body to produce antibodies to attack the allergenic food protein.  These types of allergies are also called immediate onset, type 1 hypersensitivity or IgE-mediated food allergy.  They cause symptoms within seconds or up to a few hours after eating an allergenic food.  These allergies can be diagnosed with the usual medical tests such as skin prick test or RAST blood test or via an elimination diet (where the potential food is avoided for 1-2 weeks and then re-introduced to determine if a reaction occurs).  This type of food allergy is often inherited.

One type of immediate onset food allergy is Oral Allergy Syndrome (OAS).  This condition is caused by the cross-reactivity between pollens and the certain raw fruits and vegetables upon which the pollens are found.  Itching, burning, tingling and sometimes swelling of the mouth, lips, tongue and throat can occur.  In severe cases, it is possible to have an anaphylactic reaction.   Common foods implicated with OAS include: apples, almonds, apricots, bananas, carrots, cherries, cucumbers, hazelnuts, kiwis, melons, parsnips, peaches, plums, potatoes, sunflower seeds, tomatoes, various spices and zucchini.  For the estimated 36 million people with ragweed allergies, for instance, it is important to be aware about OAS.

In the “delayed onset” or “non-IgE-mediated food allergy”, delayed onset of symptoms occurs after a food is eaten (usually 4 to 24 hours).  While there are several types of this allergy, symptoms often exist in the first few months of life (infancy) and most are outgrown in one to three years.  An infant may refuse food, have failure to thrive, seem colicy, pull legs up or have reflux, diarrhea or blood in the stools.  Diagnosis is achieved with an elimination diet.  If an infant is breastfed, the mother would need to eliminate trigger foods from her diet (or use a hypoallergenic or amino acid-based formula).  Elimination of milk products is usually done first.  Since at least half of infants with a milk allergy are also usually allergic to soy, it may be recommended to a nursing mother to avoid both milk and soy.

Other types of food hypersensitivities (allergies and intolerances) exist and involve varying responses from the immune and/or digestive system.  Several GI disorders have been linked with food hypersensitivities, including irritable bowel syndrome, eosinophilic esophagitis and celiac disease.  Additionally, other diseases and conditions, including fibromyalgia, atopic dermatitis, migraines and even depression may have connections with how our bodies respond to certain foods.

Various therapies and/or treatments exist to manage food hypersensitivities.  If you or your child suffer from food hypersensitivity (or suspect one), here are some tips:

  • Work with a specialist, such as a board certified allergist to do appropriate testing in order to get a correct diagnosis.
  • Work with a dietitian specializing in food allergies to develop a safe eating plan.
  • Read food labels diligently to ensure you know what is in your foods.
  • Choose cosmetics like California Baby and high quality supplements (such as Nature Made vitamins) that do not contain allergenic ingredients like milk, soy or nuts.
  • Research! Learn about treatments and educate yourself.

Excellent sites to learn more:

Julie Whittington is a Registered Dietitian in the Lake Norman area. Contact her at juliewhittingtonrd@yahoo.com.

Fight the Fear of the Freshman 15

Many college freshman worry about gaining the dreaded “freshman 15”. What they fear, in fact is that they will somehow gain 15 pounds during their freshman year at college, unintentionally.

When I counsel college students, I often encourage them to overcome the fear of weight gain and replace it with a sense of self assurance. When you understand your body does not intend to trick you or get out of your ideal body weight range, it can become easier to trust your body.

Unfortunately, an individual’s relationship with food can be a very complicated one. How many people do you see day to day who seem unhappy with their body? Or, perhaps it is the seemingly harmless comments like “I can’t eat that,” “I am so fat,” “That food is so bad for me,” or “I wish I could eat that.” None of these comments give respect to one’s body and in a sense, put a sort of distrust in one’s own ability to be healthy.

Combine that with the situation of a young man or woman embarking on the college path, leaving home (perhaps for the first time) and being confronted with countless choices and opportunities. Take it to the cafeteria or campus gym and you can often see anxiety escalade. Comparisons to other students (be it eating styles, study styles, workout routines, or the like) or even a desire to be so far different from usual can often lead individuals to an unknown place—where losing touch with one’s body signals and true self becomes the norm. And, it can be tough…to keep in touch with your true healthy self, especially if you are not sure who that true self really is or who it wants to be.

So, let us bring it back to the point of contention—how to avoid the freshman 15. Assuming that a college freshman is at a healthy weight (or even overweight) from the start, I can offer a few suggestions to help avoid unnecessary weight gain. And, even though the true weight gain someone might experience freshman year is likely to be less than 15 pounds (research points to a 2-5 pound gain, on average), these tips can help students make healthy choices during their college years.

Eat at regular mealtimes. Avoid going longer than 3 to 4 hours in between meals. Snacks help bridge the gap between mealtimes – especially when classes interfere with traditional mealtimes. Don’t let class get in the way of you eating breakfast, lunch or dinner!

Meet with a campus or local dietitian for an assessment of your dietary habits and for help making healthy food choices on and off campus.

Avoid frequent late night eating. While it is common to stay up late in college, be sure you eat according to your hunger levels rather than just because food is available. It can be tempting to overdo it on “free” food or food that you might not normally have ever eaten so late at night. However, frequent events like this can lead to unhealthy eating. Granted, it may be needed to have one or two pieces of pizza if dinner was at 5:00pm and you are still up studying at 10:00pm. Try to keep portion sizes in mind and mix up the routine. One night might be pizza, another might be yogurt and granola.

Stay hydrated! Many people often confuse hunger and thirst. Your brain needs water, just as much as it needs food.

Continue (or begin) incorporating regular physical activity into your schedule. A healthy balance is important – too much or too little exercise can interfere with healthy weight and stress management. See what clubs or classes are available, too. Classes like yoga and pilates are great, as they incorporate mind and body balance.

If you find yourself eating or restricting food in response to stress or anxiety, try to become more mindful about eating. Mindfulness is about being conscious about why you are eating. Are you hungry? Tired? Bored? Sad? The moment you begin to capture the true feeling of what is going on inside you, you can become more mindful about when you are hungry and when you are satisfied (not starving or painfully full).

If you struggle with separating food from your feelings, you are not alone. Seek out someone on or off campus to discuss your situation. Counselors, therapists, doctors and dietitians can all play a role in helping you to achieve life balance. There should be no stigma associated with seeking out someone to help you. Most people benefit from guidance—so seek out the options available to you!

Julie Whittington is a Registered Dietitian in the Lake Norman area. Contact her atjuliewhittingtonrd@yahoo.com.

Fashion Industry Taking Steps to Promote Healthy Body Image Among Women

In an effort to promote healthy body image, the French fashion industry has passed a charter of good conduct regarding the use of models in promoting healthy body size. The charter, supported and signed by the French minister of health, recommends the fashion industry to promote “diversity in the representation of the body, avoiding all form of stereotyping that can favor the creation of an aesthetic archetype [ideal body image] that is potentially dangerous to [youth]”. Those members of the fashion industry who signed the charter also are pledging to participate in preventative actions that would discourage idealization of unhealthy body sizes and also plan to increase public awareness about the “risks linked to extreme thinness.”

In addition to the charter, French parliament is considering a law project aimed at preventing anorexia. Possible implications of the law include fines and jail time for individuals involved in promoting eating disorders, such as on pro-anorexia (“pro-ana”) websites or in fashion ads.

Other countries have begun to address the weight of top models in the fashion industry. Spain, for instance, has banned from fashion shows models with BMI’s (Body Mass Indexes) less than 18. Milan (in Italy) bans models less than a BMI of 18.5.

The World Health Organization and other health agencies classify a healthy BMI as 18.5-24.9. Someone who is 5’8” tall with a BMI of 18.5 would weigh 121 pounds. However, ideal body weight for a woman with medium/regular bone and muscle structure is around 140 pounds. So, there is considerable variation in what might be classified as healthy. And, it is important to note that BMI is not the only determinant for the diagnosis of an eating disorder. Eating disorders are multi-factorial, life-threatening mental and physical illnesses that involve a complex interlay of emotional and physical issues. Many individuals with eating disorders (or simply disordered eating) go undiagnosed or untreated and may suffer with a life-long battle with food and weight issues.

Here are some facts that may surprise you:

  • In the US, as many as 10 million females and 1 million males are suffering from eating disorders such as anorexia nervosa or bulimia nervosa.
  • Millions more are suffering from binge eating disorder.
  • Anorexia nervosa has the highest premature mortality rate of any psychiatric disorder – the majority of deaths are due to physiological complications.
  • An estimated 42% of 1st-3rd grade girls want to be thinner.
  • Most fashion models are thinner than 98% of American women.
  • An estimated 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders.
  • The majority of people with severe eating disorders do not receive adequate care.

For more statistics, visit www.nationaleatingdisorders.org.

For eating disorder/disordered eating treatment in the area, contact the Southlake Center

Julie Whittington is a Registered Dietitian in the Lake Norman area. Contact her at juliewhittingtonrd@yahoo.com.

Published April 20, 2008 in the Statesville Record and Landmark.