Thursday, July 24, 2014

Meds & Weight Gain

What to Know About
 Antidepressants & Weight Gain     

For a vast number of people, depression and weight problems go together. One major depression symptom is in fact, significant weight loss or gain. Other symptoms follow:

  1.  Loss of interest in things you normally enjoy
  2.  Feeling down, depressed, or hopeless
  3.  Thoughts of death or suicide
  4.  Feeling worthless or guilty
  5.  Problems falling asleep, staying asleep, waking too early or sleeping too much
  6.  Unexplained decrease or increase in appetite, resulting in weight gain or loss within the last  month
  7.  Trouble thinking, concentrating, remembering, and making decisions
  8.  Extreme tiredness or lack of energy that interferes with your ability to work or take care of your  daily responsibilities
  9.  Feeling restless, unable to sit still, or abnormally slow when moving

Research shows that up to 25% of the people who take antidepressant medications may experience weight gain. Finding yourself in that group can exacerbate your feelings of frustrations.

There is a connection between depression, antidepressant medications and weight gain, however it's impossible to know how a certain medication will affect your weight, or what other side effects it might effect you. Once you start antidepressants and you do start gaining weight, it will be hard to know if the medication is causing the problem, or if changing it will correct the weight gain.

This means that, if you do find yourself gaining weight when taking antidepressant meds, you and your doctor may need to do detective work to see out what's going on and what you can do about it. Many times it can be difficult finding a medication that relieves your depression with minimal side effects, so changing from an effective medication for the chance that a different one might cause less weight gain can be defeating.

Here's some facts that can help you do this vital detective work,

so that you and your doctor can decide what is best for you.

Why do antidepressant medications lead to weight gain?
The answer is many-sided. 

  1. Sometimes the weight gain may simply be due to the fact that the medication is actually working. For many people, depression causes loss of normal appetite, reduced interest in food, or an inability to experience the pleasure you normally get from eating. 
  2. If that sounds like you, it could be that you're simply eating more food now because the medication is helping you get back to "normal" eating habits. 
  3. Or maybe you're feeling a little better than normal, and eating more for the pleasure of it, without even realizing that's what you're doing. 
  4. Changing your medication probably won't make much difference here. In this case, you'll just need to work on your healthy eating and exercise to get to a balanced weight for you. 

The other side effects in some people can be an increase appetite beyond what's "normal," or even increase cravings for certain foods, especially carbohydrates. Sometimes people gain weight even though their actual eating habits haven't changed, so it's also possible that antidepressant medications can alter your basic metabolism. (Again exercise helps increase your metabolism.)

ACTION STEP: Start to:

  1. Track your food intake and exercise for several weeks to find out exactly how much you're eating and where your calories are coming from. 
  2. Start a basic journal describing anything that feels out of the ordinary to you—whether your appetite is heartier than usual, you're exercising more or less than usual, or you're experiencing food cravings that are really hard to resist. 
  3. If you find that you're having a lot of trouble managing your appetite or cravings, or that your weight is going up even though you're sure you're not eating more or exercising less than before, then talk to your doctor about the situation. 
  4. Bring these records with you when you go.

Should I change medications to prevent weight gain?
The side effects of virtually all antidepressant medications can include weight gain. But individuals do vary in whether or how much any particular medication will cause this or any other side effect, changing medications can be an effective way to deal with this problem. There's no way to predict in advance how you'll react to any medication, but research shows that some medications are more linked with weight gain than others. 

  • Among the selective serotonin reuptake inhibitor (SSRI) drugs commonly prescribed, 
  • Paxil seems to be associated with weight gain most often, 
  • Zoloft is at the other end of the spectrum. 
  • The SNRI (serotonin and norepinephrine reuptake inhibitor) drugs Effexor and Serzone don't seem to cause weight gain in most people.
  • Welbutrin may actually cause weight loss for some individuals. 
  • There is also evidence that combining two different antidepressant medications, or adding a small dosage of certain other medications (such as anti-seizure medications), can also reduce problems with weight gain. So, changing drugs can make a difference.

If you decide to change drugs this could affect your depression symptoms. The brain chemistry of depression is extremely complex and varies from person to person, which is

why some drugs work for you while others don't. It may take some experimentation to find something that will work on your depression without affecting your weight, and that can take time and patience.

ACTION STEP: Always discuss your options thoroughly with your doctor.  Many may foolishly stop taking a medication, or change their dosage, or add any weight-loss supplements or OTC depression remedies. Not a good idea.  Some combinations can be very dangerous, and others may cancel each other out.

Is there anything else I can do to prevent weight gain when taking antidepressants?
For some people, changing medications won't be an option because the drug they're using is the one they need to control depression symptoms; in these cases some weight gain may be something you have to accept if you want to keep your depression symptoms under control. Or you may have to wait until your mood stabilizes enough to do some experimentation with other medications.

If your weight gain is overwhelming, it can take a lot of courage and determination to do the right thing for your overall health and well-being (staying on antidepressants), and resist the temptation to do quick fix diets that really never work long-term whatever is to lose the weight. Getting the right kind of support can be essential to handling this situation, so be sure to talk it over with your doctor and visit a group for people dealing with depression—you'll find you're not alone in dealing with this problem.

ACTION STEP: As always when you're talking about a balanced, healthy diet and plenty of exercise are the steps to success.
Regular exercise not only increases your metabolism, it can improve mood, reduce the effects of stress, and help you enjoy life more—even if you are carrying a few more pounds than you'd like. Likewise, a healthy balanced diet can help your brain to keep your neurotransmitters in balance and avoid big swings in energy levels and mood that can increase depressive reactions. You may be tempted to do an extreme weight-loss diet, but these types of extreme diets have the opposite effect.  Many people find that the combination of a balanced healthy diet and exercise are enough, with consistency and time, to reduce or eliminate the weight gain linked to the antidepressant medications.
      Sometimes the blessings of God are
   so down-to-earth that we overlook them.
                      Harold Klemp
          The Slow Burning Love of God,
    Mahanta Transcripts, Book 13, page 129

My Best to You, Dr. Kathleen Fuller

Monday, July 21, 2014

For Parents - Children Learn How to Control Their Frustrations/Improve Self Esteem


This is excellent to teach any young child to handle their frustration and especially frustration with their poor body image. (I have taught my two grown daughters this technique when they were 8 and 5.   At age 35 and 37 both have excellent body images and live healthy lifestyles.  So it really is amazing how well this works.  Please give this lifetime gift to your children.)  The research -- A new Australian study found that even very young children are trying to lose weight. Researchers at the Australian Institute of Family Studies (AIFS) examined more than 4,000 boys and girls between the ages of 8 and 11. At least two in five said they wanted a thinner-than-average physique. By the time the subjects were 10 or 11 years old, most of them said they had taken some action to control their weight due to a poor body image.

Children Learn How to Control Their Anger | Stress Free Kids 

22,662 views 3 years ago
  • Children relate to the angry octopus in this story as the sea child shows him how to take a deep breath, calm down, and manage his anger. 
  • This effective stress and anger management technique focuses awareness on various muscle groups to create a complete resting of the mind and body. 
  • It is used by pediatric hospitals and doctors to decrease pain as an alternative or complimentary treatment. 
  • The Journal of Behavioral Medicine did studies on 2000 which revealed that people using progressive muscle relaxation experienced increased relaxation by reducing levels of the stress hormone called cortisol. 
  • Muscular relaxation can have a positive impact on your child's health and immune system. 
  • Here are some immediate and long term benefits for children practicing progressive muscle relaxation: 
  • Ability to control anger, lower heart rate and breathing rate Increased blood flow throughout the body.  
  • Reduced anger or general frustrations Increased sense of control over emotions and moods. 
  • Decrease in generalized anxiety and anxiety produced phobias. 
  • Decrease in panic attacks Increased self-esteem Improved concentration.

This story can be found in paperback, eBook, eBook with audio and and iTunes APP.

Stress Free Kids Website:
iTunes eBook:
iTunes animated/interactive APP: 

My Best to You,   Dr. Kathleen Fuller        

Sunday, July 20, 2014

Insult to Girls Self-Esteem -You Run Like a Girl

Published on Jun 26, 2014
Using #LikeAGirl as an insult is a hard knock against any adolescent girl. And since the rest of puberty's really no picnic either, it's easy to see what a huge impact it can have on a girl's self-confidence. 

We're kicking off an epic battle to make sure that girls everywhere keep their confidence throughout puberty and beyond, and making a start by showing them that doing it #LikeAGirl is an awesome thing.

"In my work as a documentarian, I have witnessed the confidence crisis among girls and the negative impact of stereotypes first-hand," said Lauren Greenfield, filmmaker and director of the #LikeAGirl video. "When the words 'like a girl' are used to mean something bad, it is profoundly disempowering. I am proud to partner with Always to shed light on how this simple phrase can have a significant and long-lasting impact on girls and women. I am excited to be a part of the movement to redefine 'like a girl' into a positive affirmation."

So tell us... what do YOU do #LikeAGirl?

For the past 30 years, Always has been empowering girls globally, bringing puberty education to millions of adolescent girls.
Find out more at

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You are a special person who has a lot
to give others, but you've got to
be kinder to yourself.

Harold Klemp, A Modern Day Prophet Answers
Your Key Questions About Life, page 26

My Best to You, Dr. Kathleen Fuller   

Saturday, July 19, 2014

Healthy Ways to Begin Your Day

When you start your morning with good habits, you're setting yourself up for success all day long! Try one (or all!) of these eight smart a.m. tips for a healthier you. 

Wake Up Earlier

  • When you have a stressful morning, chances are that you're going to be feeling stressed for many hours to come. But it doesn't have to be that way! By simply waking up 20-30 minutes earlier than necessary, you can enjoy a leisurely morning without the usual hustle and bustle. Although that snooze button may be tempting, starting the day on a calm note thanks to that extra time is more than worth it! Plus, every time you hit "snooze," those interrupted spurts of sleep will only leave you feeling more tired. 
  • Eat Breakfast

    You've been sleeping for seven to eight hours or more, so your body needs fuel to wake up your metabolism and help you power through your morning. Eating breakfast prevents you from overeating throughout the day, and people who eat an a.m. meal are less likely to be overweight than people who skip it.

    Ideally, your breakfast should include a combination of protein, whole grains, and healthy fats. Whole-grain toast topped with peanut butter and banana, Greek yogurt with cereal and fruit, or a breakfast scramble with a whole-grain English muffin on the side are all excellent a.m. options. 
  • Veg Out

    Once you've gotten in the habit of eating breakfast, take it one step further and try to sneak in a serving of
    veggies with your morning meal. Add some mushrooms and tomatoes into your omelet, or try blending a little spinach in with your smoothie (you won't be able to taste it--we promise!). Getting some veggies in first thing is a great way to get you on track to meeting your 5-a-day quota. 
  • Take a Multivitamin

    Although you should strive to get all the nutrients you can from your food, taking a multivitamin will help you fill in the gaps in case you fall short on any given nutrient during the day. Think of it as your nutritional insurance policy! Make sure to take your vitamin with your breakfast to avoid an upset stomach. 
  • Drink Water

    You're going to need something to wash down your multi-vitamin with--so gulp a big glass of water! Not only
    are your fuel stores depleted when you wake up, but you're also probably mildly dehydrated. Drinking water first thing in the morning will help boost your metabolism, flush out toxins, and get your systems up and running. If you make this habit as regular as brushing your teeth, you may just start to notice higher a.m. energy levels. 
  • Sneak in Exercise

    Working out in the morning is one of the best things you can do to get yourself on track for the day. Not only will you not have to worry about exercising later on in the evening, but you'll also feel proud that you did something good for your body while most people were still asleep! Starting your morning with this habit will also cause you to make healthier decisions all day long; those doughnuts at the office might not seem so worth it after you just jogged for an hour! 
  • Stretch it Out

    If a full-blown workout isn't going to happen for you in the early
    You'll still get your blood and endorphins flowing, while centering your mind. Think of stretching as a cup of coffee without the jittery side effects! hours, try a simple stretching routine, instead.
  • Jot Your Thoughts

  • If your a.m. routine leaves you feeling scatterbrained by the time the sun is up, you may benefit from taking a few minutes to write down your morning thoughts. Journaling has been shown to boost self-esteem, and is a powerful way for you to work through any issues you might be experiencing. Write about anything that pops into your head and then leave it there on the paper. You can even write a to-do list to organize yourself before the craziness of the day happens. Sometimes, just getting it all out there is enough to allow you to fully move onto the next task with a clear head. 

We can change the future through
an understanding and reconciliation of the past.

Harold Klemp,
A Modern Prophet Answers 
Your Key Questions about Life, page 158

My Best to You, Dr. Kathleen Fuller 

Friday, July 18, 2014

Liberate Yourself NOW!

This month we celebrated independence here in America. But wherever you live, it also might be the day you celebrate your independence, too.

It might be the day you liberate yourself from certain behaviors, beliefs, objects or people that devastate your body image, your self-care, your mood and your life.

For instance, maybe you declare independence from dieting or the bathroom scale, which you toss in the trash.  How your clothes feel or the waist of your pants or skirts feel is a better reminder of whether you are off track with your healthy lifestyle.

Declare one or two things. Write it down. Read it aloud. Share it with someone you trust. Just making this intention can be powerful.

  • Maybe you declare independence from false beliefs of unworthiness, and practice loving-kindness such as imagining what your best friend would say to you.
  • Maybe you declare independence from engaging in physical activities that you don’t even like in the first place (and start doing ones you do).
  • Maybe you declare independence from several people who are 
  • unsupportive in your life.
  • Maybe you declare independence from certain negative thoughts or thinking about painful stories.
  • Maybe you declare independence from diet books (which never work long-term), and go on a recycling spree throughout your home.
  • Maybe you declare independence from women’s magazines, and stop buying them from now on.
  • Maybe you declare independence from clothes that haven’t fit for years, which linger in the back of your closet — and give them away.
  • Maybe you declare independence from apologizing  or from unrealistic expectations.
  • Maybe you declare independence from tuning out or denial and instead tune in to your body.
  • Maybe you declare independence from your swimsuit worries and beliefs that pleasure is a bad word.
  • Maybe you declare independence from focusing on your weight, and instead focus on your well-being.
  • Maybe you declare independence from condemning your qualities, and honor them, instead.
  • Maybe you declare independence from shadow comforts (“shadow comforts,” which refers to the various devices we use to numb ourselves).
  • Maybe you declare independence from damaging beliefs and practices.
  • Maybe you declare independence from the things you can’t control and from putting yourself last.
  • Maybe you declare independence from rigidity and guilt around eating. Because why not try a different approach? (One of the hardest things about building a healthier relationship with ourselves is changing our inner dialogue. The inner critic can just be so darn loud.For instance, when we even think about being nicer to ourselves, the nasty inner voice starts).

  • Maybe you declare independence from your own inner battle, the one where you see your body as the enemy, the one where weight worries overwhelm and consume you.

Declare one or two things. Write it down. Read it aloud. Share it with someone you trust. Just making this intention can be powerful.  Ask God as you know it to help you with your declaration for the good of the whole.  Then pay attention to the help you receive in the next several weeks.  I suggest you write down what happens so you won't forget. 

Now think of one way you can take action toward your declaration. I know it seems overwhelming. Incredibly so. But remember that it takes one step. And that one step can simply be taking one slow, deep breath.

Spirit is always with us, always guiding,
always protecting, attempting to bring joy and make our life better, but that doesn't mean that we are always aware and listening.

Harold Klemp
How to Find God, page 277-78

What are you declaring independence from?    

My Best to You, Dr. Kathleen Fuller 

Thursday, July 17, 2014

Mindfulness and Body Image

     Connection Between Mindfulness and Body Image

What do you think when you hear the word “Mindfulness”?  I want to explore this idea of mediation or finding a state of mental peace.  What is written is that there is much more involved with this therapeutic practice than may be understood.
Mindfulness can be defined as “bringing one’s complete attention to the present experience on a moment-to-moment basis” or, “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally”.
Mindfulness actually differs from mediation in that it requires attentiveness and awareness, in a non-judgmental way, whereas meditation focuses more on reflection as a religious or relaxation technique.  Though the practice of mindfulness has foundations that stem from Buddhist meditation, it has recently entered Western cultures as a secular movement that promotes countless mental health benefits.

What I practice and have practiced for the last 32 years is contemplation. The definition of contemplation differs from mediation and mindfulness because during contemplation the attention is focused and directed upward with closed eyes to the spiritual eye.   Then the attention is placed on a definite spiritual principle, thought, or idea, or upon God as you know it.   Example could be focusing on asking to be shown love and self-care or asking to love and accept your body.  This will bring a natural and deeper awareness of your thoughts and being conscientious of your attitude towards yourself, your body, and food.  Thus it can be wonderfully helpful in preventing disordered eating behavior from progressing into something worse.

Practicing Mindfulness and Contemplation Can Help with Eating Disorders

Practicing mindfulness has many documented advantages, including helping those who may be recovering from an eating disorder.  More recently, new research has demonstrated the effectiveness of practicing mindfulness as a form of treating eating disorders.
In a study completed at the University of Newcastle in Australia, researchers attempted to measure
mindfulness skills among a group of students and any connection with eating disorder symptoms and body image acceptance.
Using questionnaires for assessment, researchers found that students who practiced aspects of mindfulness, such as being present in the moment or sharing in experiences non-judgmentally, had improved mental health and a better relationship with their bodies and food.
In contrast, students were found to be less accepting of their bodies and have increased eating disorder symptoms if they spent more time observing their emotions rather than accepting without judgment.

Interpreting the Connection Between Mindfulness and Body Image

What exactly do these findings tell us, and how can this be helpful to someone recovering from an eating disorder?  This research has shown that certain aspects of mindfulness, particularly the practice of acceptance without judgment, could play an important role in the treatment of eating disorders, as mindfulness can encourage the acceptance of one’s identity and body.

Practical Way of Building Body Acceptance and Self-Esteem

Poor body image and low self-esteem can often be the portals through which eating disorders develop and fester.  Practicing greater awareness of your thoughts and being conscientious of your attitude towards yourself, your body, and food can be helpful in preventing disordered eating behavior from progressing into something worse.
When you get dressed in the morning, be aware of how you are thinking about yourself:
  • Are you critically analyzing parts of your body with which you are unhappy?
  • Do you find yourself thinking that you wished you looked different, were a smaller pant size?
  • Do you stare at magazine covers and constantly compare your body to a model’s?
If so, practice countering those negative thoughts with positive ones!  Tape affirmations on your mirror that remind you of things you are grateful for about your body or appearance.  This can create your future.

Building Self-Esteem Takes Time and Practice

If you are having a hard time thinking of yourself in a positive light, ask a loved one to help you.  Practicing acceptance of yourself without judgment may be one of the most difficult things to do, but positive self-esteem is something that can built over time.
These practices can give you the prevention or help sustain recovery of eating disorders.

The usual reason a problem exists 
for us is that we are afraid 
to take the next step

Harold Klemp, The Book of ECK Parables,
Volume 2, page 271

My Best to You,  Dr. Kathleen Fuller    

[1]: Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review, by Ruth A. Baer, available at

Wednesday, July 16, 2014

How Can Body Image Be Improved in Middle Aged Women?

Jane Fonda says aging is like  a staircase: You may decline physically, but you keep ascending in the areas it really counts. Find out why Jane is happy to be making the climb in the third act of her life.

Published on Jan 8, 2012

For more on Oprah's Master Class, visit

Find OWN on TV at



  • Standard YouTube License

What Makes One Woman Develop Body Dissatisfaction Whilst Another Does Not?

Not all middle aged women are dissatisfied with their bodies,  Factors which are loving and nurturing seem to help middle aged women avoid being unhappy with their bodies.  These are:
  • Being in a consistent loving relationship 
  • Being in a Long-term relationship
  • Having loving children
  • Having job or financial security
I believe that these points combine to distract women’s attention from their body image and reduce the inner pressure which they perceive to attain the “thin and more youthful ideal”.

So what of the  a woman in midlife who has not yet found a partner, for example, and who therefore feels compelled to stay thin and, by social pressure, youthful and attractive. She is vulnerable  to an eating disorder and body image issues.

Here's what “cognitive control” can do for midlife woman.
“The ability to accept circumstances as they are and adjust the self to fit in with the environment  has been identified as being important.”
A woman who has high cognitive control is able to reappraise and accept her changing body as she enters middle age.  This can be attained by practicing the many techniques I give in my book- Cut the Guilt- Take Control of Your Eating And Height.

The Importance of Self Care

Self care has also been shown to decrease the need for a middle aged woman to experience body image concerns. For example, women who make time for themselves regularly, and take care of their own needs without feeling guilt have lower levels of body image concern and less disordered eating than women who do not take time to care for themselves.  See my post - Self Care 
Caring and valuing one's body for the incredible miracle it is may be incompatible with body dissatisfaction which often leads to food restriction. It turns out that low self care is linked with a higher body mass index, which may explain why body image issues are a greater issue in this group of middle aged women.
Binge eating disorder (which is commoner in this age group than in early adulthood) – many of these women are overweight or obese and risk developing type 2 diabetes or cardiac problems.
Family expectations are that a middle aged woman will look after others before attending to her own needs.  This certainly contributes to this belief and behavior programming that it is selfish to attend to one's own needs.  No it is SELF-CARE.   Very important!

How Are Eating Disorders Revealed in Middle-Aged Women?

Middle-aged women in midlife may have a chronic illness which began earlier in their lives, or a relapse of a disorder which has been in remission, or a late-onset illness with no prior history.
In one a research, 69% of those over the age of 50 with a late-onset eating disorder could attribute this to changes which occur around the menopause.  The biology facts and solutions are in the first half of my book written by my  co-author Dr.Jason Schwartz.  Link to our book Cut the Guilt - Take Control of Your Eating And Weight.  You can read Kindle on your cell phone or computer.
middle aged womanIn mid-life or any age, the eating disorder can be all consuming so one's focus can take away the need to face up to major life changes, such as parents aging or children leaving home, or that it is a “defence against mortality” – an over-reaction to the health risks associated with obesity. This denial and denial is like dropping in consciousness or burying your head in the sand.  Dangerous!
In mid-life eating disorders, excessive exercise is a common reaction to normal weight gain, while plastic surgery seems to be the option for skin or body changes.
Mid-life eating disordered inpatients aged forty or older were compared with younger inpatients, more had anorexia rather than bulimia. The magnitude of the eating disorder was more serious, however there was less body image distortion.
The older patients also tended to have more concomitant affective disorders and suicidal idealizing, plus they acted out with substance abuse.

Middle aged people with eating disorders  who would benefit from an inpatient treatment have very specific needs which must be addressed by a multi-disciplinary team.

How Can Body Image Be Improved in Middle Aged Women?

Although they are two different populations, the principles behind improving body image in middle aged people who have a diagnosed eating disorder and those who do not are the same.
Psycho-education is the cornerstone of inpatient treatment and educates the facts about the normal aging process, such as the thinness that younger women enjoy may be unrealistic for mid-life women because of metabolic and hormonal shifts.  See Cut the Guilt-Take control of Your Eating and Weight.
Our book Cut the Guilt educates and raises awareness and should also be shared to raise awareness about this process in the general population.
In therapy, inpatients are helped to find the source of their eating disorder, such as unresolved conflict;
in their community, women can be helped to shift the focus of their self-worth from external appearance to internal personal growth, and wisdom.
Middle aged women with eating disorders or body image concerns in my practice are asked to challenge themselves by asking,

  1. "Why staying youthful is so important to you?"  
  2. "What values do your functional body have for you?"
All women in this age bracket can ask themselves:

  • What self-care am I willing to start? 
  • Am I willing to write a list of the positive achievements of my  life to date, such as the development of good friendships, and my inner beauty? 
  • Ask yourself,  Can spirituality help me to come to terms with changes in my physical state?


In summary, mid-life women experience incredible changes in their bodies as they pass through middle age. Body image concerns are omnipresent, and can lead to disordered eating behaviors or clinical anorexia, bulimia or binge eating disorder.
Some mid-life women are more susceptible than others but, by engaging in good self care and learning to embrace the change as it occurs, all women can make themselves less vulnerable to the psychological and physical damage which body dissatisfaction can create.  

If you have love you have everything.

Harold Klemp,
Our Spiritual Awake-Up Calls,
Mahanta Transcripts, Book 15, page 205

My Best to You
Dr. Kathleen Fuller  

  1. McLean, S et al: Factors associated with body dissatisfaction and disordered eating in women in midlife. International Journal of Eating Disorders 2010;43:527-536
  2. Zerbe, K and Domnitei, BS: Eating disorders and middle age: part two. Eating Disorders Review 2004;15:3
  3. Gagne, DA et al: Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: results of the gender and body image (GABI) study. International Journal of Eating Disorders 2012;45:832-844
  4. Cumella, EJ and Kally, Z: Comparison of middle-age and young women inpatients with eating disorders. Eat Weight Disord 2008;13:183-190