Supporting Healthy Bodies at UNC: Navigating Obesity, Eating Disorders, and Weight Bias

When discussing health, you’ll notice a trend between two approaches – weight normative and weight inclusive.

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Screenshot from American Heart Association, 1/25/2015

The weight-normative approach includes the many principles and practices that emphasize achieving a “normal” weight when defining health and well-being. This approach rests on the assumption that weight and disease are related in a linear fashion, with disease and weight increasing in tandem. Under the weight-normative approach, personal responsibility to make “healthy lifestyle choices” and maintain “healthy weights” are emphasized.  The approach prioritizes weight as a main determinant of health and as such, weight management (calories in/calories out) as a central component of health improvement and health care recommendations.

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Photo Credit: Prevention Magazine

Instead of imagining that well-being is only possible at a specific weight, a weight-inclusive approach includes research-informed practices that enhance people’s health regardless of where they fall on the weight spectrum. Under this paradigm, weight is not a focal point of treatment or intervention. Instead the weight-inclusive approach focuses on health behaviors that can be made more accessible to all people. These are behaviors such as exercising for pleasure, eating when hungry and stopping when full.

So is one better than the other? We’ll look at three questions to figure that out:

  1. What happens when people believe that everyone should reside within a certain body size / weight range?’
  2. What happens when people try to reach that certain body size / weight range?
  3. Does higher body weight / larger body size cause poorer health?

What are the effects of the belief that all people should reside in a “healthy” body size / weight range?

 

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Photo credit: Words over Pixels

The evidence does not support focusing on weight and weight loss to improve health or prevent obesity.

The emphasis on achieving a “healthy” weight implies that there is a healthy or normal weight that each of us should be striving to attain and maintain, which gives credibility to cultural messages prizing leanness and weight loss.

These socially prescribed ideals can become internalized – and when that happens, it’s connected to body shame, body dissatisfaction, eating disorders, and potentially harmful muscle-enhancing behaviors.

The medical and cultural emphasis on “good weights” and “bad weights” produces the opportunity for weight bias.

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An image from Georgia’s problematic anti-obesity campaign, Stop Sugar-Coating It

Weight bias and weight stigma refer to negative weight-related attitudes and beliefs that manifest as discrimination, stereotypes, rejection and prejudice toward individuals of any size. Common negative stereotypes about higher-weight people include ideas that they are lazy, stupid or worthless – and this results in behaviors targeting them including bullying, harrassment, pressure to lose weight, and weight related microaggressions.

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Photo Credit: More Bad News About Weight Stigma in Health Professionals

Microaggressions are intentional or unintentional verbal, behavioral, or environmental indignities that communicate hostility or negativity toward people who hold less power in society. For example, a doctor recommending a diet for a patient who presented with an issue unrelated to weight would be a weight-related microaggression.

Complimentary weightism is another type of microagression. Some examples include an anorexic student hearing that she “looks healthy” after disclosing that she has an eating disorder. And really – anyone being told they are “looking good” puts the focus and importance on appearance. The compliment could unknowingly congratulate someone who is using problematic behaviors like vomiting or restricting calories to control their weight.

Another example of complimentary weightism is when thinner people are “hated” for their thinness –  “I hate you because you can eat whatever you want.”

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Photo Credit: Some eCards

Research shows that weight stigma is associated with increased calorie consumption, a pattern that challenges the common wisdom that pressure to lose weight will motivate overweight individuals to lose weight.

Instead…

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Photo credit: I Stand Against Weight Bullying

When people believe that folks of all sizes and weights can be healthy, it results in less shame, increase trust and rapport, improved outcomes such as pro-health lifestyle changes and improved psychological well-being.

What happens when students attempt to reach a “healthy” or “normal” weight to improve their health?

The literature says that attempts to reach a healthy or normal weight rarely work. Research has repeatedly shown that dieting is not an effective means of weight management. No weight-loss initiatives have generated long-term results for the majority of participants. In fact, there are serious risks of dieting, including weight cycling, disordered eating, and emotional distress.

weightcyclingWeight cycling, or the repeated loss and gain of weight, is an almost inevitable result of dieting. Nutrition and fitness education interventions that focus on weight management are rarely effective long-term, as clients often lose weight and then gain it back.

Weight cycling alone may be enough of a reason not to recommend weight management because it is linked to adverse physical health and psychological well-being, including higher mortality, higher risk of osteoporotic fractures and gallstone attacks, loss of muscle tissue, hypertension, chronic inflammation, and various forms of cancer.

In order to maintain lost weight, formerly overweight dieters may need to consume fewer calories than their same-weight counterparts who were never overweight. During calorie restriction and weight loss, metabolic rate is often lowered, and folks may need to employ more rigid dietary habits or excessive exercise routines that may be deemed disordered.

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Photo Credit: Unite Virginia

“The best-known contributor to the development of eating disorders is body dissatisfaction.”- National Eating Disorders Association

Dieters are 12 times more likely to binge eat. A third of  “normal dieters” become pathological dieters, and of those, 1/5 – 1/4 develop eating disorders.

We Have Little Choice about What We Weigh

The weight-normative approach promotes the view that weight can be controlled easily through willpower and reduction of poor lifestyle habits. But there is ample scientific evidence that people have little choice about what they weigh due to the interplay between involuntary genetic and environmental factors. Recently, 97 regions of the human genome were identified as playing a role in the development of obesity, including the control of appetite and energy use.

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Photo Credit: American Nutrition Association

Plus, multiple uncontrollable external factors impact weight. Socioeconomic status influences weight in numerous, complex ways. America’s obesogenic environment leaves many Americans with little access to high quality fruits and vegetables and ample access to addictive, engineered, intensely marketed processed foods.

People who are focused on achieving a “healthy weight” may struggle to reach their weight-based goals, in large part due to the external factors mentioned above. This struggle often results in a sense of learned helplessness. Any adopted healthy behaviors like being more physically active, getting better sleep, or eating more mindfully may be seen as futile if attempts to reach and maintain a specific weight continually fail.

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Photo credit: I Stand Against Weight Bullying Tumblr

Weight loss promotion and achieving a “healthy weight” may instill a sense of learned helplessness in the majority of people who are unable to achieve weight-based goals. If attempts to reach and maintain a “healthy weight” continually fail or are seen as impossible given available resources, the practice of healthy behaviors may be seen as futile. If I go to the gym for a week or two regularly and see no change in my goal of reaching a desired weight, I will likely learn that nothing I do helps.

Finally, it’s important to remember that when we attribute weight-related stereotypes to each other, it affects the well-being of ALL OF US. It makes even students who are at a normal weight terrified of gaining weight. The negative effects reach across the weight spectrum.

Instead…

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Photo credit: I Stand Against Weight Bullying Tumblr

The weight-inclusive approach focuses on the PROCESS – being active because it’s fun, and eating when hungry / stopping when full. In doing so, it results in reduction of risk factors (like sedentary lifestyle) and improved physiological measures (like blood pressure or blood glucose) in lieu of pounds or BMI. There are four decades of research proving the positive impact of weight-inclusive interventions. One study looked at folks over a 2 year span and included a “diet group” and a health-at-every-size group. Over the 2 years, 41% of the diet group left the study versus only 8% of the weight inclusive group. In the same study, the researchers offered 6 months of weekly interventions and 6 months of aftercare group support to a diet group and a weigh-inclusive group. The health at every size group members maintained their weight, improved in all outcome variables, and sustained improvements. Diet group participants lost weight and showed initial improvement in many variables but by the end of the study, the lost weight was regained and little improvement was sustained.

Longitudinal studies repeatedly indicate that freedom from weight bias along with body satisfaction correlate with reduced risk for all of the following: unhealthy dieting behaviors, sedentary behaviors, eating disturbances, and weight gain. These findings hold regardless of the participant’s actual weight. 

Does higher body mass index cause poor health?

The weight-normative approach rests on the assumption that weight and disease are related in a linear fashion with weight and disease increasing in tandem. The belief is that to be healthy and avoid disease means achieving or being in pursuit of a lower weight if overweight or obese. A weight-normative approach believes that recommending weight loss to these individuals is not a function of weight bias but of health imperative.

But data does not support that a higher BMI causes poor health. correlationA higher BMI is associated with various diseases, but causality is not well-established. Interestingly enough, when accounting for socioeconomic status, nutrition, physical activity levels, and weight bias, even the correlation between a higher BMI and disease is vastly reduced or disappears. The risk for all-cause mortality is lowest for people in the overweight category and highest in the underweight BMI range.

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Flegal’s U-shaped Curve

In 2013, Flegal’s very well-known and very-debated meta-analysis showed that the risk for all-cause mortality is lowest for people in the overweight category with the highest risk in the underweight BMI range. The U-shaped curve is a well-known image used to describe the obesity paradox.

Instead… fat-and-fitStudents can be fat and fit. A 2011 study found that metabolically healthy obese individuals had a lower risk of heart failure than normal-weight people who were insulin resistant. And what does “metabolically healthy” mean? Certain characteristics exist in people who were both obese and metabolically healthy: normal BP, cholesterol, and blood sugar levels, normal insulin sensitivity and good physical fitness.

Many studies show that obesity and healthy are not mutually exclusive. And culture is starting to agree. Joni Edelman, a registered nurse and writer, recently blogged about her own experience of losing weight and truly becoming obsessed with the calorie counting and incessant exercise necessary for her to achieve a BMI in the normal/healthy range. She is an example of someone who feels healthier and happier at a higher weight.

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“There is a cultural belief that people have to be dissatisfied with their weight (or any aspect of their appearance) to be motivated to improve it. This belief has not found general support in the literature; in fact, the reverse is supported:  people are more likely to take care of their bodies when they appreciate and hold positive feelings toward their bodies.” Tylka et al, 2014

 

What should we do?

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Emphasize self-compassion

Help your loved ones shift away from habitual appearance monitoring, which is associated with lower self-care and ignoring physical health, to attending to their bodies in more positive ways that emphasize self-care. People are more likely to take care of their bodies when they appreciate and hold positive feelings toward their bodies.

Remind your friends that you’re perfect just the way you are! That unconditional positive regard goes a long way in helping people feel supported and confident in their ability to make changes when THEY are ready.

Reframe body blame and shame as internalized weight bias that has little to with someone’s actual weight or size.

“What does your body provide your life that you enjoy?”

“Be gentle with yourself! You’re amazing!”

“I love you just the way you are. No matter what.”

Appreciate all bodies – don’t compliment them, just appreciate them.

Placing a focus on appearances is problematic. Avoid: “You look great!” “Have you lost weight?” “I can tell you’ve been working out!” “You look really strong!” Again – you don’t know what behaviors your comment is supporting. And on the flip side, negative comments just make people feel bad about themselves.

Some alternatives? If you can’t stop talking about how people look – focus on how they did their hair that day or compliment their shoes. But even better? Tell them what you’re feeling – or ask about their self-care.

Instead:

“I’m really glad I ran into you.”

“What’s new with you?”

“I could use some new ideas. What do you do to take care of yourself?” and then, “how does it make you feel? Has it impacted your sleep?”

Focus on behaviors

Instead of encouraging a friend to work out more or eat differently, do it with them and make it fun and easy!

“Do you want to go for a run with me?”

“Wouldn’t it be fun to bike to the quarry and go swimming this weekend?”

“Can I make you dinner?”

“Let’s go to bed early tonight so we can play outside all day tomorrow!”

Make it sustainable

Sustainable change means that the behavior is supported, easy, and fun. One easy way to incorporate more physical activity is to move as a part of other activities. If you’re running errands, actually run them (or walk, or bike). If you have to drive, park a few blocks away so you get to move a bit more. Try to eat intuitively and encourage your friends to do the same.

“What if you and I walked to dinner instead of taking the bus?”

“Will you be my lunch buddy?”

“Hey, I got you this water bottle! I’ve noticed how much more water I drink when I carry it with me and fill it up at each water fountain I go by. I feel so much better when I’m hydrated!”

“How can I help you reach your health goals?”

Encourage quality of life as an end goal

Avoid focusing on how exercise makes bodies look, or exercise as a way to “make up for” food choices. And avoid focusing on calorie counting. Help your loved ones reconnect with their bodies –  focus on internal body awareness rather than engage in external appearance monitoring. Consider how healthy behaviors make you and your friends feel.

“It feels so good to be outside, doesn’t it?”

“Endorphins are amazing!”

“I love how good I feel after eating a meal like that.”

“Whoa, I’m full. I love this yummy food but I know if I eat more I’m going to be uncomfortable. Let’s save some leftovers to eat for lunch tomorrow.”

Critically evaluate the evidence for weight loss treatments and communicate them

Reading this blog is a good start. Question what you see and hear about health. You’re going to see body-focused health messages everywhere! Start talking about them and actively work to change the culture.

“Did you see that article about achieving a “spring break body”? What a crock! All bodies are beach bodies! And it’s not possible to do something that is healthy and sustainable but changes someone’s body over the next two weeks. I wrote a letter to the editor to ask them not to publish misleading and body-shaming articles like that anymore.”

Work to increase access, autonomy and justice for individuals of all sizes

There are several body-positive groups at UNC and lots of simple steps you can take to advocate for more weight-inclusive practices on campus.

“I’m taking the Embody: Carolina training next month. Want to do it with me?”

“I noticed that my department’s offices don’t have chairs that would fit people of all sizes, so I asked the office manager to add a wider chair to the room. The next time I went in, there was a new, larger chair!”

Trust that people move toward greater health when given access to stigma-free health opportunities

UNC is a great place for this. Campus Rec, Campus Health, and Student Wellness staff have all been trained on body-positive principles. And our community offers so many ways to stay healthy!

Want to learn more?

What do you think about this article? What ideas do you have to support health at every size on campus?

 

 

Sara Stahlman, MA, is a marketing and communication coordinator at the Campus Health Services at the University of North Carolina at Chapel Hill. She is also a member of the ACHA Healthy Campus Coalition and the ACHA Health Promotion Section.

Toni Hartley, MPH, RD, LDN, is a clinical nutritionist with Lutz, Alexander Nutrition Therapy. Antonia specializes in medical nutrition therapy for people with disordered eating patterns. She promotes Health At Every Size® principles both in her office and in her speaking engagements and practices a non-diet approach.

References

Bacon, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005). Size acceptance and intuitive eating improve health for obese, female, female chronic dieters. Journal of the American Dietetic Association, 105(6), 929-936, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005).

Bacon, L. (2010). Health at every size: The surprise truth about your weight. Dallas, TX: BenBella.Health at every size: The surprising truth about your weight. Dallas, TX: BenBella.

Flegal, K. M., Kit, B. K., Orpana, H., & Graubard, B. I. (2013). Association of allcause mortality with overweight and obesity using standard body mass index categories: a systemic review and meta-analysis. Journal of American Medical Association, 309(1), 71-82.

Leibel, R. L., & Hirsch, J. (1984). Diminished energy requirements in reduced-obese patients. Metabolism: Clinical and Experiential, 33(2), 164-170.

Locke, A. E. et al. (2015). Genetic studies of body mass index yield new insights for obesity biology. Nature, 518(7538) 197-206.

Mann T., Tomiyama J., Westling E., et al. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychology, 62, 220-233.

Neumark-Sztainer, D. (2005). Can we simultaneously work toward the prevention of obesity and eating disorders in children and adolescents? International Journal of Eating Disorders, 38(3), 220-227.

Puhl, R. M., & Brownell, K. D. (2006). Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity, 14(10), 1802-1815.

Schvey, N. A., Puhl, R. M., & Brownell, K. D. (2011). The impact of weight stigma on caloric consumption. Obesity, 19(10), 1957-1962. impact of weight stigma on caloric consumption. Obesity, 19(10), 1957-1962.

Shisslak, C. M., Crago, M., & Estes, L. S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18(3), 209-219. 

Tylka, T. L., Annunziato, R.W., Burgard, D., Danielsdottir, S., Shuman, E., Davis, C., & Calogero, R.M. (2014). The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight-loss. Journal of Obesity, 2014(2014), 18 pages.

Setting up Patterns for Sleep Success

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Patterns. Sleep is all about patterns – we do it every single night, and our ability to sleep relies on the patterns we create with our daily lives. What else do you do every day that you could shift to help your sleep become a more regular pattern?

  • Exercise routine: A tired body usually means a tired mind. Make it a goal to move your body every single day.
  • Meditation: The main requirement of meditation? Focusing your thoughts – either on your breath or a mantra, something simple, like “I will be more mindful.” Beyond that – the where and the how long and pretty much everything else is up to you. Even a few minutes a day can help. Schedule it in – perhaps first thing when you wake up and right before you fall asleep. You can even meditate in your bed – that’s absolutely allowed.
  • Eat a variety of nutrient dense, processed-as-little-as-possible foods. These are less likely to have caffeine nor high amounts of sugar and are more likely to nourish your body the way it needs.
  • Create a routine of when you go to bed and wake up. College makes this difficult, but really – we all could use more regular sleep and wake times. Ideally this includes weekends as well. Is there a wake time you could imagine working for your weekdays and weekends? Try it out for a week and see how it goes.
  • Create a sleep sanctuary. What’s your bedroom like? Cool it down at night, try to keep it quiet (now’s a great time to try earplugs and white noise at night if you have loud roommates), keep it dark (a sleep mask or blackout curtains might help!). Do anything you can to make your bedroom a place of relaxation and relief from the stress of the outside world.

What do you do right before you try to fall asleep?

  • Screen use just before bed: consider installing a filter to add red to the visual. Research has shown that blue lights of screens can mess with our brains, where the red filter helps our brain think of sunsets and sleep.  Or consider keeping all screens out of your bedroom. Make your room a space reserved for sleep.
  • Exercise just before bed: consider doing more flow yoga or a chill walk just before bed and scheduling your hardcore cardio and lifting to earlier in the day or early evening. But – your bigger priority should be to get exercise at some time each day. Movement helps our bodies be tired and ready to sleep.
  • Good options before bedtime: book reading, meditation, writing down things from the day that are running through your brain so you don’t have to think about them anymore, really any sleep routine. A good example of a sleep routine? Take a warm shower, put on pajamas, brush your teeth, read a chapter of a good novel, earplugs in, sleep mask on, nightymcnightpants.

After you have put in some effort into sleep hygiene (that’s a real term describing steps like those above), and you’re still having trouble, come see a provider at Campus Health. Some providers may recommend further changes to sleep hygiene, medication, or the use of a phone app (CBT-i Coach on Play and iTunes), which can be used alone and in conjunction with a medical provider to improve your sleep. Make an appointment at CHS to learn more.

 

Photo credit: Gabriel Gonzalez, Flickr Creative Commons

Crisis Plans or “Mad Maps”: Creating Your Own Path Through Mental Health Crisis

In 2015, 18% of UNC students surveyed reported that anxiety had interfered with their school performance in the past year and 13% said depression had affected school in the same period. People with depression and anxiety are at an increased risk for experiencing mental health crisis, which is “any situation in which a person is not able to resolve the situation with the skills and resources available” (source). Crisis can feel like being so overwhelmed that it seems impossible to accomplish daily tasks, being suicidal, or being out-of-touch with reality, in the case of psychosis. Because UNC students experience depression and anxiety, we need to take care of our own and our friends’ mental health so that we all stay healthy, safe, and out of crisis. This post will help you learn about crisis-planning, which is one tool you can use to keep you and your community safe.

What is a Crisis Plan?

A crisis plan is a plan you create that guides you and the people around you to prevent mental health crisis, and respond to crisis effectively if it happens. Think of a crisis plan as a letter from your calm, reflective self to your future, struggling self, and the people who will support you then. Crisis plans are often documents that include information about what triggers you to feel emotional distress, what helps you feel better, and who to reach out to for support.  Your crisis plan uses your wisdom and knowledge of your own needs to guide your future self through hard times and back to stability.

How do I Make a Crisis Plan?

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“Subway Style Mind Map,” by Sharon Brogan. Courtesy of Flickr Creative Commons

Your crisis plan can be as simple or complex as you like, and it can include any information you think would be relevant to your future self and your support people–everything from when your friends should feed your cats to what metal songs you like to cry to.

This is one great crisis plan template you can use.

The Icarus Project, the radical mental health collective, refers to its crisis planning tool, available here, as Mad Maps. The Icarus Project’s mission is to “advance social justice by fostering mutual aid practices that reconnect healing and collective liberation,” so its Mad Maps guide includes questions like “what does oppression feel like to you?”

Crisis plans can also be in the form of:

  • A psychiatric advanced directive, a legal document you can complete that will inform healthcare professionals how to best support you in the event that you are hospitalized for mental health reasons. Advance directives are intended for healthcare providers to read, so they include information like what medications you should and shouldn’t be given, and which of your support people doctors should communicate with about your care.
  • self-care boxes with actual stuff in them that helps you feel better
  • lists of activities you can do to perk up
  • this website , which is an interactive guide to navigating hard times . Bookmark it for exam week!
  • Safety Plan, a crisis plan app (available for free on Android and Iphone) that keeps your personalized crisis plan in your back pocket.

Why Make A Crisis Plan?

Here are some reasons folks create their own crisis plans, if you’re still not convinced.

  • Crisis planning keeps you in control of what happens to you. Crisis can be a time that other folks step in and take control to make sure you’re safe. By documenting your wishes for when you’re in crisis, you can stay both empowered AND safe during hard times.
  • Crisis planning helps you learn more about yourself. The questions you need to ask yourself in the process of developing a crisis plan prompt you to develop a richer understanding of yourself, your mind, and your unique strengths.
  • Crisis planning is tool to communicate with your  support people. Emailing your crisis plan to your friends and family can start (or continue) a conversation about mental illness–a difficult topic–on your own terms. Crisis planning also demonstrates to those around you that you are taking care of yourself, and so it could help your mom worry less about you. (But no promises on that one!)
  • Crisis planning builds more self-reliant communities. Communities with disproportionately high rates of mental health crisis, like LGBTQ  folks, also have too many negative experiences with mental health professionals and histories of oppression in mental health fields. Crisis plans encourage conversation and collaboration about mental health support within marginalized communities, so that when folks from these communities reach out to professionals, they are also grounded in networks of  friends who understand their struggles and can advocate for them.
  • Finally, a crisis plan prepares you for scary times, and that makes them less scary! Knowing that you are ready for the worst times reminds you of your inner strength. A crisis plan serves as a reminder that you always have a path out of even the darkest spots.

If you’d like help planning for–or navigating–crisis, contact the Counseling Center.  If you’re having trouble keeping up with school work because of mental health issues, contact the office of the Dean of Students for support.  If you are  experiencing mental health crisis after-hours, you can call the National Suicide Prevention Hotline at 1-800-273-8255 or text the Crisis Textline at 741741.

Anole Halper is a graduate intern with Student Wellness. They are getting a dual Masters in social work and public health. Their research interests include sexual violence prevention and LGBTQ health equity issues.

How to Make Healthy Choices Concerning Alcohol and Other Drugs

Know the Facts
Know the Facts

Enjoying alcohol responsibly can be a healthy part of your college life. When it comes to alcohol and other drugs, the first step in making healthy choices is to understand what you’re putting into your body, what the substance’s effect on your body will be and the potential risks involved. These guides can help you. The second step is to recognize how you personally react to specific substances in various doses. According to the Bowles Center for Alcohol Studies at UNC Chapel Hill, most of the harmful effects of alcohol come from drinking too much. For example, it may be important to know that you should avoid tequila because things get out of control when you start taking shots. The third step is to recognize the situations in which you find it difficult to control yourself or in which you make decisions that you later regret. Do you always end up drinking more than you originally planned when you go out with certain friends? Have you not remembered a single Halloween since you started college except through embarrassing Facebook photos the next day?

The following tips may be helpful if you want to pay more attention to your drinking habits.

Before going out. Let your friends know how much you’re planning to drink before you go out. You can watch out for each other and step in before a friend has had too much. This also requires that you count the number of drinks that you have over the course of an evening, which is always a good thing. You count how many tacos you eat at the food truck, don’t you? Speaking from purely anecdotal evidence, people seem to draw the line at 4 tacos in one sitting.

When you’re out. Don’t accept alcohol or other drugs unless you know what’s in it. Are you really going to drink whatever is in that red cup from that sketchy guy that’s been hitting on you all night? If you don’t know what kind of alcohol, how much alcohol, and what else might be in your drink, politely decline and ask for a Zima. That way they’ll know you’re a person of impeccable taste.

Throughout the night. Alternate alcoholic beverages with water. Alcohol causes dehydration because it’s a diuretic and effects the balance of vitamins and minerals in the body. The liver also requires water to process alcohol, leading to further dehydration. Drinking lots of water throughout the night slows down your drinking, gives your body a chance to process the alcohol, and prevents next-day hangovers.

When school gets stressful. Some students may turn to alcohol and other drugs as a way to cope with stress, which may gradually turn into dependence – and that’s a high price to pay for the temporary respite you might gain. If you are concerned about your alcohol or drug habits, check out the Student Wellness website for resources or write us an email to set up a one on one appointment with a trained staff member. We are here to help.

This blog was originally posted on August 31, 2011. It has been edited for clarity. 

Still adjusting to college life? No worries – it’s normal.

I wish someone had told me when I started undergrad that the adjustment can be really tough and that it can take awhile. I was also far from home, missing my friends from high school, and trying to get used to college life.

Instead, everyone told me that college would be the best four years of my life, that I would make amazing new friends, and enjoy the freedom of being on my own.

I later realized that it’s normal to feel awkward, lost, confused, homesick, and lonely (and so many other things!) when you start college. The first semester is especially hard for many people. It’s a huge adjustment, and even though everyone might not always be open about it, lots of people struggle when they start college. It’s still totally normal to not feel ready to call UNC home yet—sometimes it takes a semester or two (and sometimes more) to feel at home.

Here are some tips that I found helpful when I was struggling to adjust and that might help you find ways to make the campus feel a bit more like home.

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Remember, it took Harry a while to feel at home at Hogwarts, too! — photo: “The Wizarding World of Harry Potter: This Way To Hogwarts.” Scott Smith. Flickr Creative Commons.
  • Know that you aren’t alone. Lots of people feel the same way, even if they aren’t talking about it. You are not the only one who is having a difficult time. It’s a time of transition for everyone and it can be very overwhelming.
  • Keep your door open. If you live in a residence hall, leaving your door open is a good way to meet people in your hall. It can also be a way to invite people to hang out without having to be especially social. It’s not too late to still meet people who live in your hall! If you’re a grad student, leave your office or carrel door open. Just the “window” to the rest of the world leaves space for some interactions that might not otherwise happen.
  • Find a place on campus you like. This could be a tree to study under, a favorite spot in the library, the Union, or an office on campus, such as the LGBTQ Center or Women’s Center. Leave some favorite spots in the comments!
  • Talk to people in your classes. Did someone ask a thought-provoking question in discussion? Tell them so—it can lead to a great conversation that you can continue over lunch or coffee. Also, forming study groups is a great way to know people while also helping each other out! This can be a good way to get to know people in your class you’ve wanted to talk to all semester.
  • Join a club or organization. Getting involved is one of the best ways to meet people. In addition to being a place of higher education, college is also a great time to try something new or connect with people who have similar interests. Check out a sport, a service or political organization, or a religious or cultural group on campus. Joining a club or organization gives you an opportunity to meet friends who have similar interests, and for many clubs you can join at any point throughout the year.
  • Know your resources! There are lots of people on campus who want to help you adjust and who understand it can be rough. CAPS can be a great resource to talk out how you are feeling, especially if these feelings persist. The Learning Center and The Writing Center are great places to visit to talk about adjusting to the college workload and college level writing. All these resources are covered under student fees, so it costs you nothing but a bit of time to take advantage of them!

Welcome to UNC, y’all!

Amee Wurzburg is the Sexual Violence Prevention Program Manager at Student Wellness. She is currently earning her Masters in Public Health at the Gillings School of Global Public Health at UNC. Amee received her BA in History from Barnard College of Columbia University. Before moving to North Carolina, Amee worked at an organization in India focused on HIV, where she worked on projects related to rights-violations, LGBTQ health, and domestic violence.

This post was originally published November 2014. It has been edited for clarity. 

On Trigger Warnings, Intellectual Curiosity, and Self Compassion

Trigger warnings in academia have become a hot topic. The University of Chicago recently released a controversial letter to the Class of 2020 stating that they did not support “so-called ‘trigger warnings’…or the creation of intellectual ‘safe spaces’ where individuals can retreat from ideas and perspectives at odds with their own.” The latter, in theory, makes sense – higher education is supposed to challenge you, to make you question your ideas and open your mind to a variety of perspectives, and the ways in which trigger warnings have been exploding in use lately can inhibit that. But for someone who navigates higher education with a specific set of mental health needs, finding a balance between triggers, intellectual curiosity, and self compassion can be a challenge.

On one hand, the traditional use of trigger warnings are a great tool for those in early stages of recovery from mental health issues such as depression, anxiety, and PTSD. When a person who has experienced trauma gets triggered, symptoms of distress that result can range from physical (such as headaches, fatigue, and difficulty breathing) to emotional (like fear and dramatic mood swings, among others) to psychosocial (for example, difficulty connecting with others or an inability to manage stress). In these cases, a trigger warning can be crucial. It allows the person who has experienced trauma to prepare themselves for what they are going to experience. It gives them the agency to choose whether or not they feel capable at that moment to deal with something that could have serious consequences on their wellbeing. And more often than not, it allows for someone to come back to this potentially triggering content at a time and in a place in which they feel safe and ready to deal with it.

The other side of the argument makes some important points, too. It notes that trigger warnings seem to have been co-opted by those who think they should not have to experience information that they may disagree with or can be uncomfortable at all. Professors have reported students requesting trigger warnings for everything from famine and religious intolerance to spiders. By using trigger warnings to refer to things that can be uncomfortable, but not necessarily retraumatizing, their true meaning and utility is being put at risk. Yes, talking about topics like religious beliefs, race, and gender can be incredibly uncomfortable sometimes, but facing that level of discomfort and engaging with the topic can be rewarding and beneficial. This level of discomfort can be a catalyst to help us think more critically and can hopefully spark intellectual growth, and college is a place where growth and curiosity should be encouraged and explored.

So for people who have experienced trauma, what are some ways in which they can navigate these classroom experiences in a manner that is useful for them? There’s no cut and dry answer for that, since everyone experiences triggers in different ways, but here are a few tips that anyone could use:

  • Talk to your professors. If you see something on the syllabus and are concerned it might trigger you, ask about it. And if you feel comfortable, talk to that professor about what your needs are, whether it’s just additional time to complete a reading for class or the flexibility to step outside during a class session if need be.
  • Seek help on campus. Counseling and Psychological Services (CAPS) is a great resource for students who have experienced stress, anxiety, and trauma. The counseling staff can help you make a plan for how to deal with triggers in and out of the classroom, and are available for drop-ins Monday through Friday during normal business hours..
  • Practice grounding techniques. If you find yourself getting triggered in class, grounding can be a great tool to help minimize anxiety and other symptoms. Try breathing in and out slowly, focusing on the sound of your breathing, the chair you’re sitting in, the ground your feet are on, and other physical sensations to bring down your heart rate and relax your body. There are lots of ways to practice grounding in all sorts of situations, so find the one that works best for you!
  • Give yourself a break. Be gentle with yourself and know your limits. If you don’t feel ready to confront a trigger, you don’t have to. A little self compassion and care can go a long way.

Get outside, UNC! Your outdoor exploration checklist

“Wilderness is not a luxury but a necessity of the human spirit.” -Edward Abbey

The woods and water can be an integral part of your UNC experience. The triangle region is full of outdoor spaces to camp, hike, run, and paddle.

Ask any outdoor enthusiast and these spots will be on their list of adventures while at UNC. Explore them! We start with those closest to campus and swirl outward across the state.

Learn more about these spots – and then, go play outside! (pro tip:Don’t feel comfortable adventuring on your own? Check out Outdoor Rec’s Expeditions! They provide gear, guides and routes for some of these fantastic adventures.) Continue reading

Study Drugs: Why the Cons Outweigh the Pros

You’re new at UNC-Chapel Hill or returning from a summer away, but either way you can’t wait to jump into all of the exciting opportunities, classes, clubs, organizations, and events this campus has to offer. The sheer number of opportunities is one of the reasons this school is so great. There is such a range of interests, from clubs focusing on academics and future professions, to music and theater, to Greek life, to politics, to sports, and to so much more. But before you sign up for all 15 activities that have peaked your interest, it’s important to make sure that you have enough time to devote to everything you sign up for. Getting good grades, trying to stay involved on campus, while maintaining a social life can put students at risk of using stimulants, or “study drugs” to help them keep up.

What are people’s reasons for using Study Drugs?

Drugs including Adderall, Vyvanse, and Ritalin are prescribed to treat Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder (ADHD). However, a black market for these drugs has grown on college campuses in recent years, including at UNC. Some students are turning to these “study drugs” under the mistaken belief that these drugs will provide a magic fix that will help them stay focused, improve efficiency, and better their grades during periods of high stress.

 

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Photo by Joshua Brown, Courtesy of Flickr Creative Commons

Why does it seem like everyone is doing it?

While it may feel like you constantly hear stories about friends and classmates utilizing these study drugs, the rates of misuse are not as high as they may seem. According to a study conducted by The Coalition to Prevent ADHD Medication Misuse, 75% of students believe that some of their peers have illegally used ADHD prescription stimulant medication. However, a recent survey conducted at the University of Texas found that 87% of students do not use study drugs. While high rates of illegal drug use for academic purposes are untrue, that does not mean that a problem does not exist. In 2011, the National Institute for Drug Abuse found the 9.8% of college students had illegally used Adderall and the rates have continued to increase, especially at universities with competitive academics and admissions processes.

I need to focus, why should I NOT use Study Drugs?

Stimulant medications such as amphetamines (e.g., Adderall and Vyvanse) and methylphenidate (e.g., Ritalin) are prescribed to treat ADD and ADHD. People with ADHD have difficulty paying attention and staying focused and are more hyperactive or impulsive than their peers. These stimulants increase dopamine in the brain, which creates calming and focusing effects on individuals with ADHD. People who take these drugs who do not have ADD or ADHD can suffer from dangerous medical side effects, such as restlessness, hallucinations, and irregular heartbeat, among others. Long term misuse of study drugs can even cause addiction and withdrawal symptoms like fatigue, depression, and disturbed sleep.

Beyond dangerous physical side effects, there may be academic and legal consequences of the misuse of study drugs as well. Misusing study drugs violates UNC’s drug and alcohol policy (link this), as well as the law. Those who are caught misusing study drugs can be subjected to suspension, fines, or even jail time.

While study drugs can improve focus and motivation to study, a study conducted by the National Institute on Drug Abuse found that students who abuse prescription stimulants actually have lower GPAs in high school and college than those who don’t.

What can I do to increase concentration and focus without using study drugs?

  •         Get enough sleep – your brain cannot retain the information you are studying if you are tired. Try to get at least 6-7 hours a night during high stress times and 8 hours on other nights. Power naps are another great way to revitalize your brain. A 20 minute nap boosts alertness and motor learning skills like typing. Naps of 30-60 minutes are good for decision-making skills, memorization, and recall. 60-90 minute naps help to make new connections in your brain and to solve creative problems.
  •         Create a To-Do list and a schedule – this helps you to remember what/how much work you have to do and is a good reminder when you want to take a break or get on Facebook to manage your time efficiently
  •         Take breaks when you need it! While a break may seem counterintuitive when you have an insane amount of work, you will be more productive and more efficient if you let your mind rest every once in awhile. Use these breaks to practice other healthy and self-care behaviors such as going to the gym, eating a well-balanced meal/snack, practicing mindfulness or meditation, or another activity that distracts you from the information you are studying. Breaks, of an hour or even just 5 minutes, will promote good studying and information retention.
  •         Make use of The Center for Student Success and Academic Counseling located in SASB North, Room 2203 (919-966-2143). This office offers services including peer mentoring, The Learning Center, The Writing Center, and Men of Color Engagement.
  •        The Learning Center offers peer tutoring, academic coaching, reading skills help, study groups, test prep resources, skill-building workshops, and other services for students. They also offer support for students with ADHD and other learning disabilities.
  •         If the stress is becoming too much, Counseling and Psychological services (CAPS), is located within Campus Health, and offers counseling services where you can discuss your stress and develop strategies and plans to healthily combat it

Take a Break! Hey, Take 10

This blog post was originally published on July 7, 2015.

Tar Heels, if you’re still hanging around the general vicinity of North Carolina this summer, you don’t need me to tell you it’s hot, but…OMG it’s sooooo hot! If you’re anything like me, a long string of hot days might make you complain a lot and think less clearly than you might otherwise.

Also, while the pictures on my Facebook feed tell me that this is vacation time for a lot of people…it might not feel like vacation time for all of us. Yes, NECESSITY, as well as our culture that socializes us to ideals of BUSY! and ACHIEVEMENTS!, can chase us down even into these summer months.

So, please allow me to be your Captain Obvious right now and give you a loving reminder:

Here is a comfy pink chair in the forest a person might sit in if they were taking a break.
Here is a comfy pink chair in the forest a person might sit in if they were taking a break.

Take a break.

Take a break! There are many ways to take a break today, this week, this month, this summer, even if you’re jamming out in Summer Session II and can’t afford a beach condo for the next decade. Here are some ideas to get your creative break-making juices flowing:

  1. Finish reading this blog post and then turn off whatever screen you’re looking at for at least 5 minutes. Feeling brave? Do it in silence. Feeling tense? Think about relaxing each part of your body, starting with the toes and working your way up. It’s just 5 minutes. You can do it. Too easy? Make a summer resolution to do this every day and see what happens.
  2. Call a friend you haven’t talked to in a long time and catch up.
  3. Commit to listening to an entire album you haven’t heard ever or haven’t heard in a long time. Do it in one sitting. Invite some buddies over for a listening party.
  4. Find a path you’ve never walked and walk it. (If you’re in Chapel Hill, consider these!) Find some flowers and sniff them.
  5. Take a social media hiatus. Y’all. I haven’t been on Facebook for 3 days and I feel like a new person right now.
  6. Drink some water. It’s hot.
  7. Do something you haven’t done since you were a kid. Is there a swing set at your apartment complex? Can you get your hands on a pool noodle? Are there old board games for sale at PTA Thrift Shop? Where are those crayons your roommate was waving around? Can you YouTube your favorite old cartoon?
  8. Plan a day trip to a swimming hole or a waterfall.
  9. Cook something for dinner tonight that you’ve never cooked before. Never cooked at all? Then this assignment has NO LIMITS!
  10. Read a book…for fun. When was the last time you read a book for fun??

Other ideas? Do share in the comments!