eating disorders

IF YOU’RE GOING TO TAKE FROM MY CULTURE (YOGA), DON’T F&*@ IT UP!

Cultural appropriation is generally defined as the dominant culture stealing aspects of a minority culture, such as fashion, music, traditions, symbols, etc. It is often viewed as harmful, especially since it stems from colonialism and oppression.

Personally, I think the concept is taken too far sometimes. It’s not that I’m down with the disrespectful stealing of another’s culture, but I think the sharing of cultures can be beneficial. It can promote tolerance and empathy if done right.

I’m the first person in my Gujarati immigrant family to be born in America and honestly, there are times I feel Indian, times I don’t. There are times I feel American, times I don’t. And the culture I most identify with is hip hop culture, a culture born out of the black experience in New York City. Hip hop culture has influenced me in many positive ways and at times even saved my life. I’m thankful to hip hop, so much so that I gave it a central role in my debut young adult novel, Rani Patel In Full Effect. I intend no disrespect to the founding black culture, only gratitude. Hopefully, I succeeded in giving it the mad props it deserves.

I don’t relate to most aspects of my Gujarati Indian culture. But I do relate to yoga, a Hindu tradition that encompasses physical, mental, and spiritual practices. I focus on the physical and mental aspects in a Westernized way in a Western studio. For me, yoga, like hip hop, provides tremendous relief to the internal anguish that still plagues me given my family of origin issues. This, and because I’m a psychiatrist, I’m overjoyed that many people in the West practice yoga and find it helpful.

Not all Indians feel like that. There are Indians who consider westernized yoga to be harmfully appropriated, especially given the high commercialization of it and how far removed it’s become from ancient Indian philosophy and purpose.  

More recently, I’ve felt the sting of this cultural appropriation in my yoga classes. But for me, it’s quite specific. Usually, I’m the only Indian person in class and when I hear practitioners, mostly women, talking about being on “detox juice cleanse diets,”  “going vegan,” “deciding to quit all carbs,” or praising each other on weight loss, I feel angry. I mean do these people know that 15% of India’s population is undernourished? Do they know that most Indians in India are lacto-vegetarian? Do they know that it’s highly disrespectful when they talk about bodies like pieces of meat (which of course, they don’t eat)? Do they know that they’re perpetuating misogyny? I wonder if they talk to their children, especially their daughters, like that. More than angry, that makes me sad and scared for the future.

The worst was when a frequent practitioner began reeking of ketones during and after class. I know the smell from medical school and residency training and from my work with eating disordered patients. It’s not normal. Simply put, it represents the body breaking down. It can be dangerous, even fatal. It was common knowledge that this particular practitioner had been taking 3 classes a day. Every single day. Without eating in between. And not eating very much of anything all day. Personally, I found this to be the ultimate in disrespectful appropriation of yoga. I’m no expert on yoga philosophy, but I know for sure that it’s not meant to be harmful. And then how healing is it if a fellow practitioner dies in class because privilege allows them to take 3 classes a day and choose not to eat?

I expressed my concerns to the practitioner and the studio. I’m happy the studio made positive changes to their policies to assist practitioners in making more balanced, and less deadly, yoga choices.

I’m still all about sharing culture, but not about letting entitlement and privilege turn someone’s culture into something toxic.


Three Simple Rules That Can Have a Life-changing Impact on Kids and Teens

My teenager looked over my shoulder as I finished typing the first draft of this blog post. She proceeded to roll her eyes and mutter, “Ugh. This is our household.”

I smiled a satisfied smile to myself because, yes, this is our household.

Outside of my household, I’m a child and adolescent psychiatrist and I have the privilege of guiding young people through individual talk therapy to help them overcome mental health issues such as anxiety, depression, eating disorders, post-traumatic stress disorder, reactive attachment disorder, etc. Sometimes there are also complex family dynamics at play that require specific family interventions such as parent education or family therapy.

Over the years of doing individual child and adolescent talk therapy and family therapy, I’ve found that without a certain baseline, non-negotiable structure at home, therapy isn’t as effective or lasting. Because without this basic structure, it is that much more challenging to navigate the muddy waters of mental illness and that much more challenging to even begin to negotiate normal social, emotional, physical, and/or intellectual developmental tasks. Without limits and rules at home they may become even more entrenched in their mental illness. And a lack of boundaries doesn’t just affect youth with mental illness. It can negatively impact any young person.

So what is this baseline, non-negotiable structure I recommend? It’s three simple rules for children and adolescents that parents can enforce.

  1. Social media and screen time - 2 hours a day maximum, but less is better.

  2. Uninterrupted sleep time - 9-10 hours each night.

  3. Family meals - eat together as often as possible.

I apply these rules to my own tween and teen. I recommend the rules for all youth in general, as well as for the youth I treat. Let me give you a bit more detail on each rule.

Social Media and Screen Time

More studies are coming out about the detriment of social media and prolonged screen time. The bottom line is that excessive electronics isolates and prevents youth from learning about normal face-to-face interactions with people, which are an important part of development and happiness. The worst case scenario regarding isolation is that it is a risk factor for suicide. But being plugged in for two or more hours a day can also lead to a significant increase in suicide risk factors.

When youth have their heads buried in screens they are not self-reflecting or thinking independently. It’s not their fault that they want to stare at all the dazzling images and words on their screens. See youth do not have fully developed abstract thinking so they are more vulnerable than adults to being swayed by what flashes before their eyes. That’s also why they are more susceptible to peer pressure. So they see these fancy, filtered images and words and they may become convinced that they have to look and behave that way. They may think they have to get a certain amount of comments and likes to be worthy. They may engage in excessive texting or messaging that doesn’t allow them to learn the nuances of social communication (facial expressions, tones in voice, etc.). They may be vulnerable to online bullying. They may be constantly thinking they are missing out. They may live through their screens instead of in the moment. All of this can impair their ability to move through the normal stages of social, emotional, and intellectual development.

Incidentally, I quit social media. My tween and teen are not allowed to have social media. I figure I should practice what I preach, right?

Sleep

Poor sleep in youth can lead to negative outcomes such as struggles in school, car crashes, and/or depression. Numerous studies have shown that 9-10 hours of uninterrupted sleep is optimal for youth, especially teens because they are in an intense stage of physical, intellectual, and emotional growth.

It is helpful to remove all electronics from their bedroom at bedtime (except a good, old fashioned alarm clock) because teens will often surreptitiously use these devices in the middle of the night. They are not bad for doing this. Testing boundaries is part of normal teen development and it is up to parents to set and enforce the limits to help guide and teach them.

Most kids will not happily go to bed early, my kiddos included. They will most likely complain and fight it. They may also panic because they haven’t finished their homework. But in the long run, sleep is more important. Parents can rest assured that despite what their youth say, setting strict bedtimes helps with brain development and teaches youth to make more efficient use of their time. It may even bring up the issue of cutting back on extracurricular activities if there really isn’t enough time to get homework done. This raises another issue—that youth need time to be bored to help with their normal emotional and intellectual development. But that’s for another blog post.

Eating Meals As a Family

In this day and age of being overscheduled, I cannot overemphasize the importance of eating meals together as a family. I recommend decreasing youth activities if this will allow for more meals together. That’s how important it is. Eating meals together, especially dinners, teaches kids about face-to-face communication. It also can lead to better family relationships, improved nutrition and enjoyment of food, boosted grades and vocabulary, decreased depression and stress, increased ability to bounce back from bullying, improved overall mood, and fosters a positive outlook of the future.

As a side note, there is a trend in our society to eliminate more and more types of food from our diets. The science behind this “purer” eating is not crystal clear. There are many factors besides food that contribute to overall health and longevity.  Still, it is not uncommon for people who don’t have medical reasons for dietary restrictions to cut out all meat, gluten, dairy, sugar, etc. For adults, this is a personal choice and I’m not addressing that right now. But children and teens have different nutritional needs than adults and it can be dangerous for youth to be eating “pure,” “clean,” vegan, or some other restrictive diet unless they are properly monitored by a parent who can make sure they are getting enough calories, protein, vitamins, and minerals. Chronic lack of these nutrients can lead to medical problems and organ damage.

A typical example I see in my practice is the teen girl athlete who restricts her food intake and then doesn’t get enough calories to maintain her high activity level. She loses weight and stops having her period. Contrary to what some people think, it isn’t normal for a girl athlete to not have a regular menstrual cycle. Also parents need to be aware that restrictive diets can be a guise for eating disorders. In fact, "healthy," restrictive eating is the most common trigger for eating disorders in teens that present to my office. Eating disorders are complex and can have devastating consequences, including death.

If the family does not have long established exclusionary food preferences or practices (such as for religious or diagnosed medical reasons), I recommend that youth not be allowed to suddenly follow any restrictive diets. They can make up their own minds when they are eighteen but until then parents can protect them by normalizing inclusive, structured eating- regular meals and snacks, normal portions, preparing and offering a variety of foods, not making negative comments about certain foods, ingredients, or bodies. This makes it less likely that the youth will have disordered eating when they grow up. This makes it less likely that the youth will link food with control and self-worth. They will be more likely to grow up with the understanding that food is simply fuel and nourishment, not a means to happiness, and most certainly not who they are.