Household chores have a way of piling up, donât they? Work and other obligations take up most of our days, so when we do have free time, the last thing we want to do is even more work. Yet, as we all know, routine maintenance supports a functional household â and improves our mental health.
My clients with ADHD have shared with me all the ways that chores get sidelined, interrupted, and avoided due to ADHD. The never-ending nature of chores makes getting started and staying motivated nearly impossible. Distractions and competing priorities keep chores in a perpetually incomplete state. And no matter the issue, problems vanquishing household chores almost always lead to feelings of frustration and incompetence.
The only way to help you start, persist, and finish those pesky household chores (and do it all again) is to come up with a system that works for you. That may require you to take a step back and reassess your current approach to chores. Here are five steps to help you rethink chores, get motivated to clean, and follow an upkeep process that fits your life.
1. Identify all the household chores that are important to you. Think of the bare minimum that you need to feel good in your living space. Is it a dining table clear of clutter? No clothes on the floor? Take the time to write out a list of realistic to-dos that matter to you, even if they are challenging to complete.
2. Break down all chores into their smallest steps to reduce overwhelm. A multi-step chore like âdoing laundry,â for example, turns into sort clothes; wash clothes; dry clothes; dump dry clothes into basket; bring basket to the bedroom; and so on. Smaller steps are easier to tackle and allow you to be more realistic about what you can accomplish.
3. Set times for completing chores (and tasks) in a way that fits with your lifestyle. Is it best to schedule a block of time to work through all the chores on your list? Or would it be better to do one or two small chores daily? Would you be more productive first thing in the morning or at end of your day? Can you do the first two steps of a chore today, and the rest tomorrow? The key here is to be honest with yourself about reasonable ways to incorporate household chores into your daily life.
4. Identify your sore spots and obstacles to starting chores. What makes starting a particular chore difficult for you?
Does it seem like the chore (or a step within it) will take too long? Then set a timer and commit to working on the chore or step for just 10 minutes. (Or any amount of time that is doable for you.) When the timer rings, reassess if you want to continue or come back to it at your next designated chore time.
Does the thought of gathering supplies and tools to do the chore turn you away? Weâre often quick to dismiss pre-chore work as an actual step to complete a chore, so be sure to add âlocating suppliesâ on your chore breakdown. To save time, store supplies for a given chore in a single container and/or within a space where they are more readily available. (For example, consider keeping tub cleaning supplies in your shower instead of somewhere else within the bathroom.)
Are some chores simply too tedious? Infuse some enjoyment to help you persist! Listen to music, a podcast, or an audiobook while you work. Chew gum and blow bubbles while you tidy up. Call a friend while you clean. (A form of body doubling.) Splurge and buy a fun tool or supply that will make a chore more enjoyable. Gamify chores by competing against others (or even yourself) until the timer stops or until the end of a song.
Do you only feel âactivatedâ to do chores under pressure? Itâs good to let go of strict rules and âshouldsâ around house upkeep and chores. That said, if a sense of urgency is the only thing that motivates you to do chores, consider inviting guests to your place so that you have a firmer deadline for getting chores done.
5. Help yourself stay on track while doing chores.
Create visual reminders of your chores and tasks. Externalize your to-dos to jog your memory. Some ideas: A simple to-do list on a large whiteboard; a color-coded chore sheet (on your calendar or on an actual sheet of paper); a notecard deck of individual chores (completed chore cards can be put in a separate pile or moved to the back of the deck). Put your visual reminder of the chosen chore in a noticeable place so you can look at it periodically to check that you are still on task.
When you start a chore, set a timer to go off every few minutes. Each time it goes off, ask yourself, âAm I still on my intended task?â
Keep sticky notes on hand to write down other things and to-dos that cross your mind so those thoughts donât interrupt your chore time. Stick the note anywhere where youâre guaranteed not to miss it. (Like on your bathroom mirror.) If sticky notes arenât your thing, consider adding it to your calendar or a to-do list app. You can even set the to-do as an alarm on your phone (to ring in a few hours).
6. Take time to notice your accomplishments. Once youâve completed a chore, take in how the area looks and feels. Grab a picture of your space and print a copy to remind yourself of how good it feels to successfully manage your home. With each step of a chore, share your progress with a friend or family member who will cheer you on. Reflect on the strategies that were most helpful to you in the process so you can continue to use them in the future.
How to Get Motivated to Clean: Next Steps
CELEBRATING 25 YEARS OF ADDITUDE Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitudeâs mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
From the sanctuary of my rooftop, I listened as my family clamored around the dinner table, laughing, joking, and chatting away. In my usual hideaway, I gazed up at the stars and wondered why I never felt like I fit in anywhere, not even with my own family. At 15 years old, I felt like a misfit and a burden. I was certain my family would be a lot happier if I werenât around.
Growing up around my siblings was tough. I longed for their approval, but âbe quiet,â âsit still,â and âgo awayâ were among their most common responses to me. My behaviors irked them and made me a target. It took a long time for me to understand what was so wrong about me and why I couldnât connect the way I wanted to with my family. My behaviors, I learned, were primarily the result of undiagnosed ADHD and OCD, and my family was reacting to symptoms that were too difficult for them to understand at the time.
The Odd One Out
I remember driving my siblings mad at bedtime, to the point where they would yell at me to, âShut up and go to sleep!â To be fair, I would talk non-stop into the night. As soon as my head hit the pillow, my brain lit up, filling with zig-zagging pathways of wonder and questions.
I wanted to talk about anything and everything. I had big existential questions. I wanted to discuss the deep connections I felt to some movie characters. I wanted to share a million facts about galaxies and talk in-depth about whatever book I was consumed by that week. But my sisters did not want any of it. Their neurotypical brains slowed down at night (as is normal), and sleep came easy. (Once I finally stopped talking, that is!)
It wasnât just at night that I irritated them. My repetitive behaviors, like playing the same song over and over again (like over a hundred times each day) for months, or watching the same movie endlessly, also drove them away.
Sometimes, Iâd fall into patterns of washing my hands so much they were red and raw. Iâd also avoid touching anything with my hands or allowing anyone to touch me (I carried around hand sanitizer long before COVID). I couldnât eat food that others had touched, and I couldnât stand anyone sitting on my bedspread lest they leave behind germs.
My siblings often made fun of me for my âgermaphobia,â and would intentionally try to rile me up by sitting on my bed or touching me with unwashed hands. Angry, emotionally dysregulated, and hypersensitive (which I later learned was rejection sensitive dysphoria), my responses to their teasing were deemed over-the-top. I would be disciplined for my âbadâ behavior, and I frequently carried a deep sense of shame and embarrassment for being so âmean,â âcrazy,â and such a âproblem.â
I was constantly seeking affection and attention from my siblings, who only saw me as needy and overbearing. When they teased me, the physical heartache I experienced was real. When they pushed me away, the rejection I felt was so deep I found it debilitating. So, Iâd retreat to the rooftop, just me and the stars.
This is a Victory Story
My siblings and I did the best we could do at a time when there was very little education or acceptance around behaviors like mine. Weâve all learned a lot along the way.
The behaviors I exhibited in childhood that caused so much strife were traits of real mental health conditions and neurodivergence â body-focused repetitive behaviors, OCD compulsions, and stimming (self-stimulation). I also learned that these behaviors were my way of self-soothing to reduce stress and anxiety. Today, diagnosed and treated, these behaviors (and trying to cope with them) sometimes still drive me (and my husband this time) crazy.
Iâve spent a lot of time masking and dealing with self-hate and insecurity, but thatâs changing. Now, for the most part, I can speak openly with my siblings about the challenges I faced growing up around them as I dealt with undiagnosed mental health challenges. I understand myself better, and can take in their perspectives, too. We find ourselves reflecting on our own children, how we see so much of ourselves in them, and how learning and healing together forges a new path for them. We try to remember, for the most part, that just because things used to be a certain way doesnât mean that they still have to be.
Itâs a choice to see only the bad parts of the past; itâs a much better choice to focus on the victories instead.
ADHD and Sibling Strife: Next Steps
CELEBRATING 25 YEARS OF ADDITUDE Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitudeâs mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
Imagine this: Youâve never seen a Rubikâs Cube before and, frankly, you have no prior experience working with puzzles of any kind. Yet youâve been tasked with completing the Rubikâs Cube with no help. Oh, and you have to solve it in the next 30 minutes.
This is how a child with ADHD feels when told to tidy their room. (Though, to be fair, many adults with ADHD feel this way, too.) Itâs a baffling, insurmountable task with no real beginning or end. After all, a room has different areas, different furniture, and lots of different âstuffâ strewn all around in a giant mess. It is an abstract monster!
I know how dreadful and confusing tidying can be because I was that child. I grew up the eldest of four children, and I shared a bedroom with my brother. When it was time to clean our room, we drew an imaginary line down the middle of the floor and always argued over whether it was a fair partitioning of our space. But once the borders were settled, my brother proceeded to attack his side of the room with consummate ease. In the short time it took him to finish, my mind had wandered several times to several different topics â anything from the thing Iâd seen across the road from our window to Teenage Mutant Ninja Turtles and some toys I had forgotten about that I suddenly wanted to play with.
My mind wandered because I was unable to work out where to begin tidying. Something else would always catch my attention. Iâd hear plenty of complaints from my parents â if my brother could do it just fine, why couldnât I?
Today, Iâm the adult with four children. At 39, I was diagnosed with ADHD. Like most people with a late diagnosis, I went through a period of profound reflection; I finally knew what I was working with (and against), and it was a weight lifted off my shoulders.
My youngest boy, 10, also has ADHD. It was his assessment process that made me sit up and take note of all his symptoms and how they mirrored my own behaviors and challenges from childhood to this day. I understood, at last, that ADHD can make things like tidying a messy room feel like battling an abstract monster. Our brains find it very hard to look at a shapeless, scary problem and break it down into manageable chunks.
How to Clean Your Room: My Guide, ADHD-Style
When I ask my boys to clean their shared room, I know what to expect from the smallest. While I donât have all the answers, I did eventually learn this process for breaking down all kinds of abstract monsters:
Take a piece of paper, write the abstract thing at the top (in this case, tidying the room), and draw a box around it.
Take two minutes to think about the different facets of the abstract thing. Write those as subheadings, also in their own boxes. For tidying, I have my child pick any part of the room; the exact location or task doesnât matter. If theyâre really struggling to pick, I have them toss a pair of socks over their head â where they land is as good a place as any to begin. Coat hangers, toy cars, and dirty clothes are all good subheadings.
Work each subheading independently. Pick up the coat hangers and put them back in the closet. Then focus on the toys. Where did those toys live before they ended up on the floor? Cool, put them back there. Then, dirty clothes â are they really dirty? Check them. If they are, put them in the wash basket. If they arenât, put them on your newly hung-up hangers, or in a drawer.
This process doesnât have to be perfect or even neat. It just has to help with getting started and staying on task. For my boy, I think of it as bumper rails to help him tidy his room more effectively, and with less arguing. When he gets overwhelmed, I help get him back on track with some calming words and refer him back to the above process. I canât and wonât tidy his room for him because he will meet all manner of challenges in life that will certainly be more complicated than tidying a room. I know that helping him develop processes or coping mechanisms now will pay dividends later in his life.
So next time your kids struggle with something as âsimpleâ as cleaning their room, take a second to remember that what you see as a straightforward task can be a scary, unwieldy project for ADHD minds. A bit of guidance in breaking down the abstract monster might be just the thing they need to succeed.
Clean Your Room with ADHD: Next Steps
CELEBRATING 25 YEARS OF ADDITUDE Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitudeâs mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
On the surface, ADHD and OCD are seemingly impossible bedfellows. âMessy,â âhyperactive,â and âscatterbrainedâ are just a few common synonyms for the former, while the latter is frequently associated with being exceedingly clean, uptight, and meticulous. (While some of these assumptions about these disorders are accurate for some people, they cannot be generalized or applied to everyone.)
In my reality, ADHD and OCD are codependent frenemies that sometimes help balance each other, even as they egg on one another.
OCD and ADHD Feed Off Each Other
My OCD diagnosis came first, and it never quite felt like the whole picture. I had trouble focusing, which is a common struggle in OCD that stems from difficulty managing compulsive symptoms. Still, it didnât explain the day-to-day distractibility I experienced. It also didnât explain my childhood issues with school or my impulsivity. When my psychiatrist added the ADHD diagnosis, it all suddenly made sense.
OCD and ADHD both think they are helpful. ADHD knows you need more dopamine, but it fails to differentiate between healthy and unhealthy sources. OCD wants to relieve anxiety; it just tends to do so in maladaptive ways.
Converse to its stereotype, ADHD also brings hyperfocus â a curious combination with OCD, as âobsessiveâ is right in the name. For ADHD brains, obsessions are a way to get the stimulation your brain thinks it needs. For OCD, obsessions are a catalyst for the compulsion part of the disorder. The two frequently exacerbate each other for me; this was especially true before I understood that I have both.
The interplay might go something like this: I have an obsessive thought that creates anxiety. So I perform a compulsive action or thought to make it better. Making it better gives relief, and relief makes dopamine. Therefore, the compulsion not only relieves the anxiety temporarily but also activates my brain. Trying to avoid a compulsion, on the other hand, produces a hefty dose of adrenaline while dopamine and serotonin perform an endless dance in my brain.
OCD exploits the poor impulse control of ADHD. It is so much easier to âgive inâ to a compulsion for that quick relief.
As a kid, ADHD contributed to feelings of shame. I felt like I was lazy and could not do anything right. I felt like a failure and understood that I was not âliving up to my potential.â OCD feeds on shame; its what-ifs led me farther into this spiral. What if my obsessions and intrusive thoughts meant that I was a terrible person? And what if, as a horrible person, I was truly lazy?
While âI have OCDâ is accurate, it doesnât mean that the disorder rules everything that I think about and do. For instance, I am not neat and orderly, and germs donât bother me beyond what feels rational. Those arenât my particular flavors of OCD. So while itâs true that OCD and ADHD have functional and physiological differences, there is room in my brain for both.
OCD tends to resemble a game of whack-a-mole, with new worries and obsessions popping up just as others begin to feel manageable. ADHD means I can always find new ideas to turn into intrusive thoughts.
Uncertainty fuels OCD, and ADHD produces a lot of uncertainty. For example, itâs challenging to reassure yourself that you locked the car when you have forgotten to do so many times before.
OCD and ADHD: Too Intertwined to Tease Apart
However, I suspect ADHD works to keep OCD in check in some ways. For example, people with comorbid ADHD and OCD are more likely to experience mainly thought-based compulsions, which I find less disruptive than any physical compulsions I experience. Sometimes, the distractability of ADHD smooths the roughest edges of my OCD.
I also think ADHD makes OCD therapy more successful for me. Having a breakthrough, figuring something out, and relieving shame all bring the jolt of dopamine my brain craves. So, in some ways, their coexistence led me to more effective treatment.
It would be great if neurodivergence and symptoms of mental conditions could fit nicely into individual columns. If only we could say, âthis compulsion clangs around in the OCD bucket,â âthat quirk lines the bottom of the ADHD basket,â and âthat neurosis fits in the wider anxiety container.â But itâs rarely that easy. While OCD and ADHD are opposites in some ways, they are also too intertwined to tease apart.
OCD and ADHD Together: Next Steps
CELEBRATING 25 YEARS OF ADDITUDE Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitudeâs mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
Whoever says the Adderall shortage is over is living on a different planet. I have dozens of patients who rely on Adderall and who panic every month. Whenever itâs time to refill their prescriptions, the drama begins: Where can I find the medication I need?
This uncertainty is causing extreme hardship for many of my patients. While stimulant medication is not exactly like insulin (you wonât likely die without it), it is like eyeglasses. Without your glasses, your execution of everything suffers. You go about your day making mistakes, bumping into things, risking getting fired because suddenly youâre incompetent. I wish the Adderall shortage were over, but up here in the Boston area at least, it is as bad as itâs ever been.
I canât figure out why. Itâs not as if Adderall is like truffles; we donât need special pigs to root it out from the ground. Production is not limited by the availability of its components. Itâs easily synthesized. So why is there a limit on how much stimulant medication can be produced and marketed? Why are my patients suffering unnecessarily?
If limiting the production of Adderall is part of an effort to reduce or prevent the reselling or other misuse of the drug, that simply makes no sense. Itâs just plain stupid. Itâs like trying to reduce car theft by limiting the manufacture of cars.
Itâs difficult for me not to believe this is a misguided attempt to avoid another oxycontin debacle. But limiting the manufacture of Adderall to prevent Adderall abuse only succeeds in punishing the patients who really need the drug.
To blame the Adderall shortage, as the FDA commissioner recently did, on improper or aggressive diagnosis of ADHD and improper or aggressive prescription of stimulant medication is to penalize the many for the mistakes of a few. Unless a doctor is intentionally over-diagnosing to make a profit â which does happen, unfortunately, but not nearly often enough to create a shortage of Adderall â then we ought to have enough of a supply to meet the needs of all people diagnosed with ADHD.
There is a shortage of Adderall because, for some reason, the manufacturing quotas set by the Drug Enforcement Administration (DEA) are not keeping up with demand. Itâs good news that the demand is high because that means more people are getting diagnosed. Not too long ago, it was hard to find a doctor who knew enough to diagnose and treat ADHD.
Now that weâre diagnosing and treating more people with ADHD, especially adults, we ought to be able to prescribe for them the medications they need to live more productive, fulfilled lives.
ADHD Medication Shortage: Next Steps
CELEBRATING 25 YEARS OF ADDITUDE Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitudeâs mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
In my first full-time job after finishing my masterâs degree, I was put in charge a long-running project that was already years behind schedule. With strict, unrealistic timelines and insufficient resources, the project was mine to save.
Iâve always been a high achiever, so I dove right in. Despite the pressure and all the givens, I found the work highly engaging and rewarding â the perfect combination for hyperfocus.
Intense weeks turned into months. The longer I hyperfocused on the project and the more I accomplished, the more important my work became to me. It was all or nothing.
I kept up the pace for a year and a half. Then, with almost no warning, I broke.
I know what youâre thinking; itâs a classic case of burnout, right? Not exactly. You see, that burnout episode happened six years ago â and Iâm still recovering from it.
Burnout by Another Name
Years after that episode, with a new job and an objectively manageable workload, I am still only able to work about 20 hours a week. Iâm also highly sensitive to day-to-day work stress; some hard days can trigger depressive episodes and significant fatigue.
I finally sought help recently, and I found a therapist who specializes in ADHD. I told her my story and, I read what I could on burnout between our sessions to try to make sense of what I went through (and the effects Iâm still experiencing). The more I learned, and the more I explored my burnout during therapy, the more I realized that traditional, commonly understood concepts of burnout failed to capture my experience.
What I went through, I realized, was a form of burnout that I believe affects many of us with ADHD: I call it âhyperfocus burnout.â
Digging Deeper on Hyperfocus Burnout
The World Health Organization (WHO) describes burnout as the result of chronic workplace stress that has not been successfully managed. Hereâs how the dimensions of burnout match up to my burnout experience:
feelings of energy depletion or exhaustion (Yep)
increased mental distance from oneâs job, or feelings of negativism or cynicism related to oneâs job (Not really)
a sense of ineffectiveness and lack of accomplishment (Nope)
As stressful and demanding as leading that project was, I kept going back every day, eager to see it through. I wasnât mentally distant from my stressor â I was engaged with it. It was all I thought about, day and night. I didnât feel a sense of ineffectiveness or a lack of accomplishment on the job. It was just the opposite; my job was its own reward, and my productivity and effectiveness increased over time, fueling a positive feedback loop.
In my mind, there was nothing to escape or recover from. Sure, I wanted things to calm down, but burnout never showed up on my radar (though others in my life could see it). Thatâs why itâs typical approaches â like taking breaks, reframing, and increasing rewards â wouldnât have worked on me.
A dimension of my experience that I didnât see reflected in my research was my intense and increasing fear of falling short on my job. As time went on, my perceived consequences for failure worsened and became unrealistic. By the end, what started as âit will be a bad lookâ turned into the existential âthis project could end my career and leave my wife and I destitute.â I wonât deny that these irrational fears also kept me hyperfocused on my work.
Day to day, when I wasnât working, I just felt exhausted. Iâd have trouble focusing, I was forgetful, and I found it almost impossible to muster the energy required to start day-to-day tasks like cooking and cleaning. All other aspects of my life, including things I truly enjoyed, started to fade away. Once I started working again, that exhaustion faded away, or at least I didnât notice it.
When I did break, it was sudden â as if the branch that I had been perched on all this time had suddenly snapped, leaving me broken on the ground. From one day to the next, I could barely get out of bed. My mind was foggy, my memory was non-existent, and I couldnât make coherent sentences, let alone work. That extreme state lasted for the next five weeks. I then spent the next five years clawing my way back, only to still be half of my former self; I worked part time and struggled to keep up with the demands of life. The effects of traditional burnout, meanwhile, apparently resolve after a few months.
Hyperfocus Burnout vs. Traditional Burnout
With the help of my therapist, hereâs where I landed: Traditional burnout is triggered by a mismatch between time, demands, resources, and rewards. Symptoms occur on a spectrum and increase over time as pressure and lack of reward increase.
Hyperfocus burnout, on the other hand, is triggered only by an overabundance of pressure or demands, particularly on a high-focus activity.
In traditional burnout, there are efforts to detach and turn away from an unsustainable situation. In hyperfocus burnout, we engage and turn into the unsustainable situation. We push through until the situation ends or we break.
My therapist, who has seen her fair share of clients with ADHD who have burned out like I have, says those who reach their hyperfocus breaking point push themselves past their limits due to a strong sense of responsibility and a failure to recognize the mental and physiological strain that is accumulating to an inevitable peak.
Hyperfocus, ultimately, is just another problem with attentional shifting that characterizes ADHD. Itâs why many of us will forget to eat or go the bathroom when absorbed in a task. When unchecked, hyperfocus can cause us to sacrifice many life functions in the pursuit of a particularly salient goal.
Traditional burnout, it seems, is a protective mechanism that helps a person recognize when theyâre reaching their limit and are close to breaking. That mechanism failed, in my case, because of my ADHD and attention regulation challenges.
Recovering from Hyperfocus Burnout
There is another element to my story: Though I was diagnosed with ADHD as a child, I had gone without treatment for most of my adult life, as I had enough strategies to keep the âtraditionalâ inattentive symptoms at bay. My therapist strongly encouraged me to start taking ADHD medication, and Iâm glad she did. Medication has reduced my emotional ADHD symptoms (symptoms I hadnât even been aware were part of ADHD). My existential fear of failure disappeared almost overnight. Stimulant medication reduced my anxiety and increased my resilience to stress; it was much more effective than the SSRI I had previously been prescribed.
All in all, starting medication allowed me to increase my working hours longer than I have in years, without sacrificing the rest of my life. Now Iâm also better able to recognize instances of unhelpful hyperfocus, and Iâm much more likely to disengage and use coping strategies â something I struggled to do before. Still, medication is not a fail-safe; I have to be careful about slipping back into old patterns.
I wish I knew then what I know about extreme hyperfocus. I wish I knew that it could turn into a positive feedback cycle that gets harder to escape the longer youâre in it. I wish I knew that relentless hyperfocus would break me and result in a very long and painful recovery. Maybe if I had this information, I would have listened to my wife and friends; maybe I could have helped my manager realize that I was in serious trouble, even though I was still very effective at my job and not showing the traditional (dare I say, neurotypical) signs of burnout. Maybe I could have prevented my hyperfocus burnout.
Extreme Burnout and ADHD Hyperfocus: Next Steps
This piece was a joint effort between Matt and his psychologist, Dr. Petra Hoggarth. Based in Christchurch, New Zealand, Dr. Hoggarth specializes in adult ADHD assessment and therapy.
CELEBRATING 25 YEARS OF ADDITUDE Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitudeâs mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
After starting college in 2010, the first group I interacted with was the cross country team. While the camaraderie was positive at first, there was a lot of toxic culture around food and body image. In fact, I remember the upperclassmen really emphasized the necessity of losing your period, and running so hard that it was inevitable. Having no other role models in the sport, I took to that goal, and made it one of my own moving forward. When I lost my period, I relished in that fact, rather than flagging it as a cause for concern.
All of us had a drive to be thinâto reach performance goals, feel lighter during a race, or even slim down our bodies to look more like a competitor runner. What began as ambition very quickly became a disease.
Everyone on the team was extremely anxious about food, myself included. I vividly remember the tension when meeting up with teammates at the dining hall. We would anxiously look at each other’s plates, which never had much on themâusually a light salad, even after running 10-plus miles that day. Everyone was so nervous about eating too much. No one wanted to be the odd one out, and that feeling was so visceral.
There was also so much stigma around breakfast and eating before or during runs. We would never eat beforehand, and after a very long run, we would treat ourselves to a latte. Ultimately we ended up fasting most of the day, despite rigorous training.
I internalized all of these ideas, and they grew tenfold in my own mind. The voice in my head would remind me: âyou donât need to eat thatâ or âyouâve been crushing it lately, but maybe if you lost a couple more pounds, youâd run even faster.â I truly believed that running extremely high mileage while eating very little was what it took to be a runner.Â
I was left with an extremely unhealthy body with no menstrual cycle, energy deficiency, and a lot of mental fog. I was fueled by my negative body image, and continued to move through unhealthy training.
The problem was, I did start to see some early success in trail running, so I had no tangible reason to change my ways. After undergraduate, I decided to pursue running as a career, rather than go to medical school. While I continued to have success at the beginning, it quickly became a rollercoaster. I would have a stellar race, then crash and burn for a while. I was so in the weeds of being under fueled, undernourished, and overtrainedâuntil my body finally started to break down.
For a couple of years, I stayed broken. My body wasnât functioning, my mind wasnât functioningâand in 2016, I finally got to a point where I knew something had to change. Luckily for me, I also studied hormones and performance, so when I started to honestly look at the bigger picture of my health, I couldnât deny how horribly Iâd been treating my body. I needed to pivot if I wanted to stay in the sport and reach my potential, rather than continuing to underperform and just feel like a miserable human.
A national obsession with a new class of weight-loss drugs is turning dangerous, doctors and researchers say, as many patients are inappropriately prescribed Wegovy, Ozempic and similar medications and supply shortages generate a market for unauthorized, potentially risky copycat versions of these drugs.Â
Social media buzz about the drugs has promoted the mistaken perception that the medications are appropriate for a broad swath of people who may want to shed a few poundsâwith disastrous consequences for some patients, doctors say. Patients who previously recovered from eating disorders, for example, are coming in for treatment because they âhave had their eating disorder reactivated by use of these medications,â said Dr. Elizabeth Wassenaar, a regional medical director at the Eating Recovery Center, which specializes in treating the disorders. Some patients have wound up in the hospital, she said, and in some cases the providers who prescribed the drugs were unaware of the patientsâ eating-disorder history. âItâs a real warning to people who prescribe these medications that itâs not without risk,â she said.
Some doctors also question whether the safety of the drugs has been adequately studied in older adults, who may have an undesirable loss of lean muscle mass when taking the medications. That complicates an ongoing debate about whether Medicare should cover these drugs for weight loss. Â
And patients of all types are put at risk, experts say, by the illegal production of knock-off versions of the medications. The Food and Drug Administration and several state pharmacy boards in recent weeks have warned that some compounding pharmacies are producing unauthorized versions of the drugsâwhich poses particular safety concerns for injectable drugs such as Wegovy, said David Margraf, a pharmaceutical research scientist with the Resilient Drug Supply Project at the University of Minnesotaâs Center for Infectious Disease Research and Policy. âItâs not just a victimless crime,â he said. âPeople can be severely injured.âÂ
Novo Nordisk NVO, +0.33%,
the maker of Wegovy and Ozempic, itself sought to tap the brakes on the craze around these drugs in a statement posted on its website this month, saying itâs concerned about reports of the drugs being used âfor purely cosmetic or aesthetic weight loss,â unauthorized versions of the drugs hitting the market, and âinsufficient clinical evaluations by some telehealth providersâ promoting the drugs.Â
Drugs such as Novo Nordiskâs Wegovy, Ozempic and Rybelsus and Eli Lillyâs LLY, -0.36%
Mounjaro mimic the effects of a gut hormone known as GLP-1, which can help control blood-sugar levels and reduce appetite. (Mounjaro also affects another hormone called GIP.) Ozempic, Rybelsus and Mounjaro are FDA-approved for treatment of type 2 diabetes, while Wegovy is approved for people with obesity and certain people with excess weight combined with weight-related medical problems.Â
Billions of dollars in drug sales hinge on the breadth of the patient population prescribed these medications. Last year, more than 5 million prescriptions for Ozempic, Mounjaro, Rybelsus or Wegovy were written for weight management, up from just 230,000 in 2019, according to data and analytics firm Komodo Health. Obesity drugs could be a $54 billion market by 2030, up from $2.4 billion in 2022, Morgan Stanley said in a report last year. Reports of GLP-1 drug users seeing improvements in addictive behaviors such as smoking and drinking have lately amplified interest in the medications. Â
The drugs have become such a cultural phenomenon that Walmart during its quarterly earnings call last week blamed the medications for a shift in consumer-spending patterns that pressured its margins. In the first quarter, the company saw âa shift to health and wellness,â John Rainey, Walmart Inc.âs WMT, +0.18%
executive vice president and chief financial officer, said on the call with analysts. âAnd part of that is related to these GLP-1 drugs that are to treat diabetes,â he said, adding that the shift âcomes at a lower margin, and so that has some impact on our business as well.âÂ
Noom, a digital health company that for years has emphasized a behavioral approach to weight management, this week announced a new program that will make Ozempic, Wegovy, Mounjaro and other medications available to eligible patients. âPrescriptions are not the goal of our program. Theyâre very much an adjunct,â Dr. Linda Anegawa, Noomâs chief of medicine, told MarketWatch. Medical professionals will review patientsâ entire health history, order labs to assess their metabolic health, and engage in video visits with patients as they determine what treatments might be appropriate, she said.Â
Telling your brain youâre not hungryÂ
The reason GLP-1 drugs help control weight is pretty straightforward, said Dr. Daniel Drucker, who helped discover GLP-1 and is senior scientist at Lunenfeld-Tanenbaum Research Institute in Toronto. When people take these drugs, he said, they simply eat less because they feel more full. âGLP-1 will tell your brain that youâre not hungry,â he said, and people taking these medications may feel less stressed about food or find themselves thinking less about food. And the effects may go beyond eating, he said, as some people also see improvements in smoking, drinking, and other addictive or compulsive behaviors. âThese are really interesting areas for further investigation,â he said. Drucker has been a consultant or speaker for Novo Nordisk, Pfizer PFE, -0.61%
and other pharmaceutical companies.Â
Novo Nordisk said in a statement to MarketWatch that it is not conducting any dedicated clinical studies to evaluate Ozempic, Rybelsus or Wegovy in patients with substance-use disorders or addiction-related illnesses, and Eli Lilly said it does not have any studies planned for investigating tirzepatideâthe active ingredient in Mounjaroâfor treatment of addiction.Â
Adolescentsâ use of the drugs for weight loss is a particular concern for some doctors. Wegovy is approved for treatment of obesity in children 12 and older. âThe adolescent mental health crisis is unprecedented,â said Wassenaar, with many teens suffering severe mood disorders, eating disorders, and suicidality, and teens struggling with depression may think, âif I lose weight, Iâll feel better and people will like me. Thereâs this magic drug, and all I have to do is inject it.â And if patients can start taking these drugs as early as 12 years of age, âwe just donât know what thatâs going to do to them in 10 or 20 years,â she said, because thereâs not enough long-term data.Â
Novo Nordisk said in a statement to MarketWatch that âteenage obesity is linked to weight-related health problems such as high blood pressure, high cholesterol and type 2 diabetes,â and that cutting calories and increasing physical activity may not be enough for some patients. âThe decision to prescribe an anti-obesity medication is at the discretion of the physician and the patient/parents,â the company said.Â
Eli Lilly said that tirzepatide is not currently being studied for chronic weight management in children or adolescents.Â
Many patients may have trouble filling lower-dose Wegovy prescriptions through September, according to drugmaker Novo Nordisk.
Novo Nordisk via AP
Some doctors are also concerned about broad use of the drugs among older adults. Many older adults have sarcopenia, an age-related loss of muscle mass and strength that can contribute to frailty and fall risk later in lifeâand losing weight can mean an additional loss of muscle mass that may not be advisable for some patients, doctors and researchers say.
While âthereâs a huge push to get Medicare to cover these drugs, itâs not really certain whether they would be helpful in this population or actually more harmful,â said Judy Butler, a research fellow at PharmedOut, a research and education project at Georgetown University Medical Center. Noom is not enrolling patients over age 60 in its new program, Anegawa said, partly because âwe really donât have enough data yet with many of these drugs in the geriatric population.âÂ
In the pivotal clinical trials for Wegovy, 9% of the Wegovy-treated patients were between 65 and 75 years of age, and 1% were 75 and older, Novo Nordisk said in a statement. âNo overall differences in safety or effectiveness have been observed between patients 65 years of age and older and younger adult patients,â the company said. In an ongoing cardiovascular outcomes trial, about 38% of patients are 65 or older, the company said.Â
By law, Medicare generally does not cover drugs prescribed for weight lossâalthough some drugmakers and industry groups are pushing to change that. Some of the drugs now generating intense demand also come with a hefty sticker price: Wegovy, for example, has an estimated annual net cost of about $13,600, according to the Institute for Clinical and Economic Review. If Medicare coverage rules changed and 10% of beneficiaries with obesity used Wegovy, total annual Medicare Part D spending on the drug could be as much as $26.8 billion, according to a recent study published in the New England Journal of Medicine. Thatâs more than 18% of the net total Part D spending by beneficiaries and the Medicare program in 2019.
Dangerous copycatsÂ
There are potential physical as well as financial costs. Side effects of the drugs can range from nausea and vomiting to gallbladder problems, inflammation of the pancreas, and thyroid cancer.
More broadly, some doctors question the prescribing of drugs solely based on obesity, absent other risk factors. âIf somebody is obese and has diabetes, high blood pressure, and high cholesterol, losing weight may improve those parameters, but obesity on its own does not need to be treated,â said Dr. Adriane Fugh-Berman, a professor at Georgetown University Medical Center and director of PharmedOut. âItâs cardiovascular fitness that is important, no matter what weight you are,â she said. âWe should stop focusing on the weight itself as a risk factor.âÂ
Dr. Robert Gabbay, chief science and medical officer at the American Diabetes Association, counters that âobesity is a disease, and therefore needs to be treated as such.â Although there are people with obesity who donât have other serious conditions, he said, âthatâs relatively uncommon.âÂ
Despite the concerns, shortages of the drugs persist. Novo Nordisk says it anticipates that many patients will have trouble filling lower-dose Wegovy prescriptions through September.Â
For patients who are relying on GLP-1 drugs for treatment of diabetes, even a short-term interruption in access to the drugs can cause blood-glucose levels to rise and result in serious complications, Gabbay said. Patients also tend to gradually ramp up dosage of these drugs to get to the effective dose, he said, and if they lose access to the medication âthey might have to start back at the beginning again,â putting them several months behind on their treatment.Â
The shortages can also create risks for a broader set of patients, experts say, as they spur demand for copycat versions of the drugs. The approved active ingredient in Wegovy and Ozempic is semaglutide in its base form, but some compounding pharmacies may be using salt forms of semaglutide, the FDA said in a late April letter to the National Association of Boards of Pharmacy. âWe are not aware of any basis for compounding a drug using these semaglutide salts that would meet federal law requirementsâ restricting the types of active ingredients used in compounding, the FDA said in the letter. Boards of pharmacy in several states, including West Virginia, North Carolina and Mississippi, have also recently issued warnings about compounded semaglutide.Â
Novo Nordisk said in the statement posted on its website this month that it is âactively monitoring and taking action againstâ entities unlawfully selling compounded semaglutide, adding that no FDA-approved generic versions of semaglutide currently exist.Â
Unauthorized compounded versions of the drugs could raise serious concerns about sterility and other quality-control issues, the Resilient Drug Supply Projectâs Margraf said. âIf this drug is in high demand and there isnât enough supply, people will find a way to get it from a gray-market source,â he said. âPeople are going to find ways around the laws and potentially harm patients.âÂ
I never thought Iâd have a life-changing revelation in the cereal aisle at Walmart, but thatâs exactly what happened. As I tried to decide which breakfast option to buy, my thoughts went something like this:
I donât know what to get.
I really want Cinnamon Toast Crunch.
But I canât get that. I should get the Special K.
Shoulds and musts are instilled in us from the time we are very little. Some of these rules are valuable. Others are more arbitrary, but they still end up governing our lives as rules. In this case, I had made a rule dictating which cereals I can and canât buy.
Thatâs when it hit me.
Wait, there are no rules! I can buy what I want. I can do what I want!
ADHD Motto #1: There Are No Rules
My Walmart moment may not seem like a big deal, but it was an epiphany to me. You see, growing up, my parents taught me very specific ways of doing just about everything. From folding towels to emptying the dishwasher, everything had to be completed a certain way, which was both helpful and harmful. It wasnât until I was diagnosed with ADHD as an adult that I understood why I struggled so much to keep up with my everyone elseâs rules and norms.
Living â or trying to live â by rules set by neurotypical brains is one of the most frustrating aspects of living with ADHD. Worse than that, we donât always recognize whatâs happening â that weâre beating ourselves up for stumbling over rules that donât work for our neurodivergent brains.
After that Walmart moment, and with an understanding of how my brain works, I constantly remind myself that there are no rules. There is no ârightâ way to do a thing. Thereâs only the way that works for me.
How many trash cans should I have in my office? There are no rules â as many as I need. Do I have to fold my clothes before putting them away? No. There are no rules.
ADHD Motto #2: Anything Worth Doing is Worth Doing Poorly
My second motto came from a post I saw on social media, which reads in part: âAnything worth doing is worth doing poorly⌠because doing it poorly is better than not doing it.â
I donât have to tell you that getting things started is immensely difficult for ADHD brains. Thereâs overwhelm, for one, and then thereâs fear of failure, all of which can keep us at a standstill, perpetuating the cycle of exhaustion we tend to create.
But this motto gave me permission to do what I can and forget about the big finish line. To me, this motto helped me see that getting 10% of a task done is better than getting none of it done.
Maybe I absolutely cannot bring myself to do all the dishes â but I can do the glasses, only. Laundry is exhausting â but I can focus on folding just my shorts. No, I cannot write a 40-page paper right now, but I can jot down some ideas. By giving myself permission to do a little at a time, I actually reduced my stress and increased my productivity.
Adopting the Two Mottos for Your Life
These mottos have helped me practice self-compassion and affirm my own neurodiversity.
Embracing the fact there are no rules, and that anything worth doing is worth doing poorly, helped me adapt and learn to accept things as they happen, not as someone else says they should.
But in my own work helping adults with ADHD, I hear a few concerns when I share these mottos with my clients. Mostly, my clients worry that theyâll spin out of control if they become too self-compassionate â that being hard on themselves is the only thing keeping their lives in check. Iâve been there, and I know that this black-and-white form of thinking keeps us trapped.
Start with these four steps to work toward living with more self-compassion. Perhaps youâll use these mottos or develop a few of your own:
Watch for patterns. Which tasks do you frequently struggle to get done? Where do you find the most resistance and hot spots in your life?
Troubleshoot with your brain in mind. Time to get creative. Do you struggle to put away your clothes? Iâve seen some people replace their hangers with S-hooks, or even install a pegboard in their Does trash pile up on your desk? Move your trash can within armâs reach.
Break down daunting tasks. Think smaller steps and remember my second motto. If breaking down a big task is difficult in itself, use a tool like Magic ToDo â GoblinTools to break it down for you. (Seriously, itâs fantastic.)
Remember, thereâs always tomorrow. There will be days when we canât get everything (or anything) done. Those are the days when we need to talk to ourselves as we would to our best friend. We didnât get everything done that we wanted to, and thatâs OK â we can try again
Personal Mottos for ADHD: Next Steps
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The day before our wedding, the entire city of Sydney became blanketed by heavy red dust. I woke up coughing, I could taste dirt in my mouth, and my bedroom was filled with a rusty glow.âOf course the bloody apocalypse would happen the day before my wedding,â I thought to myself. âI bet my fiancĂŠ has been raptured while I was left behind!â
Catastrophizing is normal for me. Itâs part anxiety, part comedic coping mechanism. When my fiancĂŠ woke to the dust, he just wondered where it came from and thought about washing the car.Though we both have ADHD and had been diagnosed as adults, our general outlook and ways of functioning are wildly different. We are chalk and cheese; Iâm the hyperactive type and heâs the inattentive type, which makes for an interesting union, to say the least. But we continue to make it work after all these years (14 and counting at the time of writing). It all comes down to three vital keys.
Key #1: Never Go to Sleep Angry
A lot happens when two adults share a life â and a condition that causes countless frustrations. Weâre both forgetful, albeit in different ways. He immediately forgets about his keys if he sets them down. While I can remember where my keys are, I donât always remember what time it is, even if Iâve just checked, or where I am when Iâm driving, even on a familiar route.
We also struggle in social settings. In our early days especially, my husband â who had lots of trouble reading facial expressions, keeping up with fast-paced conversation, and even stringing a sentence together â would often withdraw from others. While he was unable to tell when people were making fun of him, I was acutely aware of othersâ mocking undertones and uncomfortable shifts in the conversation, all of which set my rejection sensitive dysphoria (RSD) and anxiety into overdrive. I felt the need to overcompensate during lulls in conversation and fill the silence with inappropriate babbling and outrageous antics. Iâd drink alcohol to try to manage my intense social anxiety, but all it did was make me even more intense, hyperactive, and hypersensitive.
It can be tempting to cast blame when our individual challenges invariably come up and affect both of us. But no matter what our day has been like, we agreed from the very beginning of our marriage that we would never go to sleep angry at each other.
This doesnât mean that we have long conversations into the night to reach resolve. It simply means that weâve made the choice to push past shame and blame to say we love each other, no matter what. All hurts and misunderstandings do not change how much we love one another.
Key #2: Always Be Willing to Learn â and to Let Things Go
Learning about our unique ways of functioning has been so helpful in our marriage. We do our best to help each other in our respective trouble spots in day-to-day living. That has meant learning to let the little things go.
There is one clutter-free, easy-access key holder in our home. Sometimes, my husbandâs keys donât make it to the took and land on a nearby table â where theyâre bound to end up under a pile of mail. If I see his keys on the table, I put them in the key hook rather than give him a hard time for forgetting. And life runs a little more smoothly for both of us that day.
In social settings, my husband has worked hard to pick up on signs that my social anxiety is kicking in. He checks in with me and firmly puts his hand on my shoulder or back to ground me. He reminds me to take a walk or remove myself from the stressful situation. More often than not, these strategies ease me back to present. When they donât work, he doesnât push it. But later, we reflect on what happened and how we can both try to do things differently next time. Then, we move on.
Key #3: Never Stop Laughing Together
The benefits of laughter and of having a sense of humor are well-known. Somehow, throughout our marriage, weâve had an innate ability to find joy in the hardest of circumstances. Laughter is our reset button. (Thatâs why itâs hard for us to go to bed angry at each other.) We have literally laughed in the middle of heated arguments (usually at how ridiculous we are behaving), the result being instant tension and stress relief.
Our Personal Key: Donât Say The âDâ Word
Many Ds have been unearthed in our relationship: diagnosis, depression, deficit, disorder, dysfunction, dysregulation, dyscalculia, and the list goes on. But we decided from the beginning that one particular âDâ word was never going to be on the table: Divorce.
That word is not hidden up the back of the junk drawer, waiting to be pulled out and thrown into an argument like a gaslit weapon. Sure, there are painful spaces in our relationship that cause us to withdraw, defend, attack, or drag up the muddy waters of the past. But we vowed until death â not diagnosis â do us part.
With both of us wired as fighters, we are willing to ânever say die.â Weâll do everything to fight for our marriage, including holding firm to our keys (the kind weâll never lose) and even looking for new ones. Itâs hard work, but we know that our diagnoses are not a marriage death sentence. They do not define us negatively. They are what make us so strong and loving.
Happy Marriage Rules for ADHD Couples: Next Steps
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Three years ago, I launched the @domesticblisters TikTok channel to serve a neurodiverse audience. Short videos on the channel present strategies for accomplishing daily care tasks. For all the ADHD information swirling around social media, very little addresses how the simple tasks of living are sometimes the hardest for us. Cleaning, doing dishes, folding piles of laundry â these tasks are simple for most people but tend to paralyze some of us with executive functioning problems. Perhaps more difficult than the struggle to stay on top of these tasks is the immense shame we feel when weâre unable to do the things we see our peers accomplish with ease.
In my experience, this kind of shame tends to spike when we struggle with personal hygiene. How could we be so incapable? Our differences in executive functioning can create significant hurdles when it comes to the daily demands of living. And that makes hygiene routines our common kryptonite.
The ADHD brain often struggles to transform multiple mundane steps into a routine that works. So instead of forcing on yourself neurotypical routines that are doomed from the start, try adapting your daily hygiene rituals with the following four approaches:
Personal Hygiene Hacks for ADHD Brains
Rather than trying to adhere to a strict schedule and setting for brushing your teeth, build in flexibility so that you can care for your teeth whenever the thought strikes you. Place a toothbrush and toothpaste in multiple locations: by your kitchen sink, in your shower, in your guest bathroom, and even in your car. Because of the way ADHD motivation systems work, you are most likely to think about brushing your teeth while headed out the door (Oh no! My breath stinks!) or when randomly prompted by the sight of your toothbrush (Iâm already here, so I might as well!). You might also consider keeping deodorant and a hairbrush or comb in these places.
If showering is too boring, try getting a waterproof speaker. A good podcast or audiobook that you save for the shower can suddenly transform an onerous chore into a decadent treat. Also, a fancy hair towel or a high-powered blow dryer can reduce time spent on your wet hair.
If showering aggravates your sensory aversion, consider changing your environment to mitigate this. For instance, turning on a space heater before a shower will prevent that awful cold shock you feel when exiting the tub or shower. Using a soft and gentle towel also typically helps.
Create a hygiene kit for the days you skip a shower or bath. You deserve to be clean and comfortable; there is more than one way to get that done. A little bag with deodorant, dry shampoo, body wipes, and mouthwash can be kept in multiple locations in your home and car.
Maintaining good hygiene is important to your health, so get creative and find what works for your unique brain.
How to Keep House While Drowning â with ADHD: Next Steps
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âYouâre going to do great things!â âYou have so much potential!â âYouâre so talented. I see great things in your future!âSo many people in my life have directed various versions of these well-meaning yet anxiety-inducing, expectation-laden comments to me during every phase of my academic career. As a gifted child, I felt as though I could succeed and, at the same time, as if I had to⌠or I would be letting everyone down.This black-and-white way of thinking did get me to check off a list of great accomplishments:
first in my family to graduate college, go on to complete a masters, and start a doctoral program
a successful career
financially independent since age 18
But hidden in these accomplishments are the many, many struggles and failures I encountered along the way:
flunking out my freshman year of college
being asked to resign from a job for an error in judgment I made
flunking out of my Ph.D. program due to being unable to complete assignments
piling on credit card debt
I eventually learned that my setbacks â so confusing and contrary to my successes â were actually due to undiagnosed and unmanaged ADHD. I was twice exceptional (or 2e) all this time, and I had no idea.
My undergraduate transcript is a wonderful example of my interest-based nervous system. I had As and Bs in classes within my major, but failed yoga (which likely had to do with my impulsive, oppositional streak).
Perspective Shift: From Never Enough to Good Enough
At the age of 29, I came to the realization that my life is my own, and while the approval of others is nice, I would never feel content if I continued to chase it. I made the conscious decision to let go of âgreatnessâ as defined by others and to start experiencing life as it came to me.
Letting go of greatness freed me up to be content with where I am currently, instead of always trying to do more or be better. I still have personal and professional goals, but these goals are now based on my values rather than the values of other people.
My shift from ânot good enoughâ to âgood enoughâ has changed my self-view from lazy, unmotivated, and stubborn to efficient, understanding, and passionate.
enrolled in a doctoral program to advance MY learning and knowledge
in a job I can see myself in long-term, with opportunities to advance or switch it up, if I choose
writing this blog from a house that I own after paying down my debt
I donât believe any of this wouldâve been possible if I hadnât made the choice to live life for me, instead of an image I could never realistically attain. Iâve found a specialty I love and a life that finally feels sustainable.
How to Live for Yourself
If you are 2e like me, or if you see yourself in my story, start living life for you with these steps:
Clearly identify your current values. Your personal values will come to define and frame everything else you do in life.
Set at least one goal for each value. They can be as broad or as specific as you like. For example, if you value family, how will you commit to spending more time with them?
Let go of the constant pursuit of greatness. If you are always thinking of where you could or should be, it only robs you of the ability to appreciate who and where you are now.
Foster self-compassion. You are a multi-faceted person. Your worth is not directly measured by your productivity or your achievements.
2e and How to Live for Yourself: Next Steps
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A former Southern California man who convinced troubled girls as young as 12 to perform masochistic acts and urged one to become his sex slave has been sentenced to 27 years in federal prison
LOS ANGELES — A former Southern California man who convinced troubled girls as young as 12 to perform masochistic acts and urged one to become his sex slave was sentenced Tuesday to 27 years in federal prison.
Matthew Christian Locher was “a parent’s worst nightmare,” U.S. District Judge Dolly M. Gee said during his sentencing in Los Angeles, the U.S. attorney’s office said in a statement.
Locher pleaded guilty last August to one count of sexual exploitation of a child for the purpose of producing a sexually explicit visual depiction.
In his plea agreement, prosecutors said Locher, 32, acknowledged that while living in Redondo Beach in 2020 and 2021, Locher got into online conversations targeting girls suffering from mental health issues such as depression, schizophrenia, anorexia and suicidal thoughts.
âLocher groomed his victims to engage in self-mutilation and instructed a victim struggling with an eating disorder to starve herself, ordering her to film herself cutting her body when she disobeyed him,â the U.S. attorneyâs office statement said.
Two girls sent him images and videos of self-harm that included cutting their breasts with razor blades, prosecutors said.
He convinced a third victim, who was 12, to run away from her Ohio home and attempt to reach California to have sex with him, prosecutors alleged.
Encouraged by Locher, the girl first set fire to her home in a failed bid to kill her parents, prosecutors alleged.
Locher had promised he would pick her up, âbring her to California, and make her his âslave,ââ the U.S. attorneyâs office said.
Locher moved to Indiana in 2021 after authorities searched his home. He was arrested in January 2022 in Indianapolis and sent back to California.
March 2, 2023 — As a veteran fitness assistant and trainer, Samantha Ward was well aware of the impact eating disorders can have on a womanâs health. Suddenly, though, the issue became personal.Â
âI developed an eating disorder later in life,â Ward says. âI was 55 years old when it started. I had never had one before.â
Ward was going through tremendous stress. âI believe that my eating disorder was a way to cope with a very difficult time in my life,â she says. âI had lost my job, my marriage was falling apart, and I was struggling with depression.â Â
Although eating disorders like binge eating, anorexia nervosa, and bulimia in older women are rarely discussed, they’re a prevalent and growing problem. A new study from Yale School of Medicine reports that almost 3% of U.S. women ages 50 to 64, and almost 2% of women 65 and older, have an eating disorder.Â
Whatâs more, a study published in the Journal of Eating Disorders found that roughly 26% of older female participants reported binge eating one or more times a week. Sometimes, medical conditions such as GI difficulties or dental problems can lead to an eating disorder, the researchers found, as can depression and dementia. The studyâs authors also report, however, that menopause can be a time that leaves a woman more vulnerable to developing an eating disorder. Some women start dieting to stop hormonal weight gain, for example, and develop a distorted body image.
Itâs very important that a later-life eating disorder be addressed as quickly as possible.Â
âOlder adults may become frail more quickly, faster than younger individuals,â says Dorothea Vafiadis, director of the National Council on Agingâs Center for Healthy Aging.
âIn older adults, body systems may not bounce back as quickly as they used to, so eating disorders resulting in rapid weight loss can create problems quickly.âÂ
Research has shown that 21% of older adults with an eating disorder die of the condition. The first vital step to take: Recognize that emotions most often lie at the root of the problem.
Emotional Causes of Eating Disorders in Older Women?Â
According to the National Council on Aging, some people have a genetic predisposition to eating disorders. There are also three main patterns to eating disorders in older women. Some women will have struggled when they were younger, recover from their disorder, then relapse. Some women never recover and suffer to some degree for most of their lives. Other women, like Ward, develop a first-time eating disorder in response to environmental triggers.
âStress and anxiety can occur for older women due to life changes â a female midlife crisis,â says Nancy Lee Zucker, PhD, professor of psychiatry, behavioral sciences, and neuroscience at Duke University School of Medicine in Durham, NC. âSome women use food intake and exercise to cope â they focus on self-improvement, initially. But then, their focus on food can become all-encompassing â it narrows their focus.âÂ
Challenges such as divorce or widowhood, an empty nest, financial problems, or adjusting to retirement can set off this behavior.Â
A womanâs psychological mindset as a whole can also play a significant role.Â
âIndividuals with certain personality traits may be more prone to eating disorders, such as those who have perfectionistic tendencies or obsessive impulses,â says Vafiadis.
Symptoms of an Eating Disorder in an Older Woman?Â
If a friend or loved one displays any of the following symptoms, she may need help:
 Appearing to feel guilty about food or eating
 Weight loss
 Eating by herself
 Acting secretive
 Exercising constantly
 Expressing being emotionally upset
 Oral health problems like jaw pain or dental problemsÂ
If you notice someone going to the bathroom after a meal, or complaining of stomach issues, she may be bingeing and purging. âBinge eating disorder has been shown to be more prevalent in older women,â Zucker says, although researchers are not sure why.
How to Treat Eating Disorders in Older Women?Â
The first step is compassionate outreach. If you suspect someone close to you is dealing with an eating disorder, you definitely want to offer help. Be gentle and respectful.Â
âOlder women with eating disorders are often ashamed, so it can be hard for family and friends to bring up the subject,â says Zucker. âInstead, focus on the isolation youâve noticed. You could say, âIâve noticed youâre eating by yourself these days â you donât want to go out to dinner anymore. You also sound a little down on yourself.ââÂ
Offer to bring the person you care about to the doctor and tell her how much you care about her.
A full medical evaluation is extremely important.Â
âOlder adults are commonly undiagnosed,â says Vafiadia. âEating disorders in the elderly may not be the first diagnosis due to other health issues at play.âÂ
Diagnosing any underlying medical condition that co-exists with an eating disorder is vital.Â
Depending upon the severity of a womanâs condition, inpatient treatment may be the right solution. Australian researchers reported that for adults over the age of 66, a combination of hospitalization, drug therapy, and psychotherapy led to improvement in almost 80% of surveyed patients. Cognitive behavioral therapy, family therapy, and nutritional counseling are all useful options. Medications to treat eating disorders may include Prozac or Vyvanse.Â
âThe good news is, treatment can really help,â Zucker says.Â
Ward is in full agreement. âIâm currently in treatment,â she says. âI have a great therapist whoâs helped me to get better.âÂ
Most of all, Ward stresses that you should not try to handle things alone: âYou need support to overcome an eating disorder.â
TikTokâs algorithms are promoting videos about self-harm and eating disorders to vulnerable teens, according to a report published Wednesday that highlights concerns about social media and its impact on youth mental health.
Researchers at the nonprofit Center for Countering Digital Hate created TikTok accounts for fictional teen personas in the U.S., United Kingdom, Canada and Australia. The researchers operating the accounts then âlikedâ videos about self-harm and eating disorders to see how TikTokâs algorithm would respond.
Within minutes, the wildly popular platform was recommending videos about losing weight and self-harm, including ones featuring pictures of models and idealized body types, images of razor blades and discussions of suicide.
When the researchers created accounts with user names that suggested a particular vulnerability to eating disorders â names that included the words âlose weightâ for example â the accounts were fed even more harmful content.
âItâs like being stuck in a hall of distorted mirrors where youâre constantly being told youâre ugly, youâre not good enough, maybe you should kill yourself,â said the centerâs CEO Imran Ahmed, whose organization has offices in the U.S. and U.K. âIt is literally pumping the most dangerous possible messages to young people.â
Social media algorithms work by identifying topics and content of interest to a user, who is then sent more of the same as a way to maximize their time on the site. But social media critics say the same algorithms that promote content about a particular sports team, hobby or dance craze can send users down a rabbit hole of harmful content.
Itâs a particular problem for teens and children, who tend to spend more time online and are more vulnerable to bullying, peer pressure or negative content about eating disorders or suicide, according to Josh Golin, executive director of Fairplay, a nonprofit that supporters greater online protections for children.
He added that TikTok is not the only platform failing to protect young users from harmful content and aggressive data collection.
âAll of these harms are linked to the business model,â Golin said. âIt doesnât make any difference what the social media platform is.â
In a statement from a company spokesperson, TikTok disputed the findings, noting that the researchers didnât use the platform like typical users, and saying that the results were skewed as a result. The company also said a userâs account name shouldnât affect the kind of content the user receives.
TikTok prohibits users who are younger than 13, and its official rules prohibit videos that encourage eating disorders or suicide. Users in the U.S. who search for content about eating disorders on TikTok receive a prompt offering mental health resources and contact information for the National Eating Disorder Association.
âWe regularly consult with health experts, remove violations of our policies, and provide access to supportive resources for anyone in need,â said the statement from TikTok, which is owned by ByteDance Ltd., a Chinese company now based in Singapore.
Despite the platformâs efforts, researchers at the Center for Countering Digital Hate found that content about eating disorders had been viewed on TikTok billions of times. In some cases, researchers found, young TikTok users were using coded language about eating disorders in an effort to evade TikTokâs content moderation.
The sheer amount of harmful content being fed to teens on TikTok shows that self-regulation has failed, Ahmed said, adding that federal rules are needed to force platforms to do more to protect children.
Ahmed noted that the version of TikTok offered to domestic Chinese audiences is designed to promote content about math and science to young users, and limits how long 13- and 14-year-olds can be on the site each day.
A proposal before Congress would impose new rules limiting the data that social media platforms can collect regarding young users and create a new office within the Federal Trade Commission focused on protecting young social media users Ⲡprivacy.
One of the billâs sponsors, Sen. Edward Markey, D-Mass., said Wednesday that heâs optimistic lawmakers from both parties can agree on the need for tougher regulations on how platforms are accessing and using the information of young users.
âData is the raw material that big tech uses to track, to manipulate, and to traumatize young people in our country every single day,â Markey said.
TikTokâs algorithms are promoting videos about self-harm and eating disorders to vulnerable teens, according to a report published Wednesday that highlights concerns about social media and its impact on youth mental health.
Researchers at the nonprofit Center for Countering Digital Hate created TikTok accounts for fictional teen personas in the U.S., United Kingdom, Canada and Australia. The researchers operating the accounts then âlikedâ videos about self-harm and eating disorders to see how TikTokâs algorithm would respond.
Within minutes, the wildly popular platform was recommending videos about losing weight and self-harm, including ones featuring pictures of models and idealized body types, images of razor blades and discussions of suicide.
When the researchers created accounts with user names that suggested a particular vulnerability to eating disorders â names that included the words âlose weightâ for exampleâthe accounts were fed even more harmful content.
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âItâs like being stuck in a hall of distorted mirrors where youâre constantly being told youâre ugly, youâre not good enough, maybe you should kill yourself,â said the centerâs CEO Imran Ahmed, whose organization has offices in the U.S. and U.K. âIt is literally pumping the most dangerous possible messages to young people.â
Social media algorithms work by identifying topics and content of interest to a user, who is then sent more of the same as a way to maximize their time on the site. But social media critics say the same algorithms that promote content about a particular sports team, hobby or dance craze can send users down a rabbit hole of harmful content.
Going viral: Health misinformation spreading on social media such as TikTok
Itâs a particular problem for teens and children, who tend to spend more time online and are more vulnerable to bullying, peer pressure or negative content about eating disorders or suicide, according to Josh Golin, executive director of Fairplay, a nonprofit that supporters greater online protections for children.
He added that TikTok is not the only platform failing to protect young users from harmful content and aggressive data collection.
âAll of these harms are linked to the business model,â Golin said. âIt doesnât make any difference what the social media platform is.â
In a statement from a company spokesperson, TikTok disputed the findings, noting that the researchers didnât use the platform like typical users, and saying that the results were skewed as a result. The company also said a userâs account name shouldnât affect the kind of content the user receives.
TikTok or Not? Putting viral beauty trends to the test
TikTok prohibits users who are younger than 13, and its official rules prohibit videos that encourage eating disorders or suicide. Users in the U.S. who search for content about eating disorders on TikTok receive a prompt offering mental health resources and contact information for the National Eating Disorder Association.
Story continues below advertisement
âWe regularly consult with health experts, remove violations of our policies, and provide access to supportive resources for anyone in need,â said the statement from TikTok, which is owned by ByteDance Ltd., a Chinese company now based in Singapore.
Despite the platformâs efforts, researchers at the Center for Countering Digital Hate found that content about eating disorders had been viewed on TikTok billions of times. In some cases, researchers found, young TikTok users were using coded language about eating disorders in an effort to evade TikTokâs content moderation.
The sheer amount of harmful content being fed to teens on TikTok shows that self-regulation has failed, Ahmed said, adding that federal rules are needed to force platforms to do more to protect children.
Ahmed noted that the version of TikTok offered to domestic Chinese audiences is designed to promote content about math and science to young users, and limits how long 13- and 14-year-olds can be on the site each day.
A proposal before Congress would impose new rules limiting the data that social media platforms can collect regarding young users and create a new office within the Federal Trade Commission focused on protecting young social media users â privacy.
One of the billâs sponsors, Sen. Edward Markey, D-Mass., said Wednesday that heâs optimistic lawmakers from both parties can agree on the need for tougher regulations on how platforms are accessing and using the information of young users.
Story continues below advertisement
âData is the raw material that big tech uses to track, to manipulate, and to traumatize young people in our country every single day,â Markey said.
This year my 20-year-old son is skipping Thanksgiving.
I texted him to ask how he would explain ARFID to a friend who didnât understand eating disorders. âItâs like a fight or flight response with food,â he texted back. âPeople with ARFID have a small number of âsafe foodsâ they can eat without any psychologically adverse effects, something they default to on a daily basis. Thereâs vomiting only with certain foods.â
Avoidant and Restrictive Food Intake Disorder (ARFID), a new diagnosis, not widely understood, is a type of sensory processing disorder, affecting 3% of the population. It often co-occurs with anxiety, attention deficit and hyperactivity issues, and neurodivergence.
When he was little, his mother and I thought our son was just a âpicky eater.â At family meals he preferred to hold forth in conversation, his charming self, forgetting to touch his food. When one of us nudged him to try the broccoli, the power struggles started, often leading to tears and temper tantrums.
As he grew up, his food preferences narrowed. The number of safe foods â white bread, cheddar cheese, green apples, noodles, bagels â had to be specific brands from particular stores, one of ARFIDâs signature characteristics. Worried, we pestered, even criticized, as if it were a question of personal will.
He was at risk for nutritional deficits and anemia, had blood work at all pediatrician visits, and was often prescribed vitamins and supplements which made him gag. It all felt like a punishment.
When we first started seeing nutritionists, they recommended different ways of sneaking nutritious stuff into the few foods he liked â the chocolate zucchini birthday cake will never be forgiven â which always failed.
Until you have ARFID, or have a child who has ARFID, you do not realize the extent to which human relationships are organized around eating together. Holidays like Thanksgiving are the worst.
When well-intentioned people notice my son eating his safe foods â it happens every Thanksgiving â they default to the ways they respond to toddlers who are picky eaters: cajoling, encouraging, talking up new foods (sometimes more direct, critical ways of responding).
During food-focused holidays, people like my son face a barrage of uncomfortable corrections when they just want to be left alone with what is essentially an invisible disability. He can either smile and tolerate the interrogations, educate the person â which is fraught because it is sad to have ARFID â or escape the situation. Any conversation about food is associated with shame and being reminded that thereâs something âwrongâ with you.
In earlier food-focused holidays, my son would join us, reluctantly, after we insisted, and either tolerated the alarmed attentions of others or escaped and didnât come back.
A specialized nutritionist told us he had ARFID. Proteins in his taste buds didnât communicate with his brain in the same way that ours did. As a teenager, he worked for several years on âexposures.â
âBecause taste buds change every 30 days or so, âexposuresâ get your body accustomed to a food in hopes that it will become safe,â he texted me. The logic is that continued exposures to new foods eventually changes the communication between taste buds and the brain. It is a frustratingly slow process.
Each month he chose one âfood challenge.â He took one to two bites a day and kept a log of his reactions. One summer month he chose strawberries. While he took a bite and grimaced, I had several. (OK, I ate the rest of the pint, delighted with the juicy sweetness.) In his log, my son wrote words like âbitterâ and ânasty.â Strawberries never became a safe food.
The sad reality hit me: Food gave him no happiness.
As a psychotherapist, I frequently find myself playing this cognitive game: What if the âdisorderâ demanding âcureâ â shame-infused words that become part of the problem â is just an exception to the usual ways of social being, putting the âsuffererâ in the position of having to adapt, adjust, minimize, rationalize, or deny legitimate feelings of inconvenience, when the real problem is that the world is organized around other peopleâs way of doing things? What if the problem is other people with their insistence on social conformity?
When he told us he was sitting out this holiday, my son mentioned the persistent grievance about Thanksgiving: It celebrates what is essentially the genocide of native populations. To enjoy it, you have to unsee, or at least reckon with, a tortured history, a reality ignored in the warm colors and ambient light of the Norman Rockwell painting. The insistence on one narrative, one imposed meaning, sidesteps other realities. As we talk about Thanksgiving with friends with marginalized and targeted identities, we realize that my son wonât be the only one doing something else.
Still I was disappointed that he wouldnât join us, secretly wishing he would change his mind.
Last spring, when his older brother finished college, our family made a trip to Berlin for his graduation. Historically, travel abroad has been terrible because of the lack of familiar foods. This time, armed with self-awareness, we packed a suitcase full of safe foods: macaroni and cheese, peanut butter and jelly, his favorite crackers. But we still wanted to have a special dinner out.
My younger son, who hates restaurants but loves his brother, begrudgingly conceded. He dreads the attention of the wait person when he only orders one bland dish. Inevitably, they ask questions like, âAre you sure?â or they talk up other items, or other members of the dinner party launch into correcting mode.
In our hotel before the dinner, we checked the online menu to confirm there was a safe food. When we entered the bustling restaurant, the yellow glow on the tables, happy diners chattering, beautifully plated dishes being brought to tables, my son looked pained. The waiter mentioned there was a fixed prix âFamily Feast.â A chefâs selection of dishes would be brought to our table. No one had to order an individual meal. We were thrilled. My son wouldnât be asked any questions.
âAnd there will be french fries?â I asked the waiter. âWe all want to try them.â
âThere are always french fries,â he said.
My sonâs expression relaxed. He even ordered a fancy cocktail â bourbon, sherry, cranberry syrup and lemon â and he liked it! It was a rare moment when we had a family dinner at a restaurant. It was the best dinner we ever had, and he didnât feel like there was something wrong with him.
Early in my journey as a dad I might have said that I loved my three children unconditionally, but thatâs a lie. Discovering them as complex individuals with their own ways of navigating a difficult, unfair, sometimes cruel world, has revealed that there are conditions: my own needs, attachments, and fantasies about who they might be, which are sometimes unclear, unconscious, but potent.
Continually shedding expectations, I move closer and closer to a purer form of caring â that ideal of unconditional love. That self-discovery is the real pleasure of parenting.
This Thanksgiving some of us will have dinner with our neighbors. We are in charge of pies â chocolate pecan, traditional pecan, and pumpkin â and my partner will bring a new gnocchi and Brussel sprouts dish for my daughterâs girlfriend, who is vegan. My son will stay home where he wants to be, away from the attention of others (and the bad memories that brings up), play video games and watch movies, and talk to his grandmother who is in a different time zone.
We will miss him, of course, but I trust he will be OK.
Later we plan to come home for dessert with him. Through some holiday magic I donât pretend to understand, but for which I am grateful, pumpkin pie is a safe food.
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Award-winning actor Zendaya celebrates all body types. Supermodel Bella Hadid openly shares how she has dealt with anorexia and cautions her Instagram followers that âsocial media is not real.â
Despite their efforts to serve as role models, celebritiesâ photos and videos on social media can trigger people who have negative body images, especially those with eating disorders.
That content â and social media itself â doesnât cause eating disorders.
âSocial media can be an empowering tool for connecting and community building,â says Lauren Smolar, vice president for mission and education at the National Eating Disorders Association (NEDA).
But, Smolar says, âIt can also be the exact opposite and reinforce unhealthy messages about dieting and appearance.â
Nearly 29 million people in the U.S. will have an eating disorder at some point in their lives, NEDA estimates. Most of those people â 95% â are between ages 12-25, an age group for which social media is a key part of daily life.
The problem has grown with increased social media use since the start of the COVID-19 pandemic. Calls, texts, and chats to the NEDA Helpline rose 58% from March 2020 to October 2021, Smolar says.
Eating disorders are serious medical conditions that can be life-threatening and are linked to suicide risk. People of all sizes, ages, racial and ethnic groups, and genders can have eating disorders. These conditions can be treated. If you or someone you know is dealing with a harmful relationship to food or body image, get help. You can start with your doctor or a therapist. Or call or text NEDAâs helpline at 800-931-2237.
âShame and Guiltâ
Research links social media use to eating disorders including:
Anorexia nervosa: undereating and often an obsession with thinness. This condition can cause severe health problems and can be fatal.
Bulimia nervosa: eating large amounts of food in a short period of time and then trying to counter it in unhealthy ways like purging, diuretics, laxatives, and excessive fasting or exercise
Binge-eating disorder: binge eating without purging or other attempts to offset repeatedly eating large amounts of food.
The relationship between social media use and binge eating shows in a 2022 review of studies. âThe more participants use social media, the more likely they are to have increased appetite or intention to eat, which can lead to binge eating,â says researcher Bo Ra Kim of the University of Texas at Austinâs School of Nursing.
Other unhealthy behaviors include compulsive workouts and so-called cheat meals. âAlthough cheat meals can be packaged as a reward for me for exercising and dieting hard, losing control during that period can have negative health consequences in many cases,â Kim says.
Research also shows that seeing idealized (and unrealistic) Instagram images can negatively affect how young women feel about their bodies. Efforts to promote body positivity and spot unrealistic content may help counter that.
Unhealthy Comparisons
Some people do whatever it takes to look like people they perceive as looking perfect, regardless of whether it is a realistic or healthy goal.
âThereâs a lot of hero worship,â says Nancy Mramor Kajuth, PhD, a Pittsburgh psychologist and author of Get Reel: Produce Your Own Life. âIt generates a false reality to think you need to look that way. Youâre so strongly identified with someone on social media that you stop separating yourself from the fact that theyâre just people who are paid to look good. Thatâs their job.â
People also overlook the fact that in real life, celebrities donât even look like their visual images without all the makeup, styling, and photo editing, Kajuth says. The idea of whatâs âperfectâ or what âlooks goodâ is also subjective and varies among different groups. Still, it can be harder to resist social media imagery if youâre vulnerable to an eating disorder or body image issues.
These influences arenât new, Kajuth points out. Before social media, the unhealthy gaze came from magazines, TV, movies, and billboards. But social media can bombard you with images and messages that can multiply and follow you around, thanks to algorithms and shared posts. The comparisons can go on and on.
Growing Use of Social Media
Facebook and Instagram, both owned by Meta, are making it easier for people to change their settings to opt out of seeing certain ads or content. For instance, they can set their settings so that if they type in certain words on Instagram, such as âskinny,â they will automatically be taken to self-help content. TikTok has a page devoted to awareness of eating disorders.
However, the Social Media Victims Law Center says that technology companies havenât done enough to protect users. The Center has filed 14 eating disorder cases against social media companies.
NEDA has asked Congress to allocate at least $1 million for the National Institute of Mental Health to research the effects of social media on teenagers and children. NEDA has also called on lawmakers to push technology companies to release their social media research, to hold them more accountable, and to stop them from micro-targeting young people with ads and content.
âWe continue to ask social media companies to evaluate their policies and to continue to do better to make their sites safer for users,â Smolar says.
A Social Media Checkup and Other Ways to Help
Experts and researchers encourage health care providers to assess the social media activities of their patients. They also offer these tips for individuals and families to help reduce the impact of social media on mental health:
Get help if you think you may have an eating disorder or body image problems, or if your social media use affects how you feel about yourself. Consider cognitive behavioral therapy (CBT), Kim says. âMindfulness programs are highly recommended treatments.â
Take stock of the message and images that you view and how they make you feel, Smolar says. Make sure that the content is healthy for you.
Donât dwell on numbers related to measuring food or weight. This includes social media posts that include specific weights or body-part measurements, body mass index (BMI) levels, and calorie counts.
Spend more face-to-face time with family and friends who are positive, supportive, and healthy for you.
If youâre the parent of a teen, be aware of the spaces they are in â not only in real life, but also on social media.
Take a timeout from social media. âIt loses some of its power when you are not attached to it,â Kajuth says.
YouTube on Tuesday announced a series of changes to how it deals with content related to eating disorders.
The platform has long removed content that glorifies or promotes eating disorders, and YouTubeâs Community Guidelines will now also prohibit content that features behaviors such as purging after eating or extreme calorie counting that at-risk users could be inspired to imitate. For videos that feature such âimitable behaviorsâ in the context of recovery, YouTube will allow the content to remain on the site but restrict it to users who are logged into the site and are over the age of 18.
The policy changes, developed in consultation with the National Eating Disorder Association and other nonprofit organizations, aim to ensure âthat YouTube creates space for community recovery and resources, while continuing to protect our viewers,â YouTubeâs Global Head of Healthcare Garth Graham told CNN in an interview.
âWeâre thinking about how to thread the needle in terms of essential conversations and information that people might have,â Graham said, âallowing people to hear stories about recovery and allowing people to hear educational information but also realizing that the display of that information ⌠can serve as a trigger as well.â
The changes come as social media platforms have faced increased scrutiny for their effects on the mental health of users, especially young people. In 2021, lawmakers called out Instagram and YouTube for promoting accounts featuring content depicting extreme weight loss and dieting to young users. And TikTok has faced criticism from an online safety group that claimed the app served eating disorder related content to teens (although the platform pushed back against the research). They also follow several updates by YouTube in recent years to how it handles misinformation about medical issues such as abortion and vaccines.
In addition to removing or age restricting some videos, YouTube plans to add panels pointing viewers to crisis resources under eating disorder-related content in nine countries, with plans to expand to more areas. And when a creatorsâ video is removed for violating its eating disorder policy, Graham said YouTube will send them resources about how to create content thatâs less likely to harm other viewers.
As with many social media policies, however, the challenge often isnât introducing it but enforcing it, a challenge YouTube could face in discerning which videos are, for example, pro-recovery. YouTube said it will be rolling out enforcement of the policy globally in the coming weeks, and plans to use both human and automated moderation to review videos and their context.
âThese are complicated, societal public health [issues],â Graham said, âI want never to profess perfection, but to understand that we have to be proactive, we have to be thoughtful ⌠itâs taken a while to get here because we wanted to articulate a process that had different layers and understood the challenges.â
