Transgender and Eating Disorders

Transgender and Eating Disorders

Christie Caggiani, RDN, LDN, CEDRD
Christie Caggiani, RDN, LDN, CEDRD

It has long been said that eating disorders don’t discriminate: we know they affect people of all ages, education levels, ethnic backgrounds, lifestyles and genders.  We’ve become clear that it affects middle-age women at an alarming rate, is on the rise in underdeveloped countries and impacts males as well as females. Yet little has been researched on the prevalence of eating disorders among the transgender community.  However, the research is slowly emerging, giving us some insight on the impact felt in this community.

One study of 289,024 college students found that transgender students, compared to cisgender students, are almost five times as likely to report an eating disorder and two times as likely to use unhealthy compensatory methods (e.g., vomiting) for weight control.*  Another study of almost 2,500 teenagers shows that transgender individuals are almost three times as likely to restrict their eating, almost nine times as likely to take diet pills, and seven times as likely to take laxatives.*

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Peaceful Eating: Creating Calm Throughout the Holidays

Christie Caggiani, RDN, LDN, CEDRD

We have arrived at holiday season. Here we are.


This time of year is fraught with crazy busy schedules, high expectations, traditions, emotions, exhaustion….and food is often central to all of it. But does food need to add more confusion, or can it actually help us create some peace, balance and sanity during this festive time?

It is my belief and experience as a nutrition therapist that we often interact with and respond to food as a reflection of the way we “do life”. So if food is our Life on a Plate, then it’s no wonder we feel overwhelmed with food choices when we enter this intense, calendar-packed time of the year. Can we celebrate, be fulfilled and feel joy – both with food and our holiday experiences?

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Students Receive Tips on Fueling Their Creative Selves

Students in grades 3-12 gathered in West Palm Beach on Saturday, October 24, participating in the year-round enrichment programs offered through the Kravis Center.   Underwritten by the Lawrence J. and Florence A. De George Charitable Trust, the De George Academy for Performing Arts provides instruction and coaching to economically disadvantaged youth interested in the performing arts.  Through these ongoing programs, students learn necessary tools and strategies that enrich their creative lives.

Christie Caggiani, RDN, LDN, CEDRD, understands how good nutrition helps students achieve goals.  Christie’s presentation, “Fueling Your Creative Self: Simple Strategies for Super Students”, emphasized the connection between regular, balanced meals fueling creative endeavors.  Children eagerly listened on as Christie shared important tips that included:

  • Always eat breakfast!
  • Don’t skip meals. 
  • • Have grains, protein, and color at all meals.
  • • Eat when you’re hungry, stop when just right.
  • • Have Growing Foods (whole grains, fruits & veggies, dairy, nuts, protein) for a sharp brain & body, and include Sometimes Foods (candy, desserts, sweets)
  • Enjoy your food and let creativity shine!

Wishing the best to these budding super stars!


In May, Team Oasis had the pleasure of meeting Lindsey Averill, feminist activist, scholar, and filmmaker.  Averill, a PhD candidate at Florida Atlantic University, is currently working on her first documentary.  Fattitude explores representations of overweight people in popular culture, which often include unflattering stereotypes, discrimination, and ridicule. Through interviews with scholars and activists, Fattitude reveals to viewers that every body is worthy of love, pleasure, and acceptance.

Ms. Averill shared the Fattitude trailer, as well as unreleased clips.  After viewing, we spoke passionately about the objectification of women’s bodies, the false correlation between thinness and health, and even fatkinis.  It was evident to all in attendance that cultural perceptions of body image need to be examined and discussed openly, regardless of the reactions of others.

Fattitude is an ambitious project currently in its post-production stages.  Fundraising efforts have already generated over $44,000; however, costs have proven to be higher than anticipated.  Here is what we ask of you:

  1. View the trailer at:
  2. Help spread the word!  Discuss Fattitude with friends, family, and co-workers.
  3. Follow Fattitude on Facebook, Instagram, and Twitter.
  4. If you feel compelled to give, make a tax-deductible donation.

Just this past weekend, body shaming made national news.  We cannot wait for Fattitude to change minds and hearts.  What are your thoughts?

Snacking Sense: Tips for Healthy Kids

Christie Caggiani, RDN, LDN, CEDRD

Since all foods can be part of a balanced eating relationship, I tend to recommend buying full-sized bags of products (chips, crackers, cookies), rather than 100-calorie individual versions.  Not only does this save you some money, it most importantly avoids all of the subtle messages that we give our kids by placing “calories” as part of a food decision.  Have you ever had a 100-calorie bag of anything?  Were you completely and utterly satisfied after finishing it?  If you wanted another one, did you feel like you “shouldn’t”?  In my experience, they leave us hanging, wishing we had more. There is nothing magical about that number “100”, except that it’s an effective marketing strategy.  By focusing on the number, we have a much harder time listening to our tummies and the signals that tell us if we are still hungry or comfortably satisfied.  Instead, present these foods on a plate or in a serving bowl, allowing kids to fill their own plate and gauge the food amounts to their hunger levels.  For snacks you need to pack, keep some reusable snack containers on hand and make certain to include enough so that they can eat sufficiently.  Happy Snacking!


Metabolism: A Neutral, Natural Process

by Kristina Bergman

Everybody, regardless of color, shape, or size is born with a metabolism.  It breaks things down—so we may have the energy to do the things we love—and it also builds things up—so our cuts may heal fast and our hearts may beat strong.  Certainly, the unseen reactions that compose our metabolic pathways are fundamental to our very existence.  However intricate and complex, this innate system of “breaking down” and “building up” only requires one conscious effort from each of us: to consume the nutrients it requires to keep the system running.  All three of the macronutrients play countless essential roles: protein is converted into the enzymes that metabolize carbohydrates into usable energy and fats/lipids into the compounds that create our hormones and strengthen our minds.  Our bodies are made of countless interconnected, interdependent systems, each relying on an adequate intake of protein, carbohydrate and fat.  Our metabolism knows it needs these things to keep us going.  So, in the midst of continuous, devoted effort, it speaks to us.  When it needs fuel, it tell us to be hungry—so that we may seek its nutrients—and when it has all it needs, it tells us to feel satiated—so that it can work its scientific magic.  Our brilliant metabolism naturally tells us what to do; all we have to do…is listen.

 By Kr

Beat The Heat

by Kristina Bergman 

As a South Floridian in the summertime, you know this all too well: whether you’re taking the dog out for a walk, or just trying to get from the front door to the car, it’s nearly impossible to be outside without breaking a sweat!  Sweating out water and other nutrients can leave us feeling tired and dehydrated, which can ruin our summer fun.  Thankfully, Mother Nature doesn’t want us to melt!  To help endure the grueling heat, we’re offered an abundance of the perfect thing to keep us hydrated and full of energy: fruit!  Full of water, vitamins and even fiber, fruit can help us beat the heat and enjoy the summery flavors we love. Cherries, nectarines, berries, honeydew, peaches and plums are all in season.  You can always enjoy fruit on its own or incorporated into your favorite dishes to give them a summer twist: try topping your oatmeal or cereal with berries or slicing up pears or mangos for a salad.  So if you’re feeling the heat this summer, “Don’t sweat it!”  Remember that fruit is a nice refresher.


What is a Registered Dietitian Nutritionist?

The Institute of Medicine identifies registered dietitians as qualified professionals for nutrition therapy. According to IOM, “the registered dietitian is currently the single identifiable group of health-care professionals with standardized education, clinical training, continuing education and national credentialing requirements necessary to be directly reimbursed as a provider of nutrition therapy.”

A Registered Dietitian Nutritionist (RD or RDN – these credentials can be used interchangeably) is a food and nutrition expert who has at least a Bachelor Degree in Nutrition and has completed a rigorous training with supervised practice in a variety of clinical settings.  The majority of Registered Dietitians work in the treatment and prevention of disease (administering medical nutrition therapy, often part of a multi-disciplinary team), in private practice, hospitals, other health-care facilities, as well as research, business and sports nutrition. All Registered Dietitians are nutritionists, however not all nutritionists are Registered Dietitians.

The following criteria have to be met to earn the RD or RDN credential:

  • Completion of a ACED (American Council for Education in Nutrition and Dietetics)-accredited supervised pre-professional experience program including practicing at a variety of settings such as healthcare facilities, community agencies, and foodservice institutions.
  • Passing an extensive national Registration Examination for Dietitians administered by the Commission on Dietetic Registration (CDR).
  • Completion of continuing professional educational requirements to maintain registration.

Additionally, nearly all states have their own licensure requirements which further helps regulate standards within which the dietitians must practice.

How does a Registered Dietitian differ from a Health Coach, Health Counselor, Nutrition Coach or Holistic Wellness Provider?

As people have become more interested in nutrition and overall health, there has been a rise in programs and services disseminating nutrition information.  Additionally, online nutrition schools are emerging, many of which have no prerequisite to enter.  They usually do not require or produce a Bachelor’s degree and can be finished in less than a year online.  There is typically not a licensure governing the practices of Health Coaching or Nutrition Coaching, and they are not reimbursable by insurance plans.  Registered Dietitians have a minimum Baccalaureate degree granted by a U.S. regionally accredited college or university, or foreign equivalent.  There are a variety of specialty certifications available within the field, including sports nutrition, eating disorders, pediatrics and diabetes to name a few.  Many RDs practicing in outpatient or private practice settings employ a therapeutic approach as a Nutrition Therapist, guiding their clients toward balanced and normalized eating patterns.

Christie Caggiani, RD, LDN, CEDRD is Co-Founder of Therapeutic Oasis of the Palm Beaches in Delray Beach, Florida. Christie is a Registered Dietitian within the State of Florida and is certified as an Eating Disorder Registered Dietitian from the International Association of Eating Disorders Professionals (IAEDP).

Savor the Flavor of Nutrition: Olive Oil

I knew I liked olive oil, but after visiting Spain and Italy, I developed a newfound interest in it, something so basic.   As I think about being an intuitive eater, I am reminded that our bodies enjoy foods that are healthful for them – sometimes we simply need to slow down, pay attention and taste.   So take a moment to do so, knowing that olive oil is also helping you in a variety of ways, by providing:

  1.  Anti-inflammatory phytonutrients, which may prevent development of heart disease and stroke (by reducing the damage to the heart by atherosclerosis, or the build up of fatty deposits in the inner walls of arteries)
  2. Anti-oxidants, i.e. vitamin E, which reduce oxygen free radicals in the body, reducing risk of cancer development 
  3. Polyphenols, whichreduce LDL cholesterol levels, and may lower overall cholesterol levels
  4. Monounsaturated (good) fat–your body needs fat to carry out daily processes, but not harmful saturated fats and hydrogenated oils–monounsaturated fats are helpful in preventing chronic diseases like heart disease and diabetes, whereas other types of fats contribute to their development
  5. Skin health- UV radiation causes oxidation of skin cells, which accelerates appearance of aging and sun damage–antioxidants in olive oil prevent this process
  6. A few studies have found that olive oil consumption, instead of hydrogenated oil, trans fat, etc. is associated with alower risk of depression, possibly related to anti-inflammatory and anti-oxidant properties of olive oil that boost overall healthy brain functioning.
  7. May reduce risk of developing Alzheimer’s disease, due to  oleocanthanal which breaks down neuron-damaging proteins that contribute to the Alzheimer’s development.

The next time you drizzle some olive oil on your salad, or dab it on some fresh bread, notice its flavors and savor the fact that you’re giving yourself something that is truly making your body smile, inside and out.

 Christie Caggiani, RD, LDN, CEDRD is Co-Founder and Registered Dietitian at Therapeutic Oasis of the Palm Beaches in Delray Beach, Florida.

Is Restricting Food Really OK?

“We don’t keep bread in the house.”     “One serving is enough – kids don’t need seconds.”      “We just have protein and veggies at dinner.”      “Why is my child sneaking food and snacking all the time?!”

Hmmm – at first glance, these may seem like separate, unrelated statements.  There is, however, a common thread and a chain reaction that is in play throughout the scenarios…and it all starts with restriction.  Carb restriction, calorie restriction, food restriction.   If you consider the unrelenting headlines that tell us obesity is an “epidemic”, that individual foods will either kill or save us, and the sneaking messages that lead us to think we’ll only be happy if we are sexy and skinny, then it makes some sense that people are grabbing at the latest food rule (aka, restriction), to take control of their or their kids’ lives.   Yet the more we reach for restriction, the more out of control we become.

Let’s keep it straightforward.  There are some basic side effects of over-controlled under-eating:

  • it confuses body chemistry, triggering it to more readily lose muscle and regain weight as fat
  • it causes feelings of deprivation and depression that often rebound to overeating
  • it creates a lowered self-esteem, and disconnects individuals from their emotions  and sense of well-being
  • it creates irritability, decreases concentration and memory, (especially if carbs are limited) and causes tension in relationships
  • it can disrupt a female’s menstrual cycles
  • it makes exercise ineffective, because there isn’t enough fuel to run your body’s basic processes

So when you feel the need to snack on cookies and chips after the kids have gone to bed, notice if you’ve eaten enough during the day or pulled carbs out of the meal prior.  We can’t function effectively if we are depriving ourselves of enough fuel – and we are destined to swing the pendulum the other direction to try to create balance.

And the next time you feel the emotional tug to try the latest fad diet, label carbs as evil or tell your kids to stop eating, take a deep breath and remember:

Eating is Normal.  Restricting is Ridiculous.   

 Christie Caggiani, RD, LDN, CEDRD is Co-Founder and Registered Dietitian at Therapeutic Oasis of the Palm Beaches in Delray Beach, Florida.