My new book, The Art of Playing Defense, launches today; Two favors; Eating disorders

1) My new book, The Art of Playing Defense: How to Get Ahead By Not Falling Behind, launches today! Here's the cover:

Unlike the three previous books I've written, which all focus on investing, this one is a labor of love. As I wrote in the dedication...

This book is dedicated to my three wonderful daughters, Alison, Emily, and Katharine, who make me proud every day.

If they find even a few nuggets here that help them discover what they want to do with their lives; overcome challenges; avoid setbacks; recover from adversity; seize opportunities; develop deep, loving relationships; achieve genuine happiness; and become the best people they can be, then, to me, the huge effort of writing this book will have been worth it.

And if it's helpful to others as well, that's icing on the cake!

To be successful and enjoy a happy life, it's important to do all the right things: Become well-educated and wise, develop a strong work ethic, always act with integrity, and treat others well.

What's equally important (but widely overlooked) is avoiding the calamities that can cause you to suffer, go back to square one, or worst of all, die a premature death.

My career has been focused on managing risks with investments. In this book, I turn my attention to the risks in our everyday lives.

The Art of Playing Defense is meant to be a practical and actionable guide filled with common-sense ideas for avoiding life's calamities, such as marrying the wrong person or having a good marriage go bad, getting thrown in jail, going bankrupt, or suffering a debilitating illness or injury. I've managed to avoid these disastrous outcomes – and hope I can help you do so as well!

It's no fun thinking about all the things that can go wrong in life, but if you want to get ahead, you have to start by not falling behind.

2) I wrote this book not to make money, but to help as many people as possible live their best lives, so to make it totally affordable to everyone, I've priced the Kindle e-book at only $0.99 for the next week.

I would be so grateful if you would buy the book here, and if you like it, post a review.

3) The pandemic has led to an alarming spike in eating disorders, which I'd like to discuss in the rest of this e-mail.

This has nothing to do with investing, but it very much has to do with managing risk in your life. Simply put: If you have a teenage daughter, this is the No. 1 risk that could destroy her – and your – life.

Let's start with this recent New York Times article: Eating Disorders in Teens Have 'Exploded' in the Pandemic. Excerpt:

As a psychologist who cares for adolescents I am well aware of the prevalence of eating disorders among teenagers. Even still, I am stunned by how much worse the situation has become in the pandemic.

According to the psychologist Erin Accurso, the clinical director of the eating disorders program at the University of California, San Francisco, "our inpatient unit has exploded in the past year," taking in more than twice as many adolescent patients as it did before the pandemic. Dr. Accurso explained that outpatient services are similarly overwhelmed: "Providers aren't taking new clients, or have wait-lists up to six months."

The demand for eating disorder treatment "is way outstretching the capacity to address it," said the epidemiologist S. Bryn Austin, a professor at the T.H. Chan School of Public Health and research scientist in the Division of Adolescent and Young Adult Medicine at Boston Children's Hospital. "I'm hearing this from colleagues all across the country." Even hotlines are swamped. The National Eating Disorders Association helpline has had a 40% jump in overall call volume since March 2020. Among callers who shared their age over the last year, 35% were 13 to 17 years old, up from 30% in the year before the pandemic.

It's not just teens who are affected, as this earlier NYT article notes: Trapped in the House With an Eating Disorder. Excerpt:

Indeed, some doctors, therapists and dietitians who treat eating disorders, such as anorexia, bulimia, and binge eating disorder, are reporting an overwhelming spike in the need for their services, with waiting lists growing at many practices and treatment centers across the country.

The National Eating Disorders Association reported a 41% increase in messages to its telephone and online help lines in January 2021 compared with January 2020. And in a study of about 1,000 American and Dutch people with eating disorders published last July, more than one-third of subjects reported that they were restricting their diet and increasing "compensatory behaviors," like purging and exercise. Among the Americans, 23% also said they would regularly binge-eat stockpiled food.

"I'm seeing more clients, and I'm getting clients who are sicker when they come to me, because we cannot get them access to a higher level of treatment," said Whitney Trotter, a registered dietitian and nurse in Memphis who provides one-on-one nutritional counseling for adolescents and adults of color with eating disorders. She noted that many in-patient treatment centers are fully booked due to the heightened demand.

The uptick in her practice stems from a mix of relapse cases, like Ms. Hill's, and disorders that have newly taken hold in the past year...

Teenagers have been particularly vulnerable to developing eating disorders during the pandemic, both because adolescence is already the most common time for such struggles to emerge and because of the added pressures they face now. "It's a combination of the loss of structure, the loss of peer connections and the loss of their usual activities," Dr. Muhlheim said. "They have all this time and they decide to focus on an exercise program, or maybe it feels like running is the only thing they can really still do. But we know exercise is a huge trigger."

That's how it started for Lily, a 16-year-old high school sophomore in Los Angeles who said that body image anxieties weren't a big part of her life until the pandemic. "I don't think weight loss was ever on my mind at all," she said. "It was more of, 'I love running, I have all this time, so why not push myself and see how far I can run?'" She began working out every day to fill the time previously occupied by school and team sports.

5) Here's what I wrote about eating disorders in my new book:

Eating Disorders

The single thing I worried about most as my daughters went through their teenage years was that they might develop an eating disorder. It's a widespread problem in America. According to a 2018 New York Times article entitled "Recognizing Eating Disorders in Time to Help”:

According to the Family Institute at Northwestern University, nearly 3% of teenagers between the ages of 13 and 18 have eating disorders. Boys as well as girls may be affected. Even when the disorder does not reach the level of a clinical diagnosis, some studies suggest that as many as half of teenage girls and 30% of boys have seriously distorted eating habits that can adversely affect them physically, academically, psychologically, and socially.

Eating disorders can ultimately be fatal, said Dr. Laurie Hornberger, a specialist in adolescent medicine at Children's Mercy Kansas City. "People with eating disorders can die of medical complications, but they may be even more likely to die of suicide. They become tired of having their lives controlled by eating and food issues."

The problem is especially common among, though not limited to, gymnasts, dancers, figure skaters, models, wrestlers, and other athletes, who often struggle to maintain ultra-slim bodies or maintain restrictive weight limits. The transgender population is also at higher risk for eating disorders.

It is not unusual for teenagers to adopt strange or extreme food-related behaviors, prompting many parents to think, "This too shall pass." But experts say an eating disorder – anorexia, bulimia or binge-eating – should not be considered "normal" adolescent behavior, and they urge the adults in the youngsters' lives to be alert to telltale signs and take necessary action to stop the problem before it becomes entrenched.

As bad as the problem is nationally, it's an absolute epidemic among teenage girls in wealthy families like mine, thanks to a complicated web of factors, including a cultural emphasis on thinness and the systemic misogyny that led to it.

I can easily think of a half-dozen close friends with daughters who have eating disorders, and every time I go jogging in Central Park, I see multiple women who are clearly anorexic – just skin and bones (though almost half of those with anorexia are at or above normal weight). Eating disorders can last a lifetime and dramatically increase the chances of broken lives and, as noted above, even suicide. I've seen it up close, and it's heartbreaking.

The problem isn't limited to girls trying to lose weight. According to a 2019 study, "Predictors of muscularity‐oriented disordered eating behaviors in U.S. young adults," among young adults aged 18 to 24, 22% of males and 5% of females were striving to gain weight or build muscle by relying on risky eating habits, including overeating, and using poorly tested dietary supplements and anabolic steroids.

On the other end of the spectrum, 60% of the girls surveyed said they were trying to lose weight. Some maintained unbalanced diets that can jeopardize growth and long-term health. Others resorted to induced vomiting, laxatives, diuretics, diet pills, or engaged in other hazardous behaviors like fasting or excessive exercise.

The pandemic has undoubtedly made things worse, as this June 2020 NYT op-ed, "Disordered Eating in a Disordered Time," highlights:

"Then the pandemic happened and threw a huge wrench in my recovery," Mx. Roll said. "The rationing of food, the loss of a regimented schedule. It all happened so quickly. It was the perfect ground for unhealthy coping mechanisms to start sucking me in."

Now Mx. Roll is not working, so the days are unstructured and lack the comfort of meals with neighbors. Mx. Roll feels anxious when friends report that, because of the pandemic, they are in the best shape of their lives. "I keep having to remind myself that exercise and productivity don't define your worth," Mx. Roll said.

Roughly one in 10 Americans struggle with disordered eating, and the pandemic has created new hurdles for those managing difficult relationships with food. Working from home means spending the day next to a fully stocked refrigerator. Grocery trips are less frequent, creating pressure to load up. Social meals are out of the question. And many individuals feel an enhanced degree of uncertainty and angst, which can exacerbate existing mental health challenges.

"When the world feels out of control, people want to have control over something," said Jessica Gold, a psychiatrist at Washington University in St. Louis, who treats patients with eating and other mental health disorders. "Often, it's what you put in your mouth."

In March and April, the National Eating Disorders Association, or NEDA, saw a 78% increase in people messaging its helpline compared with the same period last year. Crisis Text Line, a nonprofit organization that provides mental health support by text, saw a 75% increase in conversations about eating disorders in the two months since March 16, to around 700 conversations from around 400 conversations weekly. A vast majority of those texters – 83% – were women, and more than half were under the age of 17.

"There are jokes circulating about people's fear of weight gain during the pandemic," said Claire Mysko, the chief executive officer of NEDA. "There are influencers putting out messages about what you should and shouldn't be eating. On top of that we're seeing pictures of empty grocery shelves. That can be a trigger to people with eating disorders."

Community is often a critical component of healing from an eating disorder, so the isolating nature of the pandemic has been especially difficult for those in recovery...

In another NYT article in May 2020, "I Have an Eating Disorder but Can't Escape the Kitchen," a woman named Susan Burton, who is in her mid-40s and has been struggling with eating disorders since adolescence, wrote:

Stay-at-home orders present special challenges for people with eating disorders. The kitchen is always there: You can't get away from it. You can't get away from food online, either, where it's more present than ever: Sourdough starters and bean shortages and the ease with which people with healthier, typical relationships with food joke about these things, or fill their Instagrams with photos of family meals. I don't begrudge others that ease; I long for it.

Eating disorders are isolating. They are often misunderstood, perceived as the kind of thing you could get over if you just got a grip. Right now, many in our country are suffering profoundly, facing death and loss of livelihoods. Being able to afford food is a marker of privilege. Shouldn't our primary relationship with food be one of gratitude for it?

It's not that simple for people with eating disorders. For someone with an active eating disorder, food can be an agent of destruction. For someone in recovery, isolation can prompt a shift to old coping mechanisms...

Parents need to be hypervigilant. If you suspect that your child has an eating disorder, intervene quickly and forcefully. It's critical to nip it in the bud – both before the disease progresses and before they turn 18 (at which point they are legally an adult, and you can no longer compel them to get treatment).

The Family Institute has listed these signs to look for:

• Restricting an increasing number of food groups without replacing them with others. "Kids announce they want to eat healthfully and eliminate sweets, then carbs, then fats, and soon there's little left."
• Significant weight change. Teenagers can become fixated on the numbers on the scale and continue to pursue weight loss despite having no evidence of a weight problem.
• Repeated extended trips to the bathroom, especially with water running to conceal vomiting, a part of the binge-and-purge cycle of bulimia.
• Excessive exercise, especially when coupled with restricted eating habits.
• Avoiding activities that involve food, like family meals or friends' parties. Comments like "I'll eat in my room" or "I'm not hungry – I had a big lunch" can be a sign of unhealthy food avoidance.
• When such indicators are coupled with accompanying symptoms like reduced energy, isolation, irritability, and social withdrawal, professional help should be sought. If possible, referral to an eating disorder center is ideal.

My wife Susan and I very deliberately did a number of things to reduce the chances that our girls would develop eating disorders. We never discussed dieting or weight (studies show that dads are particularly important in this regard, so I was careful never to comment on any woman's appearance or weight).

I remember one time when I was out in the park with one of my friends and our daughters. We stopped at a convenience store to grab something to drink. When his 10-year-old selected a bottle of chocolate milk, he told her to put it back, saying, "That'll make you fat." I was horrified – he'd just dropped a neutron bomb on her, and he wasn't even aware of it!

Susan and I have been careful never to make food an issue. She cooks healthy meals, and we have plenty of mostly healthy food in the house. But if the girls want to snack on Frosted Mini-Wheats or have a bowl of ice cream at night, we don't say a word.

And, as noted earlier, we raised them to be physically strong, athletic, and self-confident. While it's impossible to completely insulate them from outside pressure to look a certain way, all three of them are active and have healthy body images.

Best regards,

Whitney