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Family and the signs of eating disorders

Sarah Blake, Social Worker and Outreach Coordinator at the Center for Eating Disorders at Sheppard Pratt, offers insight on what factors may cause eating disorders, and associated with signs and symptoms.

Eating disorders can develop for a number of reasons, and loved ones should be watchful for the signs that may lead to a family member developing such a condition.

Although the physical signs of having an eating disorder may vary depending on which condition your child or family member may have, here are some potential characteristics, or historical personal issues, that may lead to the development of an eating disorder:

Interpersonal signs
• Troubled family and personal relationships
• Difficulty expressing emotions and feelings
• History of being teased or ridiculed based on size or weight

Psychological signs
• Low self-esteem
• Feelings of inadequacy or lack of control in life
• Depression, anxiety, anger or loneliness

It’s important to note, that while all of these signs should be closely monitored, there’s no exact recipe that dictates which specific factors may lead to an eating disorder. The more we can do to build awareness of the causes and risks, the better.
The following are tips for parents to help prevent eating disorders among their children:

• While it is wonderful to praise your child, it sends a mixed message when you tell them they are beautiful and then negatively critique your own body in front of them
• Do not allow family members to tease one another or those outside the family about body size, shape or appearance
• Encourage and engage in healthy eating
• Educate your children about the media images they see, and teach them to be informed consumers

Most importantly, get help and support for yourself and if necessary, for your child and/or family. Getting into a treatment program at an early stage of the disorder, increases ones chances of a positive experience in the recovery process.

Please call the Center for Eating Disorders at Sheppard Pratt at 410-938-5252 to speak with someone in confidence.

Published by Kara DePaola
April 23rd, 2008 in Body Image
0 Comments

Parent/Child Co-Current Eating Disorder – Q&A with Janet Treasure

Dr. Janet Treasure, an internationally renowned expert in eating disorders, offers her insight on parent/child co-current eating disorder - a topic she will be discussing at the upcoming symposium on April 12, 2008, hosted by The Center for Eating Disorders at Sheppard Pratt.

The symposium will serve to educate the professional community on how to support and promote eating disorder prevention efforts. Keep an eye out for interviews with other experts as we get closer to the date!

How common is it to have parent/child co-occurring eating disorders?

Though there are no concrete figures, about less than 5% of eating disorder cases are parent/child co-occurring. This is not to say, however, that a parent’s eating disorder does not have a monumental impact on how a child perceives eating habits and body image.

Are children of parents with eating disorders more or less likely to receive treatment?

The good news is that preliminary findings show that children of parents with eating disorders are more likely to get treatment early. However, there is also evidence that the outcome of treatment is less successful if there is a family history of an eating disorder.

How does one intervene when the parent of a child is identified to have an eating disorder?

Unfortunately, there is no simple answer to this question. It depends on numerous things and its important to consider such things as:

Whether the parent themselves has acknowledged that they have an eating disorder;
Whether it is thought that the parental eating attitudes are acting as maintaining factors for the child’s eating disorder;
Whether or not the co-parent is involved.

The most important step is ensuring that the entire family is involved. Sharing common goals, such as working together to ensure that they are not maintaining the illness by enabling behaviors, and aiming to help the individuals with an eating disorder overcome eating disorder behaviors. Families need to make sure that the individuals are eating socially with sufficient amounts and nutrients. It is especially important for the parent without an eating disorder to play a key role. This may involve several stages:

1. Coming to terms with guilt or avoidance in the feeling that they have not been able to provide a safe protected environment for their child.

2. Understanding that their child’s eating disorder is different than that of their spouses and the realization that management plans in dealing with the eating disorders will have to be different.

3. The role of a spouse is very different from that of a parent in supporting an individual with an eating disorder. Developmental stages and emotional maturity will need to be factored at all times.

4. Understanding that while a spouse is dealing with an eating disorder, it will make it difficult for them to play a balanced care-giving role.

5. Providing balance in dealing with both eating disorder cases.

Read more about Dr. Janet Treasure.

If you are a mental health professional and are interested in hearing Dr. Treasure speak on this subject, you can register for the April 12th symposium.

Published by CED Editor
April 11th, 2008 in Editor's Picks
1 Comment

Night Eating Syndrome – Q&A with James Mitchell

Dr. James Mitchell, an internationally renowned expert in eating disorders, discusses the two most common types of night eating syndrome. He will be presenting this topic at the upcoming symposium on April 12, 2008, hosted by The Center for Eating Disorders at Sheppard Pratt.

What is night eating syndrome?

There exist at least two forms of night eating syndrome, or NES. The first, most commonly referred to as NES, involves people who overeat late in the day and/or get up during the night to eat. These people also have marked problems with insomnia and are fully aware of what they are doing when they wake up to eat. The other form of night eating is usually related to a sleep-related eating disorder. Those individuals wake up and eat during the night, but many times are amnestic for it and are only partially aware of what they are doing. This type of night eating is a parasomnia, much like sleepwalking.

How does an individual identify that they are struggling with this issue?

People with NES are usually fully aware of their problem. Those with a sleep-related eating disorder may be amnestic for the eating episodes, but may discover evidence the following day that they have been eating during the night; such as food that has been left out, or that the oven has been left on.

Is there effective treatment available for NES?

There is a structured form of counseling which has been manualized and is available as a self-help manual by Allison & Stunkard for NES. For sleep related eating disorder, medications are usually indicated and can be quite effective.

Read more about Dr. James Mitchell.

If you are a mental health professional and are interested in hearing Dr. Mitchell speak on this subject, you can register for the April 12th symposium online at www.eventville.com/sheppardpratt

Published by CED Editor
April 9th, 2008 in Glossary Definitions, Editor's Picks
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Borderline Personality Disorder – Q&A with Randy A. Sansone

Dr. Randy A. Sansone, an internationally renowned expert in eating disorders, talks about borderline personality disorder and the unique challenges those who suffer from it may face. He will discuss this topic at the upcoming symposium on April 12, 2008, hosted by The Center for Eating Disorders at Sheppard Pratt.

What is borderline personality disorder?

Borderline personality is a longstanding dysfunction in personality that is characterized by three fundamental features: (1) a superficially intact social facade or veneer; (2) longstanding difficulties in self-regulation (i.e., an inability to effectively regulate oneself, which might emerge as eating disorders, alcohol/drug problems, promiscuity, difficulty regulating money, chronic pain syndromes); and (3) chronic self-harm behavior (e.g., self-mutilation such as cutting, hitting, burning, or scratching oneself; suicide attempts; engagement in abusive relationships; high-risk hobbies/behaviors with the intent of gambling with death).

How frequent does this co-occur in individuals with eating disorders?

The data indicate that about one-quarter to about one-third of individuals with eating disorders have co-morbid borderline personality disorder. The disorder is less common among those with restricting anorexia nervosa and more common among eating disorder syndromes characterized by impulsivity (such as anorexia nervosa, binge-purge type; bulimia nervosa, purging type).

What unique challenges face this population in learning to manage their eating disorder?

While standard eating disorder treatment is helpful, it must be augmented with psychotherapy intervention for the personality disorder. In many cases, the function of the eating disorder symptoms extends beyond food/body/weight issues and may relate, in addition, to self-harm behavior. In addition, there are oftentimes adjunctive self-regulatory and self-harm issues that must be addressed in treatment (e.g., substance abuse, suicide attempts). Because borderline personality is oftentimes associated with early developmental trauma, these issues must be taken into account, as well.

**Some data suggests that individuals with eating disorders and borderline personality may have more severe symptoms as well as less robust treatment outcomes, compared to individuals with eating disorders, alone. Other data suggests that the treatment response to the eating disorder symptoms may improve equally well, but the individual’s overall functionality is less.

Read more about Dr. Randy A. Sansone, M.D.

If you are a mental health professional and are interested in hearing Dr. Sansone speak on this subject, you can register for the April 12th symposium online at www.eventville.com/sheppardpratt.

Published by CED Editor
April 8th, 2008 in Glossary Definitions, Editor's Picks
1 Comment

“Your Child Registered at Miss Bimbo.”

Here lies the subject line of a confirmation email sent after registering at Miss Bimbo - the world’s first virtual fashion game, approved for nine year old girls, where young women aspire to become the world’s most famous and beautiful bimbo.

Miss Bimbo allows girls as young as nine years old to choose outfits, accessories and boyfriends for their respective Miss Bimbo avatars. Once they have settled on a boyfriend who “brings them money for all their girlie needs - earning them more bimbo attitude,” they can flirt or dance with them at Club Bimbo. They can also search for an apartment, enlist a personal trainer and visit a plastic surgeon for a face lift or even breast augmentation, if they’re feeling adventurous.

Numerous news outlets have gotten word of the website and developed their own take on it. The site recently removed the option to purchase diet pills for one’s respective bimbo, citing an influx of negative media attention.

But we’ve seen at least one comment, praising the site, arguing that it teaches young children how to take care of their bimbo and instills values concurrent with the “real world.”

Although the removal of the diet pill feature is a step in the right direction, Miss Bimbo still refers to young women as “bimbos” and touts an unrealistic weight standard, encouraging the use of a personal trainer to get rid of “love handles, packed on by excessive eating.”

As we write this post, it’s our intention to bring to the forefront the negative impact this controversial site could have on young women. We believe values such as responsibility and taking care of oneself can be instilled in ways other than channeling a website that infiltrates negative body image within the impressionable mind of today’s youth.

We’d like for our readers to sound-off about this website. Does this website sound like the “real world” to you? Having our voices heard will strengthen the online community as we resist the “values” society places on young women and men.

Published by CED Editor
April 4th, 2008 in Editor's Picks, Body Image
4 Comments

Athletes and Disordered Eating – Q&A with Ron Thompson

On April 12, 2008, The Center for Eating Disorders at Sheppard Pratt will host a symposium to educate the professional community on how they can support and promote eating disorder prevention efforts. Check out the Q&A with Dr. Ron Thompson, one of the five internationally renowned experts in eating disorders who will be presenting. Keep an eye out for interviews with other experts as we get closer to the date!

What is unique about the athlete’s environment that places them at risk for development of an eating disorder?

There are several factors that make athletes a special population at risk. Athletes have the same risk factors as non-athletes as well as factors that are specific to sport participation. The greatest risk has to do with the belief in the sport world, held by both coaches and athletes, that the leaner athlete performs better, which leads to dieting.

Significant risks also lie in the aesthetic, judged and endurance sports. “Good athletes” have similar traits to those who suffer from anorexia nervosa, which may predispose them to potential development of an eating disorder. Additionally, some athletes who wear revealing uniforms are more at risk for body dissatisfaction and competitive thinness.

Although these are all significant risk factors, I believe that the greatest risk to athletes is the challenge to identify an eating disorder within the sport world. If an at-risk or symptomatic athlete isn’t identified, they cannot be treated.

Another issue that complicates identification involves “sport body stereotypes” in which the stereotype of thinness is not only accepted as “normal,” but is also desirable. In such a situation, the athlete who may be too thin would be difficult to identify because she fits the stereotype. Another issue complicating identification is the presumption of health with good performance. Many in the sport world do not suspect an eating disorder if the athlete is performing well.

Finally, many in the sport world do not identify eating disorder symptoms such as weight-loss, amenorrhea and excessive exercise as symptoms, as they are oftentimes viewed as desirable.

What are a few key signs that an athlete may be developing and/or struggling with an eating disorder?

Although many athletes are able to perform well for quite some time despite their disorder, the disorder will eventually affect their health and performance. A decrease in sport performance may be the first sign. For female athletes, one of the first signs is often menstrual irregularity. The combination of too much training and inadequate nutrition leads to what has been termed “low energy availability,” which has been adopted in the sport world as the explanation for exercise-induced menstrual dysfunction. Stress fractures and overuse injuries can also be an indicator, as well as if the athlete is doing more training than is recommended by his/her coach.

What advice can you offer for either an athlete or a coach on how to minimize the risk for this population?

I have always believed that the coach is the most important and most influential person in the process. Coaches first need to recognize their power and influence with their athletes, which can either be used to promote or prevent eating disorders. They must commit themselves to learning the risks involved in their sport and more importantly how to prevent them, part of which has to involve de-emphasizing weight.

Athletes and coaches are most receptive to discussions about performance. Performance, however, cannot become subordinated to health. I suggest to coaches and athletes that, other than genetics, the most significant contributor to good sport performance is good health and the most significant contributor to good health is good nutrition.

Dr. Ron Thompson works for the Bloomington Center for Counseling and Human Development where he specializes in the assessment and treatment of anorexia nervosa and bulimia nervosa, specifically with athletes on their psychological issues, relating to eating and exercise. He has specialized in the treatment of eating disorders since 1986.

If you are a mental health professional and are interested in hearing Dr. Thompson speak on this subject you can register for the April 12th symposium online at www.eventville.com/sheppardpratt

Published by CED Editor
March 27th, 2008 in Editor's Picks, Body Image
2 Comments

The Center for Eating Disorders Receives more than 80 Posters for “Love Your Tree” Campaign

Here’s a press release that went out today regarding the Center for Eating Disorders’ “Love Your Tree” campaign:

The Center for Eating Disorders at Sheppard Pratt received more than 80 posters, created by students from five public and private schools in Baltimore County, in response to the Center’s second annual “Love Your Tree” campaign. This challenge invited students to create posters that confront narrow ideals about beauty, and embrace body diversity and acceptance. “Love Your Tree” is a body image campaign based on the work of Eve Ensler, the author of the award winning plays “The Good Body” and “The Vagina Monologues.”

“We really appreciate the creativity and energy the students have shown in crafting their posters that promote positive body image,” said Steven Crawford, M.D., associate director of the Center for Eating Disorders at Sheppard Pratt. “We are looking forward to holding the ‘Love Your Tree’ poster campaign next year and seeing more great work.”

The posters were displayed and participating students were celebrated during a reception held during National Eating Disorders Awareness Week. One poster was selected for reproduction and it was created by Ariana Vaeth, a seventh grade student at Sudbrook Magnet Middle School, who resides in Windsor Mill - see attached photograph. The title of the poster is “Evening Lit-tra-tree,” and depicts a girl reading the book “Love Your Tree” under the shade of a loving tree.

“Ariana’s poster really stood out for us because of its very visual impact, strong positive body image message and overall holistic approach to the theme,” said Julia Andersen, senior expressive arts therapist at the Center for Eating Disorders at Sheppard Pratt. “We thank all the participating schools and students for their great work.”

More than 60 people attended the reception, including students, their parents and family members, Dr. Crawford, Julia Andersen and Farrell Maddox, art supervisor at Baltimore County Public Schools.

Art is one form of therapy that the Center for Eating Disorders uses to help patients with eating disorders such as, anorexia nervosa, bulimia nervosa and binge eating, express feelings and explore conflicts. This course of treatment helps patients become more aware of the connections between eating disorder symptoms, negative body imagery and impulse control.

Schools interested in being notified of next year’s “Love Your Tree” poster campaign should contact Julia Andersen at the Center for Eating Disorders at 410-938-5227.

Published by Kara DePaola
March 13th, 2008 in Body Image
2 Comments

Jess Weiner – Living Life to the Fullest

As part of the 21^st National Eating Disorders Awareness Week, hosted by the Center for Eating Disorders at Sheppard Pratt, Jess Weiner (author of “A Very Hungry Girl” and “Life Doesn’t Begin 5 Pounds from Now”) met with and spoke to over 100 male and female children, teens and adults.

Jess was charismatic, energetic and light-hearted as she recounted her own journey and ongoing recovery from EDNOS (Eating Disorder Not Otherwise Specified). She kicked things off by showing “Onslaught”, a video created by the Dove campaign for Self Esteem. “Onslaught” encapsulates the assault of body image messages imposed upon consumers by the media. Audience members felt scared, confused and pressured after viewing the video. Jess also recommends checking out Evolution.

Jess’ experience with EDNOS and negative body image is felt by many worldwide. Having the chance to discuss personal experiences was a therapeutic exercise that Jess brought to the audience. She shared the following steps we can all take to capitalize on the opportunities in our own lives:

• Vote with the almighty dollar and control your intake of media: If a magazine makes you feel badly, don’t buy it.

• Walk your talk: Children listen, watch and absorb messages from parents, relatives and peers about body image.

• Embrace teachable moments on a daily basis: Discuss messages conveyed by ads in order to help build positive body image within your children.

• What are you willing to do today? If you’re not happy with the current path you’re on, take steps to change it. Taking the more difficult route can offer you a fuller, more satisfying life.

From everyone at the Center for Eating Disorders at Sheppard Pratt, thank you Jess for sharing your inspiring, motivating and moving journey with us. Read more about Jess’ personal story.

Published by CED Editor
March 10th, 2008 in Editor's Picks, Body Image
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The Artificial Pursuit of Perfection

…is apparently beginning at an increasingly younger age. Is this a surprise? Not to the doctors at the Center for Eating Disorders at Sheppard Pratt. The age of patients in need of eating disorder treatment is getting younger as well. The constant barrage of “perfect” images of ideal beauty creates a dissonance within all of us. But the new ways such insecurities are manifesting is even more worrisome.

According to a recent Newsweek Article, parents for children in the second grade are asking for retouching of their children’s school pictures. If there was some sort of bad-hair-day epidemic this might be excusable, but every photo-alteration agency contacted by Newsweek said that their clients are getting younger.

Some agencies even offer “restyled hair, blended skin, added makeup, reshaped eyebrows, enhanced eyelashes - even changed facial expressions. And then, of course, the photos are cropped and sharpened.”

“Today 42 percent of first-to-third-grade girls want to be thinner, while 81 percent of 10-year-olds are afraid of getting fat, according to a 2004 global study by the Dove “Real Beauty” campaign. Out of 3,000 women and girls surveyed by Dove in 10 countries, that study found that just 2 percent said they’d describe themselves as beautiful, while two-thirds said they avoided basic activities on days they felt unattractive, ranging from going to the beach or a party to showing up for work or school-or even voicing an opinion. ”

Here are some tips for how we can help kids understand and appreciate their own beauty:

1) Refrain from focusing on weight and shape in your comments about yourself. One way kids learn to dislike themselves is from watching us compare ourselves to others and listening to our comments about our own negative body image.

2) Educate children on the technology used to create the images they see in magazines and TV. Help them understand that the images they are viewing are constructed to sell a product, and to do that they use means to make us feel badly about ourselves that creates a need for said product.

3) Educate kids on healthy and positive ways to care for their bodies, such as using exercise as a means to feel our bodies move and grow stronger, picking a balanced variety of foods to nourish the body, limiting time spent in front of the mirror critiquing our bodies and more time spent doing things that we enjoy.

4) Focus on qualities other then how a person looks. Help kids to come up with a list of some of their positive characteristics such as understanding, humor, intelligence, and creativity, so they can be reminded of how much more there is to who they are then just the ways they look.

5) Encourage our kids to surround themselves with people and things that make them feel good about themselves and what they have to offer. Do the same with the individuals YOU surround yourself with!

Published by Kara DePaola
February 28th, 2008 in Body Image
0 Comments

National Eating Disorders Awareness Week: Q&A with Yoga Practitioner Heather Whittington

As part of the activities arranged by the Center for Eating Disorders at Sheppard Pratt to acknowledge National Eating Disorders Awareness Week, February 24 to March 1, Heather Whittington, a certified Phoenix Rising yoga therapy practitioner and meditation instructor spoke with us about the connection between eating disorders and yoga. See below for more info on yoga classes with her during NEDAW.

1. Do you think meditative and yoga therapies directly help ease the symptoms of eating disorders, like anorexia and bulimia, or do you think those disorders are inadvertently helped through the healthy self esteem that the therapies help create?

Healthy self-esteem is certainly a side-effect I encounter with both private Phoenix Rising Yoga Therapy clients and meditation students. Some say it out loud, others exhibit it though their actions. While I am not a researcher (yet!), my experience is that the majority of people I work with express a change in the relationship with their body. They begin to connect with the little things that feel good, often discovering that something as simple as their breath invites an element of self-acceptance and release. I can say that I have seen people respond to this work even in their first session! It affirms my commitment to this type of work over and over again.

A 2005 study from Psychology of Women Quarterly states that people who practice yoga “reported less self-objectification, greater satisfaction with physical appearance, and fewer disordered eating attitudes compared to non-yoga practitioners.” The article goes on to say, “results suggest that not all physical activities have the same relationship to disordered eating symptoms with increased participation, and some, such as yoga, may promote better eating habits with greater practice.” Furthermore, the study found that “yoga practice is associated with greater body awareness and responsiveness, which, in turn, are associated with lower levels of trait self-objectification, greater body satisfaction, and lesser disordered eating attitudes.” The study says, and I agree, that these results “are encouraging because they suggest that yoga may be a means to reduce the internalization of a self-objectified view in girls and women.”

2. What is it about yoga that positively affects self esteem?

There is a saying that in yoga there is no right or wrong, no good or bad, no better or best. In yoga, we learn the art of not comparing, but accepting this moment and ourselves just as we are. Sure, it takes practice and willfulness. It may seem impossible at first. But if you are courageous, and ready to step out of what Tara Brach calls the “trance of unworthiness,” you will find the rewards are endless. I have seen powerful transformations - in myself - in my clients. It often starts with something as simple as enjoying your breath. Ultimately, I would say that learning to be compassionate to one’s self, and eventually others, is the essence of the practice.

3. Why is yoga more effective at helping eating disorders than other types of exercise/therapies?

I like to say that yoga is a work-in, not a work-out. The first instruction in yoga is to incorporate “present moment awareness” into your practice. This is achieved by paying attention to your breath, to body sensation.

This means pay attention to what is happening right here, right now. Consider a gym full of cardio equipment with headphones and televisions, or people reading while on the treadmill. They have little connection to their body, and in many cases do not even enjoy what they are doing! By paying attention in a yoga class, many people find out that there are things about their body they actually like! “This stretch feels good” or “Hey! I feel my breath!” or “I noticed I stopped worrying for a moment.”

They learn to slow down, to watch their thoughts, and to be more aware and take an active role in their own life.

Unlike many exercise programs, in a yoga class you are experiencing your body in a way other than visual - it is rare that you will find mirrors in a yoga studio! If you can imagine stripping away the image of an ideal, and really experience your body from the inside, you might be surprised what you will find. I have seen many first-time practitioners weep as though they just reunited with a long lost friend. In this case, the friend is their body. It is powerful.

4. Are there certain types of yoga, or specific moves, that are more (or less) beneficial than others?

This depends on the person. Yoga class is an opportunity to find balance in your life. If you are anxious, competitive or lead a fast paced life with no downtime, you will benefit from the slow pace of a gentle, restorative class. If, on the other hand, you find it challenging to get out of bed in the morning, and feel you have virtually no energy, a flowing vinyasa class may be more your style. There are gradations in between. Ultimately, find a practice that helps you achieve equilibrium, and does not add stress and anxiety to your life.

As far as specific postures, there are many schools of thought. My style of yoga is non-prescriptive, so generally I will say find the postures that make you feel connected to your body, and explore them with curiosity.

5. Is it important to go to yoga in a group (for the support) or is stay-at-home-yoga OK too?

Why pick one or the other? Here are my thoughts:

I think many people benefit from a group class because of the support and the instruction that a certified teacher is going to give. While there is no “right or wrong,” there are certainly postures where you can harm yourself through improper alignment. It also gives you a way to keep your practice going - how many times have people decided to make a positive change, only to abandon the effort a few weeks in? The support you can get from a teacher and a class is priceless.

Don’t be discouraged if the first studio you visit isn’t for you. It may take a little shopping around to get the right chemistry. Another tip - call or meet the instructor prior to class and ask questions. If you are comfortable, let them know where you are coming from. Yoga teachers and therapists are compassionate people who want to support you. Use that to your advantage. If you are not comfortable in a group, you can always seek out a private instructor or yoga therapist.

Once you learn postures and techniques in class, practice at home. You will find that you develop your own posture series just by going to class! There are some good books and DVDs out there, but often they present an idealized image - what I call “model yoga.” By combining the two venues, the benefits will increase significantly.

6. How does meditation positively affect the urges/symptoms of binge eating?

Jean Kristeller completed a study at Indiana State University that implemented a 6-week meditation group. The results showed a decrease in the frequency of binge eating, as well as a decrease in reported depression and anxiety. It seems that the compassion towards self and others, paired with a clearer connection to physiological cues, were particularly important. I am especially happy to see that the practice of “forgiveness meditation” was incorporated into the study, and a reported half of study participants found this especially helpful. When we can forgive others, and ourselves, our life really can open up. When we slow down and listen to our body - I mean really pay attention - transformation can take place.

In addition to being a yoga instructor, Heather K. Whittington is also a former executive and winner of the 2003 Entrepreneur of the Year award. She now works with corporate executives and other people who are ready to manage stress and feel fully alive. We thank her for her input on this entry. To participate in Heather’s free yoga classes during National Eating Disorders Awareness Week, visit www.eatingdisorder.org/events.php or call CED at 410-938-5252.

Published by Kara DePaola
February 25th, 2008 in Celebrity Topical News
7 Comments