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How Does Stress Affect Your Metabolism?

Brooke

Did you know that your metabolism can be affected by stress? Most people think that their metabolism increases during stressful times, but actually it has the opposite effect for most people.

Some amount of stress is “normal”, and actually encourages your body to produce the appropriate amounts and types of chemicals to keep in a state of equilibrium. When your body is in balance, you will occasionally produce stress chemicals (hormones) to handle the stress and then your body goes back to normal. This level of physiological stress is typical, and one’s metabolism isn’t greatly impacted for any length of time.

The state that many of you find yourself in, however, is not a “normal” amount of stress. You may experience heightened stressors in your home environment and/or work or school environment. These stressors are ongoing and unfortunately, some of them aren’t controllable by you. Added to the outside stressors are the ones that are controllable by you, but often are the worst offenders when it comes to the amount of stress chemicals you produce. Why are they the worst offenders? Because they are happening all the time, instead of occasionally. If stress chemicals slow down your metabolism, wouldn’t you want to lessen them if you could?

A quick lesson in physiology:

As humans, we have an autonomic nervous system (beyond our conscious control) that regulates our internal organ system (heartbeat, lung function, brain, etc). The two sub-parts of this autonomic nervous system are the sympathetic nervous system and the parasympathetic nervous system. In very general terms, the sympathetic one causes us to “act” where the parasympathetic one causes us to “relax”. Another way to look at them is “quick response” and “slow response”.

Stress activates the sympathetic nervous system and our “fight or flight” response. Stress de-activates our parasympathetic (relaxation) nervous system. It makes sense, for example, if you are being chased by a saber-tooth tiger, you would want your “fight or flight” response to kick in to save you from being eaten.

During “fight or flight”, your body produces a surge of cortisol, a stress hormone, as well as insulin. Both of these hormones accelerate fat storage. The movement in your intestines slows down (your body isn’t interested in digestion when a saber tooth tiger is after you). Blood flow to your gastrointestinal tract drastically slows down. There is a significant decrease in your digestive enzyme production, as well as a decrease in thyroid hormone production. Healthy gut bacteria die off, and you excrete essential minerals and vitamins. There’s an increase in inflammation and a decrease in oxygen. In a nutshell, when you are in a constant state of stress, or “fight or flight”, your metabolism slows down.

What does all this mean for you?

Ask yourself 2 questions:

1.      Where am I creating my own unnecessary stress?

2.      How can I lower the stress that I have created?

Are you too hard on yourself? Are you taking on too many responsibilities that you don’t need to? Are you not speaking up for yourself? Are you taking on others’ stresses as well as your own? Are you speaking negatively to yourself?

Studies show that NEGATIVE SELF-TALK is a tremendous controllable stressor. This is an unnecessary stress that will have an enormous negative effect on how you digest and assimilate your food. If you are “trash talking” yourself all day long, beating yourself up for anything and everything that you do, you are hurting yourself in an unconscious physiological way, and slowing down your metabolism.  How many of you say things like:

·        I’ll only be happy when I lose weight.

·        I am disgusting.

·        I hate my body.

·        Everyone else is skinnier than me.

·        I suck.

·        I’m worthless.

·        I’m a loser.

YOU ARE SLOWING DOWN YOUR METABOLISM EVERY TIME YOU SAY THESE COMMENTS TO YOURSELF.

On the other hand, if you REDUCE OR STOP some of your controllable stressors and trash self-talk, AND attempt to add pleasurable things into your life like:

·        sense of purpose

·        healthy connections/relationships

·        sense of belonging

·        spirituality

·        healthy hobbies

·        relaxation

·        quality, enjoyable food and drink

·        sunshine

·        POSITIVE (or neutral) SELF TALK

You will have a positive effect on your overall well-being, you will dramatically reduce your physiological level of stress, and you will effectively increase your metabolism.

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Tips for “Normal” Eating

The following information is the best I’ve seen, as a basic model for trying to normalize disordered eating. It is especially geared for those individuals who have been chronic dieters. 

No matter how many years or decades you have overeaten or how many diets have failed you, you still can learn how to become a “normal” eater—eating when you are hungry, choosing satisfying foods, remaining aware while eating and enjoying food, and stopping when you are full or satisfied.

 

Note: You did not fail on these diets. These diets failed you.

To succeed at eating “normally”, you will need to:

  • Focus like a laser on eating “normally”
  • Stay persistent like a dog digging for a bone
  • Not expect overnight success
  • Switch your attention from the scale to your appetite
  • Learn effective life skills to manage stress and internal distress

Disregulated eaters can learn how to eat “normally.” Here are some tips to speed you on your way.

Using self-talk

Learn “normal” eating skills: Look in the mirror daily and tell yourself you can learn the skills of “normal” eating.

Think of foods as nutritional and non-nutritional: Instead of thinking of foods as “good” or “bad,” consider them as nutritional or non-nutritional. “Good” and “bad” are moral terms that are best avoided in the food arena.

Give yourself praise: Do not put yourself down for the mistakes you make with food. Instead, lavishly praise yourself for your successes, even the tiniest ones.

Try a different approach: If experience tells you that diets do not keep your weight off, do not try to convince yourself that you should diet. Instead, give yourself points for trying a different approach.

Become your own cheerleader: Never say anything to yourself that you would not say to a young child you love, including calling yourself stupid, hopeless, bad, a failure, or worthless. Become your own cheerleader by generating positive thoughts about yourself and your progress.

Avoid all-or-nothing thinking: Do not use words like “never” and “always.” Remind yourself that most of life is not black and white, but gray. Think incrementally.

Do not dwell on untrue comments: Detoxify negative things people say about or to you that are untrue, rather than repeating them to yourself. Remember that what people say belongs to them, not to you, even if your name is attached to their words.

Connect to your emotions: Ask yourself often how you are feeling, so you can connect more easily to your emotions, but explore only with curiosity, not condemnation.

Stop judging yourself harshly: Develop self-compassion. Treat yourself lovingly. Practice speaking to yourself with extreme esteem.

Keep a positive attitude: Do not keep telling yourself that learning to become a “normal” eater is hard, because saying so only programs you to find the work more difficult. Instead, substitute words like challenging or doable.

 

Recognizing hunger

Rate your hunger: Check in with yourself often to see how hungry you are by using descriptions such as “not hungry,” “moderate,” “very,” and “famished” or a 1-10 scale.

Evaluate if you are hungry: Every time you think about food, ask yourself if you really are hungry enough to eat or if you actually need something else.

Consider having smaller meals: Experiment with eating smaller meals more frequently.

Think about hunger as a signal: It means that you need fuel, not that you have to go out and seek the most fantastic eating experience of your life.

Know what hunger means: Practice believing that hunger is for fuel and pleasure, not for meeting emotional needs.

 

Choosing satisfying foods

Choose for yourself: Do not get hung up on what other people are eating. Instead, ask yourself what you would like to eat.

Forget about good and bad: Remind yourself that foods fall on a nutritional continuum (high value/low value), not on a moral continuum (good/bad).

Make a satisfying choice: Never eat without first stopping to consider what you want. Spend time making your decision by tuning into your appetite.

Stay clear of guilt or shame: Refrain from allowing guilt or shame to contaminate your eating decisions. Avoid secret eating.

Choose foods that you like: Do not eat foods that you do not find satisfying or enjoyable. Eating them will make you think that you are on a diet.

 

Eating with awareness and enjoyment

Look before you eat: Before you eat, look at your food, its portion size, and presentation. Breathe deeply. Look again before taking a mouthful.

Chew every mouthful thoroughly: Chewing a lot helps to thoroughly release the flavor of foods.

Let food sit on your tongue: This allows your taste buds to absorb the flavor and transmit messages about your appetite to your brain.

Talk or eat: When you are talking, stop eating. When you are eating, stop talking.

Stay connected: Pay attention to your body’s appetite signals while you are eating.

Forget about guilt and shame: Push away guilt and shame while you are eating. Focus only on sensory pleasure.

Pause while you are eating: Think about how you are feeling about your food in terms of quality and quantity.

Know when to stop eating: Stop eating when flavor intensity declines, as it is bound to do. Do not try to polish off all of the food in front of you. Instead, aim for the moment when flavor peaks and you feel an internal “ah” of satisfaction—then stop.

Evaluate how full you are: Keep asking yourself while you are eating, “Am I still hungry?” and “Am I satisfied?”

 

Stopping when you are full or satisfied

Know the definitions: Think of “full” as having enough food (fuel) in your stomach and “satisfied” as reaching thehigh point of pleasure.

Quantify fullness and satisfaction: Use words, such as “nearly full,” “too full,” or “just right,” or a 1-10 scale to rate fullness and satisfaction.

Tell your body: When you feel full or satisfied, focus on that sensation, and broadcast it to your whole body.

Disconnect from food: When you are done eating, put down your utensils, push away your plate, and get up, if possible. At least mentally move on. Do whatever you need to do to disconnect yourself from the food.

Decide when enough is enough: Make sure you do not focus on food that is left in front of you. Recognize that you do not have to finish it or clean your plate.

Changing your beliefs:

 

From: To:
“I need to diet to lose weight.” “Diets do not work long term.”
“This is too hard.” “I can learn to do this over time.”
“This will take too long.” “If I do not change now, I will only end up back in this same place again, so I might as well get going on it.”
“Losing weight is the most important thing.” “I will lose weight if I honor my appetite and learn to eat ‘normally.’”
“I am bad/worthless/ugly if I am overweight.” “I accept my body as it is and still will try to improve it.”

 

Stopping emotional eating

Consider your feelings: If you have the urge to eat when you are not hungry, identify the emotion you are feeling.

Think of a different response: Remind yourself that feelings need an appropriate response—not food.

Know the emotions that trigger unwanted eating: Boredom, loneliness, anxiety, shame, guilt, disappointment, confusion, and helplessness can trigger unwanted eating. Look for more effective ways of dealing with these feelings.

Keep a feelings log: This will help you keep track of what is going on inside of yourself all day long.

Reduce stress: This will lessen frustration, helplessness, and the overwhelmed feeling you sometimes have that may drive you to eat.

Take care of yourself: Make sure you are taking care of yourself (with rest, sleep, hobbies, and fun) at least as well as you take care of others.

Learn from your behavior: If you find yourself eating when you are upset, do not take it out on yourself. Treat yourself with compassion and curiosity. Think about your behavior as a learning experience.

Find help: If you have a history of trauma or abuse, get help through therapy. A strong correlation exists between such a history and emotional eating and weight gain.

Take responsibility for yourself: Do not blame others for your emotional eating. Take accountability for your actions.

Build emotional muscle: Tell yourself that you can bear any emotion and practice doing so. You will find that the emotional muscle you build is amazingly strong and enduring.

 

References and recommended readings

Koenig KR. Nice Girls Finish Fat: Put Yourself First and Change Your Eating Forever.New York,NY: Fireside/Simon and Schuster; 2009.

Koenig KR. The Food and Feelings Workbook: A Full Course Meal on Emotional Health.Carlsbad,CA: Gürze Books; 2007.

Koenig KR. The Rules of “Normal” Eating: A Commonsense Approach for Dieters, Overeaters, Undereaters, Emotional Eaters, and Everyone in Between!Carlsbad,CA: Gürze Books; 2005.

Koenig KR. What Every Therapist Needs to Know About Treating Eating and Weight Issues.New York,NY: WW Norton and Co; 2008.

Contributed by Karen R. Koenig, LCSW, MEd

 

 

 

 

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Donna’s Top Ten Basic Nutrition Tips

 

I developed a list of basic nutrition tips as a result of consistently being asked questions related to these topics. There are many more tips I feel are important. I’ll share them in future posts.

 

 

  1. If you have the choice between eating a whole fruit or drinking the juice from that fruit, eat the fruit. They both contain fructose (fruit sugar) but whole fruit also contains fiber. Fruit juice causes greater spikes in blood sugar than whole fruit does. It is also pasteurized which eliminates all bacteria, including “good” bacteria, and can reduce the amount of essential vitamins and minerals found in fruit.
  2. Eat frequently during the day.  Eating frequently (every two to four waking hours) will keep your metabolism going. Your blood sugar will also be more stable throughout the day giving you sustained energy.  It will also prevent you from getting excessively hungry, putting you at lower risk of overeating.
  3. Eat real butter (organic, if possible) instead of margarine. Butter and margarine contain the same amount of fat. Butter contains more saturated fat and cholesterol than margarine but margarine can contain trans fats which are correlated with higher risk of heart disease. Butter is a natural product where margarine is synthetically manufactured from vegetable oils.
  4. Eat fruits and vegetables that are varied in color. Many fruits and vegetables contain similar nutrients, however different colors contain some essential differences too. For instance, red fruits and vegetables contain natural substances called lycopene and anthocyanins. Lycopene (in tomatoes and watermelon) can reduce the risk of certain cancers and help prevent heart disease. Anthocyanins (in strawberries and red grapes) have antioxidant properties which keep all your cells healthy.  Orange and yellow fruits and vegetables such as carrots, sweet potatoes, pumpkin, mangoes, and yellow peppers contain carotenoids which your body can convert into Vitamin D. They help keep your mucous membranes and your eyes healthy. They are also helpful for your heart, your immune system, and can help reduce your risk for cancer. Green fruits and vegetables contain a natural pigment called chlorophyll. Some of these fruits and vegetables (spinach, green peppers, peas) contain a natural substance called lutein. Lutein is an antioxidant that can prevent free-radical formation in your body’s cells. It can also help prevent macular degeneration of the eyes. Leafy greens such as spinach and broccoli contain folic acid, a B vitamin that has numerous functions including helping prevent birth defects. Purple and blue fruits and vegetables (eggplant, blueberries, plums) contain anthocyanins that are natural antioxidants. Some white fruits and vegetables such as bananas and potatoes contain potassium. Others such as cauliflower and garlic contain allicin, a natural chemical that can help lower cholesterol and blood pressure and can reduce the risk of heart disease.
  5. Before following any nutrition advice, find out the credentials of the person dispensing the advice. There are many people who dispense nutrition advice who have no credentials or credentials that don’t qualify them to offer nutrition advice. When advice is given by a non-nutrition credentialed professional, it is often based on personal experience and/or non-scientific information.  Be especially wary of nutrition information you read in magazines or on the internet. Much of this information is money-making propaganda.
  6. Never skip breakfast.  After having fasted all night while you sleep, your body’s cells need to be refueled. The only form of energy your body can use comes from the food you eat. Unlike a plant, you cannot photosynthesize by sitting in front of a window. Eating breakfast fuels your brain to enable you to concentrate. Also, by feeding your brain at breakfast, your mood will be better. You will be less likely to be easily agitated or depressed. By having breakfast, your blood sugar will be more stable and you will not be overly hungry at lunch time, enabling you to better regulate the types and amounts of food you will eat at lunch.
  7. Eat the skin on (organic) fruits and vegetables. Buy organic fruits and veggies if possible, as the skin won’t contain pesticides and provides an excellent source of fiber, antioxidants, vitamins, and minerals. Examples of healthy skins are those on potatoes, apples, peaches, pears, and plums. Certain skins are too tough to eat but eating as close to them on the inside will be beneficial (spaghetti squash, pumpkin, melons).
  8. Eat frozen vegetables instead of canned, and often instead of fresh. Frozen vegetables are healthier than canned because there is no added water or sodium used in preservation. Fresh vegetables that are locally grown and “in season” are the best choice overall. But once their season passes, the next best choice would often be frozen.  Frozen vegetables are picked and frozen at their peak of ripeness when the nutritional value is highest. Prior to freezing, they lose a small amount of their nutritional value (they are initially heated before frozen to kill off bacteria), but retain much of the overall value. On the other hand, fresh vegetables are often picked before they are ripe, therefore losing some of the health benefits of continuing to ripen naturally. Then they are shipped from the farm to the grocery store, often thousands of miles away. During shipping, they are exposed to a variety of conditions (including time) that could diminish the amount of nutrients they contain. They may sit on the grocery store shelves for several days before they are purchased.  First choice is “in season” fresh vegetables. Second best is frozen. Last choice is canned.
  9. When you read the food label for a list of ingredients, fewer ingredients is always better.  If the list of ingredients takes up the entire side of the package, don’t waste your money (Lunchables, for example). The closer a food is to its natural state, the better it is for you. For example, a piece of fruit is a better option than fruit snacks. Cheddar cheese is better than Velveeta cheese spread. Also, on the package of food itself, the more words there are before and after the “main food word”, the less healthy it is. For example, “cheese” is better than “processed cheese food product”. “Cranberry juice” is better than “cranberry juice cocktail”.
  10. Drink water. Your body is composed of about 60% water. Every job in your body happens in a fluid environment. For example, this fluid is used in digestion and absorption of food, circulation and transportation of nutrients (blood and lymph), production of saliva, and regulation of body temperature. It is also used to keep your muscles, joints and skin lubricated. It protects your organs and tissues. Water helps eliminate toxins (through breath, sweat, urine, and feces). It also helps you have regular bowel movements.

 

More nutrition tips to come related to organic food, GMOs, fiber, nuts and seeds, and “fun” foods in future posts!!!

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First Days of School and Body Image

For many school-aged kids (preschool through senior year in high school), “back to school” shopping is fun. They love buying new outfits and shoes and backpacks and school supplies. With every item they buy, they get more excited to get back to school. They happily try on their new clothes. They stuff their new backpacks with all the pens, pencils, notebooks, and planners. The night before school starts, they feel a mixture of excitement, anticipation and a little anxiety.  The first days back to school, they put their new outfits on, head out to school, and experience all the first days activities. They may have ups and downs. They may like some teachers, and dislike others. They may have difficulty figuring out where to sit in the classroom, or in the lunch room. They may be a little anxious about finding their classrooms or getting there on time. They also may be excited to reacquaint with friends. This is all normal.

For those school-aged kids with eating disorders, a different experience is felt altogether. Although there are no universal experiences, I’ve seen enough eating disordered kids to know there is an element of difficulty that accompanies the “back to school” transition. They may experience all the same activities as non-disordered kids, but they also may experience a multitude of inner thoughts and heightened anxieties that non-disordered kids don’t experience. Many of these thoughts are negative and distorted. Many of them are body related.

Shopping for clothes to go back to school in can be a very upsetting endeavor. When one’s body has changed, there can be both physical and emotional discomfort. Looking for sizes, trying on multiple articles of clothing in various sizes, experiencing physical sensations associated with the way clothes fit, and standing in front of mirrors in the dressing room can trigger all sorts of thoughts and feelings.  These thoughts and feelings can taint the experience, and can trigger urges to use eating disordered behaviors. It is always best for the individual to shop with a compassionate friend or family member who understands the sensitivity of the individual and can offer support if needed.

If the eating disordered student’s body has changed over the summer, due to recovery related goals or as a result of the eating disorder itself, he/she has tremendous fear that others will comment about his/her body. “Wow! You look so much better than you did last year!” “You gained weight. You look great!” “You lost weight. I wish I was as skinny as you!” “Did you put on a few pounds over the summer?”

Any comments regarding one’s body can trigger someone with an eating disorder. Comments can be well-intentioned but may still be perceived as triggering. I tell my clients over and over that they cannot control the comments made by others. All they can control is their reaction to the comments. Comments about one’s body also exacerbate the body image distortion that the person already feels because they draw unwanted attention to the body. I usually advise my clients to either change the subject or try to walk away from the conversation. Then, they need to talk to a good friend to get the support and distraction they need, in order to move on with their day.

Getting dressed in the morning before school is also challenging. When someone has an eating disorder, he/she is uncomfortable in his/her own body. He/she experiences it in a distorted way. He/she does not necessarily have the ability to see him/herself objectively.

Below is an example of what someone with an eating disorder may experience in the morning, before the school day begins:

Allyson has set out her clothes the night before the school day. She wakes up in the morning already a little anxious for the school day ahead. She’s worried about a test she has to take, and she’s overwhelmed by the amount of school work she faces in her AP classes. She puts on the clothes she had picked out, but they just don’t feel “right”. They feel tight this morning. They didn’t feel tight when she tried them on yesterday. But this morning, she feels like she will burst at the seams. She begins to feel more anxious than she felt when she woke up. She convinces herself that she absolutely cannot wear the outfit. She tears it off and throws it on the floor of her room. She urgently searches through her closet and pulls out another pair of jeans and another top. These jeans feel too tight and the shirt looks “ugly”.   Off they go, onto the pile of clothes that are on the floor. She grabs a skirt, tries it on, and doesn’t like the way her legs look in the mirror. It goes onto the pile. Her anxiety escalates. The amount of time she is taking to pick out something to wear is cutting into the time she needs to devote to the rest of the morning activities, including eating breakfast. Her mother reminds her that she will be late if she doesn’t hurry up. Her anxiety is mounting. She grabs a dress out of her closet. She doesn’t like the way her arms look. She throws a sweater on over it. It just doesn’t feel or look the way she wants it to. She throws it on the top of the heap of clothes. Her time to get ready is significantly dwindling. She digs through the clothes and finds the original pair of jeans. She puts them on, pulls them up, buttons them, and throws a sweatshirt on. She feels “gross” and defeated. She heads to the kitchen where she has to figure out what to eat. Due to her anxiety and subsequent loss of appetite, as well as her “gross feeling”, she has urges to skip breakfast altogether. Her mother is watching though, so she eats part of her breakfast and promises her mother she will make up for it later. The school bus comes and she races out. On the way to school, she can’t get her body off her mind. She still feels “gross” in her body and she’s worried about the test and all the other stresses of the day ahead. From the outside, Allyson appears “fine”. She’s friendly but a little quieter than usual. On the inside, she’s suffering. She’s worried. She’s conflicted. She wants to be “in recovery”, but at the same time, she’s desperate to use eating disordered behaviors to make herself “feel better.”  The best strategy for her to follow to “get out of her head”, is to distract herself with friends or find a friend to voice her struggle to. Communication of her feelings may lessen the power they have over her. Also, if she shares her feelings, her friends may help to “normalize” them. If she has a treatment team, she might want to discuss this with them during her next session to help strategize for these types of situations, as well as to get help gain a more positive perspective on recovery.

The experiences outlined above are only a few examples of the types of situations that may trigger a student with an eating disorder. Situations that intensify negative body image are challenging but do not have to derail recovery!  It is his/her responsibility to work through these difficulties using the coping mechanisms he/she has learned and practiced so that he/she does not use any type of eating disordered behavior. Using his/her voice to express feelings is a key coping mechanism. Having an understanding circle of friends and family is also essential.

It is important to remember that negative or distorted body image is a byproduct of low self-esteem, stress, anxiety, negative feelings, life experiences, messages from others, distorted beliefs that are exacerbated by the media, societal pressures and other personal issues. Distorted body image is NOT about the weight, size, or shape of one’s body.

If you or a loved one experiences distorted negative body image issues, the National Eating Disorders Association says it best when they say “We all may have our days when we feel awkward or uncomfortable in our bodies, but the key to developing positive body image is to recognize and respect our natural shape and learn to overpower those negative thoughts and feelings with positive, affirming, and accepting ones.”  It is also vital for recovery to learn to separate your feelings from your body, and take care of your body as best you can through satisfying balanced eating and the types of pleasurable movement that energize and strengthen your body.

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Well-Intentioned Mothers and Fathers

Several conversations I have had lately with mothers prompted me to write this post regarding parenting around food. There is an extensive amount of controversy over how to handle food and weight with children. The following opinions are based on the extensive experience I have had with parents, children, adolescents, and older teens. Since I am a nutrition therapist specializing in eating disorders, I see those individuals who have had a multitude of negative experiences around the issues of food and weight.

I’ll begin by recounting a story from the first mom I spoke with this past week. Her 13 year old daughter, “Abby”, came to her and said she was unhappy with her weight and wanted to lose a few pounds. Abby would be described as a normal weight girl by “normal” standards, but as a slightly overweight girl by the media’s unrealistic standards. Her mother said she approved of Abby’s plan to lose weight and would help Abby accomplish her goals. She told Abby to write down everything she ate so Abby could assess her portions sizes, and also recommended that she cut out “junk food”. This all seems innocent enough…except for a couple problems.

  1. Abby is 13 years old, which is right in the middle of growth and development. During growth and development, a girl’s body often gets a little larger prior to a growth period. It also gets larger prior to the onset of menstruation. This is normal and should not be interrupted.
  2. Abby is influenced by an array of negative, misguided and often inaccurate influences such as dieting peers, magazines and other forms of media that present a constant unrealistic source for body and weight comparison and dissatisfaction, and a constant barrage of internet sources that tout all types of unhealthy forms of dieting.  All these sources of misinformation may cause Abby to take her innocent diet too far or in a direction that could be harmful.
  3. Abby is not going to be under the supervision of a qualified nutrition professional that can help her through the process, therefore all her decisions will be made by herself and as a result of all the “outside influences”. This is a breeding ground for arbitrary, unhealthy rule-making.
  4. Dieting at any age is the number one behavior that leads to an eating disorder. Dieting at age 13 is tremendously risky.

The second mother I encountered this past week did some research on a particular method of eating that has been shown to have value in certain populations such as those with learning and developmental disabilities such as autism-spectrum disorders. As far as I know (I do not have all the information regarding her children), none of her four children have any type of learning or developmental issue. The reason I tell this story is because I have encountered many mothers who change their children’s diets drastically for one “good” reason or another and many (not all) children react in a very negative, adaptive way.   This mother restricted all breads and other wheat products, as well as all other grains from her children’s diets. I reiterate that I am not writing this post to discuss the pros and cons of any type of eating plan, just to illustrate the effect on children of drastic eating changes. These children frequently come over to my house to visit, and the family dines with ours a couple times a month.  The mother made me aware of the changes she was making to her children’s diet so I prepared meals that included a number of options that they were permitted by their mother to eat. I also included grains and breads for my family to eat, if they desired. On every single occasion the children have been at my house, they have “snuck” some type of bread or other grain while their mother wasn’t looking. I hadn’t been paying much attention at first, but my children pointed it out to me because they were worried the other children would get reprimanded by their mother and wanted to let me know that they were not encouraging nor discouraging the other children to eat any of the “forbidden” foods. They would sneak bread at meal time and would “raid” the cabinets for cookies and other snack foods. Whenever my children would notice, the other children would say “shhhh…don’t tell my mom.”

This mother’s intentions are to help her children but unknowingly, she is helping create a disordered relationship between her children and food. It would be my assumption that they are “sneaking” food in other places as well as my house. They may be feeling deprived of the foods they are not permitted to have in their home. The mother thinks her children are eating in one way when in fact they are eating in another.

I see another phenomenon over and over in my practice. Parents call me to tell me that their child is sneaking food. They find wrappers and all sorts of food paraphernalia hidden in couch cushions, dresser drawers, backpacks, garbage cans, etc. Their solution is to make the food environment even more restrictive, their child becomes even more creative in finding ways to get food, and the disordered relationship between the child and food worsens. If the child has the tendency to appear to the parents as “overweight”, the parents often become overly restrictive with food, reprimand the child for eating “too much”, criticize the child for his/her weight, and create unfair food rules for the child that the other children in the family don’t have to follow (if they are perceived to be of normal weight). An enormous amount of energy is spent by the parents trying to “control” the child’s eating, creating a stressful environment for all, especially for the child. The child ends up feeling deprived and becomes obsessed with food leading to a non-intuitive dysregulated relationship with food.

A (well intentioned) dad once said to me that he was demanding  his 9 year old daughter spend at least 45 minutes on the treadmill each day because she was developing a “stomach”. He was so concerned that she would become an overweight teen and then an overweight adult. He insisted that if he didn’t “help” her, she would be bullied and have no friends.   I met this little girl. She looked like a beautiful 9 year old girl. She had a little roundness to her stomach, as many little pre-pubescent girls do. There was nothing noteworthy about her appearance. I later found out that the dad had been bullied as a child and became an avid exerciser to cope with his negative experiences.  I expressed my concerns to the dad. I explained to him that it was my opinion that his daughter was just fine and did not need to be on the treadmill  to “get rid of her stomach”. I explained that she was perfectly normal. She was probably going to get a little wider before she grew taller and experienced puberty. If allowed to eat a wide variety of foods and experience movement in a way that she enjoyed, she would not be doomed to a life of being bullied and having no friends. She would hopefully develop a healthy relationship with herself and food and he would be better off supporting her in all ways, instead of worrying excessively about her physical appearance.

A dad came to see me to discuss his picky eater. This dad was one of the most intelligent men I have ever met. He had numerous degrees and was very well respected among his peers. He said his daughter ate only a few foods and he was desperate to improve her variety of choices and help her develop a more “sophisticated palate”. I asked him what methods he had already tried to help his daughter. He had only tried two…force feeding and bribery. For every new food she tried and liked, he would give her money. If she tried it and didn’t like it, she’d get no money. If she didn’t try it, she’d get no money. If it was put in front of her and she didn’t want to try it, he would force her to eat a bite by actually forcing it in her mouth. My first thought was “Oh my goodness. This poor child is in a bad situation.” My second thought was “Intelligence sure doesn’t equate to good parenting with food.” He was shocked that I disagreed with his methods.  I gave him some helpful suggestions, mostly regarding giving his daughter the power to make her own choices, not making them for her. I also told him not to pressure her in any way. She would not develop a “sophisticated palate” via any of his methods. The only things that these methods would create would be disordered feelings about food, and food aversions. I informed him that the worst thing that might happen if he gave her more freedom and less pressure would be that she would continue to be a picky eater. I also suggested that he invest some of the “bribe money” in a good full-spectrum multivitamin for her so that she wouldn’t develop any vitamin/mineral deficiencies.

None of these parents are bad people. They clearly love their children and want them to be healthy and happy. They are possibly misguided or ill-advised. Perhaps their own issues have clouded their judgment regarding parenting around food.

It is always important, as a parent, to put extensive thought into the actions you take regarding your children’s diet. Bear in mind that a child’s perception is his/her reality. If the child feels deprived or hungry, he/she will take strong measures to meet his/her needs.  If a child is receiving negative or mixed messages at home and in his/her outside environment, he/she may not have the skills to decipher between what is healthy and what is unhealthy. Messages may be internalized and create distorted thoughts and feelings about his/herself.

Force feeding creates long term food aversions. Deprivation creates powerful cravings and rebound overeating.  Try to remove your own food/weight issues from the decisions you impose upon your children. If you are on any type of diet, be careful how you speak about food around your children. Be especially careful about the language you use about your own body and the bodies of others. I treated a 5 year old girl once who was convinced that her thighs were fat because she heard her mother repeatedly say that her thighs were fat. If you are constantly popping on the bathroom scale and commenting negatively about your weight, you are teaching your child that it is normal to base his/her self-worth on the number on the scale.

A great resource for parents is http://www.ellynsatter.com/. Ellyn Satter is a pioneer in the topic of parenting with food. She has written several books that are very informative and helpful. On her website are informative handouts for all types of issues around parenting with food.

Ultimately, when parents lay the groundwork  for their children’s  relationship with food and relationship with themselves, they need to use extreme caution, insight and sensitivity.

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Why Can’t I Just Stop?

 

“When I’m having a bad day at work, I fantasize about the food I have at home.”

“When I’m making dinner for my kids after a long day of doing a million things for them, I can’t wait till I put them to bed so I can be by myself and eat all the leftovers.”

“I look forward to the times my husband goes away on business so I can do whatever I want with food.”

“The split second I am upset, I race into the kitchen and eat, eat, eat, as though my life depends on it.”

“As I feel the anger start to bubble up, I race to the box of xxx and crunch until I feel calm.”

“On Sundays, I feel so lonely I can’t wait to dive into the xxx to feel better. Then afterwards, I feel even worse. I also feel defeated, like I will never get better.”

“I feel so overwhelmed at times, I just can’t stop eating. I’m not sure whether I am overwhelmed and then can’t stop eating or if I can’t stop eating which causes me to feel overwhelmed, or both.”

“As I am jamming my hand into the package for another mouthful, I am promising myself that this will be the last bite but I can’t stop until it’s all gone.”

The above quotes from some of my clients illustrate that an eating disorder is not about the food. It is about the “state of mind” or “state of being” that the food and food behavior accomplishes. These quotes also illustrate the urgency these clients experience when thinking about getting to use the food behavior, as well as the helplessness that they feel.

I consistently try to help my clients see the relationship between their food behavior and what they are trying to “accomplish” by engaging in that behavior. Look at the words highlighted in the quotes above:

Bad day>>>fantasize

Doing a million things>>>be by myself

Look forward>>>do whatever I want

Upset>>>my life depends on it

Anger>>>feel calm

Lonely>>>feel better>>>defeated

Overwhelmed>>>can’t stop eating

Can’t stop until it’s gone

 

If an eating disorder were just about food, these clients would be able to “just stop” doing these types of behaviors and eat without all the urgency and subsequent remorse. But, an eating disorder is a complex combination of brain “hardwiring” and chemistry, environmental and familial issues and traumas, inability to communicate and feel authentically and effectively, etc. These food behaviors are an adaptation to many things.

If you are suffering from the type of eating disorder that causes any circumstances similar to the types of scenarios mentioned above, you personally know how hard you have tried to “just stop”. It doesn’t work that way. It’s not that simple.

But, there is hope.

First off, you have to try to understand that you have a complex history of underlying issues, combined with a brain that is genuinely trying to make you feel better.  It’s not your fault that you have found a food behavior that “works” in the moment to calm you down, numb you out, or wash away the thoughts and feelings that are painful to you. If it weren’t such an “effective solution”, you wouldn’t be so urgently seeking it out. You wouldn’t obsess or fantasize about it. You would be able to “just stop.”

Second, you must be willing and able to be kinder to yourself. If a loved one were going through the same pain and suffering you were going through, you would have compassion for them. Give yourself the same compassion. Tough love or self-criticism is not only ineffective; it worsens the behaviors every single time.

Third, without judgment, you have to be willing to self-reflect about what the food behaviors are trying to “tell you”. What are they accomplishing? Insight is essential. Without it, you will continue to beat yourself up and try to “fix” the problem behaviorally. It never works.

Fourth, you have to be willing to discover and tolerate the feelings you are attempting to numb out from, without the fear that you can’t do it. This is an area where clients often ask me “how do I feel my feelings? I don’t know how to do that.” The answer is simple and complex at the same time. We know that the food behavior is designed to numb out the feelings, so by delaying using the food behavior, you will feel something. You most likely won’t be able to do this for more than a few minutes at a time. During the few minutes you are trying to be abstinent from using the behavior, you may only feel anxious and obsessed about wanting to use the food behavior, but use the time wisely to gain information about the function of the food behavior. You may want to say to yourself, “I want to eat xxx so badly right now, but I’m going to hold off for 15 minutes to try to learn something about myself. During these 15 minutes, I’m going to journal whatever I am thinking or feeling. Then after 15 minutes, if I want to eat xxx food, I will.” By doing this through repetition over time, you may get some answers and may elongate the time during which you can be abstinent from the behavior.

Fifth, take the information you have gathered and try to make some life changes with it. For example, the woman who found that she fantasized about being by herself with food, after a long day with her children, used the information she gathered to try to make more time for herself  during the day. This way, she wasn’t in such need for it at night. The client who experienced loneliness every Sunday, decided to plan an activity with a friend or at least reach out and talk to one or two people every Sunday to feel connected. By realizing what the food behavior is “telling” you, you can work on improving the quality of your life.

Lastly, seek support. Both professional and personal support will help you make the changes you are seeking. You truly cannot do this work alone.

By no means does this process change your food behaviors in a day, or week, or month. You didn’t get to where you are in a day and it will take some time to make lasting changes. It can be done though…one baby step at a time.

Through (1) understanding, (2) kindness, (3) insight and self-reflection, (4) taking time to feel, (5) making slow life changes, and (6) getting support, you will heal…

 

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Vacations

When you go on vacation, wouldn’t it be nice to take a vacation from your eating disorder instead of having your eating disorder travel with you?

I’m sure some of you are not even able to go on a vacation because it so stressful that is sets back your recovery. I wanted to write this post because so many people will be embarking on vacations over the next couple weeks due to the spring break from schools. Also, summer is on its way and people often take vacations in the summer. This post is designed to provide you and your loved ones with insight into the challenges faced on vacations and strategies for working through them.

I recently got back from a vacation and realized how nice it was to not have my eating disorder tagging along. In the past, it would involve itself in every move I made, ruining the trip to the point where I was desperate to be back in the safety of my routine, the sameness, the disordered prison I called “home”.

Why is going away so challenging when you have an eating disorder?

No matter what type of disorder you struggle with, there are issues that you face that non-disordered people simply don’t worry about.

The following are some quotes from some of my clients regarding their challenging experiences on recent vacations, due to their eating disorders.

“I don’t remember anything fun about my family vacation. The months prior to the trip, I spent endless hours trying to buy clothes that fit and wouldn’t make me feel enormous. All this clothes shopping made me obsess even more about my body and reinforced to me how abnormal I feel. As the trip got closer, I pulled out all the stops and used every disordered behavior in my arsenal, somehow thinking this would make me feel better before I got there. So, by the time the day arrived when we left, I felt horrible, washed out and more obsessed than ever.

All I remember about the resort was scoping out every single bathroom there that I could escape to in order to use my behaviors. I spent the entire trip pretending to be normal and eating normally. Then when no one was looking, I would bolt to the least conspicuous bathroom. I was exhausted, bloated and depressed. I snapped at my kids and my husband because I couldn’t enjoy all the fun events we were partaking in.”

_____________

“I show up at a tropical resort after weeks or possibly months of anticipation. I’ve probably spent those weeks or months dieting and exercising because I need to look semi-acceptable in ‘resort-clothing’. Chances are that I have failed to lose any weight, so that weighs heavily on me causing me to be cranky.  Part of me says, ‘It’s not over. Try again.’ So, I decide to eat only one meal while I’m there. In fact, I even select cocktails that aren’t high in calories.

The attractive, thin, people around me make me self-conscious.  I feel awkward when I have to talk to them because I think they think, ‘She’s way too fat to be here.’ I decline when they out of pure politeness invite me to 8am yoga.

I try to make healthy food choices, but it’s hard because I am limited to what it available.  Depending on where I am, there may be a plethora of food, but the quality or the preparation may be bad, so I end up feeling unsatisfied, causing me to eat excess Carbs.  (Lots of Carbs at resorts!)  If the quality is great, then I probably indulge and feel guilty after.

Needless to say, at some point in my vacation, I snap and become super-bitch.   After I snap, I hate myself for starting a petty argument and that blows up to hating myself for EVERYTHING bad that I am and have including my body.”

_____________

“My family looks forward to this family reunion on a cruise every year. We all go away for a week where all there is to do is eat, eat, eat. For the months prior to the cruise, I agonize over wearing a bathing suit. I feel so awkward showing my body but I know it would be weird to not wear one. I find myself body checking more and more the closer the trip approaches. I strategize for weeks about how I will handle all the food. I devise a great plan to eat only three small meals, lots of fruit and vegetables, walk around the deck for exercise and drink alcohol minimally.

I am with extended family all the time. There’s no escaping them. The drinks are pouring. They are all feasting at every chance they can get. They stay up till all hours of the night at the clubs drinking and then binge at the midnight buffet.

I usually last about two days with my plan of restricting myself till on about the third day, I can’t take it anymore and a switch is flipped. I go wild. I begin eating like a crazy person. I gorge myself at every chance I get. I spend the next 5 days bingeing and purging over and over and over…usually at least 4 or more times a day. I keep trying to get myself back on track but I don’t have the energy to do it. I just resign myself to being disordered for the rest of the trip.

My personality changes too. I drink and become a ‘party animal’, so everyone thinks I am having a ball. Little do they know I am screaming at myself behind the scenes.”

_____________

“We usually go on a big trip, often to Europe, in the summer. Last year it was to Italy and France. The thought of going somewhere this summer sends chills up my spine. I have such a hard time breaking out of my routine of safe foods and my exercise plan. Everyone tells me that I will do a lot of walking on my trip but it doesn’t feel the same. I end up with strong urges to compensate for the lack of regular exercise. I also have a really hard time eating in restaurants and when we go away, we eat all our meals out. I just get so scared about all the changes and things I can’t control, I do terribly while we are away.

My family ends up getting furious with me because I can’t enjoy the food like they do. I end up ruining all the meals because I always let them down by ordering the safest food on the menu. My parents get in arguments over my eating and then their trip is terrible. I feel like a burden.

When we get back from our trip, my parents get even angrier with me because my weight will be affected and then they are scrambling to get me to eat more to get back on track. It’s a disaster all around.”

_____________

Well…these four stories of vacations are all too real for those who struggle with these illnesses. So, what do you do? How can you go on vacation and keep your eating disorder from ruining it?

First, you need to understand that you have a psychological illness that has been used as a coping mechanism and it doesn’t just vanish because you decide to go away. (Wouldn’t that be nice if it did???) Depending where you are in your recovery, a vacation can be a positive experience or a negative one.

I have treated many clients who have had fabulous vacations, ones when their eating disorders haven’t ruined the trip for them. Those clients were either fairly far along in recovery and/or strategized for the trip so that they felt as comfortable as possible.

Some strategies for your vacation:

  • Accommodate the Time Difference: First, if you are going to fly, plan for your flight and the times changes if there are any. Often, when you are gaining time or getting up extra early, there may be some challenges with figuring out your meals. In my opinion, if you are awake for extra hours, you will need to have an additional meal or snack to accommodate the extra time. Plan for this “extra” and have something comfortable to add in for the day.

 

  • Bring Food:  If you are flying, bring food with you on the plane. You can either buy things at most any airport, or take food from home. Think about in what time frames you will be flying and what meals and/or snacks you would be consuming if you were home…if you weren’t flying. I have been to numerous airports and I have found the packaged foods to be quite universal. I usually bring protein bars, nuts, and dried fruits for snacks. Depending on what time my flight is, I will perhaps buy a sandwich or a salad at the airport if my flight will be during a meal time. I always buy a beverage after I go through the security gate so that I have a drink on the plane. If you are lucky, you might be offered something on the plane, but lately, you have to buy the food. Plus, plane food often sucks. Always be prepared. You never want to be left with no food choices while traveling. Always pack food in your suitcase. Plan to bring enough snacks for every day you will be gone, at every snack time. Worst case scenario, you can bring them home with you. I look at food as important as medicine, and you would never forget to take your medicine on a trip. If you have favorite foods (obviously they cannot be perishable if you are flying), bring them – cereal, peanut butter, crackers, bars, nuts, etc. 
     
    If you are going to a destination and staying in a house or condo, hopefully you will have access to a grocery store once you get there and you might want to go to the store within a short period of time after you arrive so you have all the food you need. You will most likely have some meals in the house/condo which will provide you with structure and familiarity.If you are traveling somewhere by car, bring food as well. The good thing about traveling in a car is that you can bring perishable food with you like yogurt, cheese, sandwiches, etc. If you like to make stops periodically to get food along the way, you will have a choice of either getting something at the restaurant or “rest stop” or eat what you have brought with you. This would be a good time to challenge yourself if the restaurant or ”rest stop” has comfortable food. Most restaurants have a variety of options for a variety of needs. Get as much information about where you will be stopping before you stop so that you have a good game plan.

 

  • Add Structure to Your Meals:  You may need to be flexible if traveling with several people because everyone’s needs will vary, but try to get as much structure in your meals as possible on travel days as well as on vacation days. When you know where you will be going, make a “healthy” mental game plan for your meals and snacks. The last thing you want to do is plan to use behaviors while you are away. That will certainly ruin your trip.  Try to make sure your plan is to eat as recovery-focused, comfortable, and satisfying as possible. Planning to restrict, binge or purge will put your eating disorder in charge from the start and you will not enjoy yourself.

 

  • Try to Avoid Catastrophizing Things:  No matter how long or short your trip is, don’t let the time you are away overshadow the work you have done the other days, weeks and months of the year. Remember, it’s a vacation – a reprieve from the stresses of life.

 

  • Try Not to Compare Yourself to Other People:  You don’t want to ruin your trip by making comparisons that will only serve to make your eating disorder stronger. If you are feeling awkward, remember that people don’t really care what you are doing. They are more interested in what they are doing. On my recent vacation, we were on the beach every day. It was so freeing to just enjoy the sun and the water without feeling the awkwardness that my eating disorder used to inflict upon me. There was the momentary discomfort of walking across the beach into the water but the water felt so good and I am sure no one cared what I wore or what I looked like. Even if they did, I didn’t know any of them and I will never see any of them again.

 

  • Keep Your Food Expectations Realistic:   No matter what eating disorder you struggle with, the food will NOT be the same as it is at home. It most likely will elicit some challenging thoughts and feelings. Your eating won’t be perfect. It’s not supposed to be. This goes back to what I said previously. Go into the trip with a “healthy” positive, recovery-focused game plan and expect that you can’t control everything. On my vacation, the food was not that good. I was in an all-inclusive resort. Frankly, the food was disappointing. But, I ate what I liked, felt excited about a few things and was disappointed by a number of things. The food is a big part of what I look forward to on a trip, but although I was a little disappointed overall, I tried to maintain perspective and for me, perspective is key! If I look too much toward the food as the “make or break” aspect of the trip, I am often let down.

 

  • Get Support:  If you are traveling with family or other people, find someone who will support you when things are difficult. Maybe this will be a parent, friend, sibling, or significant other. Reach out and speak up about what your worries are. They may not “get” it but they can help support you through a rough patch, it can help prevent a disastrous trip.

 

  • Change Your Movement Expectations:  If you worry about movement during your trip, remember, once again, you are on vacation. Things will most likely not be the same as they are at home. Try to change your expectations about movement. If you follow an exercise routine at home and you won’t be able to do the same routine while you are away, use the trip as a time to practice flexibility in your routine. Please try not to catastrophize the change. Change is often very challenging for some people with eating disorders. Sameness is so safe, but once again, try to keep your expectations realistic. I find vacations to be a good opportunity to recharge myself, not to put pressure on myself to do everything the same.  The more pressure you put on yourself about all the things you “should” do on vacation, the more “guilt” your eating disorder will make you feel.

 

  • Stay OUT of Your Head!!! If you start going into eating disorder mode, press your mental “reset” button and try to challenge any negative thoughts and behaviors before they take over.

Remember, there are 365 days a year and your vacation is a small period of time within that year. Try to make the most of it. Try NOT to let your eating disorder and all the associated obsessions and compulsions ruin what could be a fun-filled break from the stressors you experience during the rest of the year.

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Is It Possible to Lose Weight ?

Many of my clients ask this question, whether their body has
changed as a result of their eating disorder or as a result of the recovery
process itself. Weight, size and body image are such sensitive subjects. They
are intricately woven into the complexities of eating disorders and must be
dealt with very carefully.

After gaining some weight, many of my clients want to revert
back to some type of restrictive eating in order to change their weight/lose
weight. This type of restrictive eating may be as simple as eating foods they
“know” are low-calorie foods but that the individual hates or reminds them of
their disordered/dieting days. Restriction can also crop up in subtle ways,
like the following:

  • Convincing yourself you like a food because it is healthy when you really don’t like it and have never liked it.
  • Trying to eat a smaller portion size than youknow will fill you because you’ve gained weight and think a smaller portion“should” fill you.
  • Trying to eat a volume of low-calorie foods to fill you up, hoping it will prevent you from eating what you really want.
  • Setting any unrealistic goal that you know deep inside goes against what your “inner eater” wants.

 

The following vignette is an example of this
phenomenon…inevitably slowing down recovery, giving power to the eating disorder,
and causing the exact behaviors one is trying to alter:

A client came in for a session last week. She has been on
both ends of the eating pendulum. During her restrictive days, she would limit
herself to very few foods as a means to an end (weight loss). Then she went
through a period of rebound bingeing that lasted for an extended period of time
causing some subsequent weight gain. She currently doesn’t want to restrict or
binge but she feels confused about what to do. She feels she is in a body that
is not her “normal” one but knows she can’t restrict to get back to normal. She
is repulsed by the foods she ate while restricting but desires to eat them
again because they are “healthy”. The thought of eating these foods again also
causes her to “rebel” and binge.

She’s trying to eat whatever she is in the mood to eat, but
gets frustrated because her choices are often “unhealthy” and are not leading
to weight loss. It seems though, whenever she tries to negate her intuitive
appetite, she eats more than she initially wanted to, she feels more out of
control, her weight goes up, and she wants to give up.

Not only are there psychological dynamics going on in this
situation, but physiological ones as well. When the body is deprived of food,
there are many complex physical/hormonal/brain side effects that occur as a
result that will ultimately create a temporary heightened hunger and appetite.
These chemical changes cannot be “willed away”. They need to be attended to and
understood. There is no specific time frame for these effects.

I also want to mention, as we all know, an eating disorder
and recovery from an eating disorder are not about the food itself. Recovery is
about achieving other healthy coping mechanisms so that food isn’t the ONLY one
used. Continually placing all the emphasis in treatment on the eating patterns
and the food choices themselves, will take the individual further away from the
ultimate goal…trying to understand what the food is being “used” for, and
reducing the need for food (in any way, shape or form) as the only coping
mechanism. Ultimately, when someone who has an eating disorder is using a
multitude of other coping mechanisms, effective communication skills, and
healthy forms of self-care, as well as experiencing and tolerating all of their
feelings, food can begin to be “just food”.

The following was written by Karin Kratina, a pioneer in the
field of eating disorders. It truly exemplifies this process.

Sometimes recovery from eating issues involves weight loss.
Sometimes it does not. Regardless, any focus on weight is a potential danger
zone since a focus on weight loss can cause a return to the eating behaviors
you are trying to change. If you are above your body’s set point weight range,
it is possible that with intuitive eating, your weight will slowly shift until
you are back at your set point range. But you need to first be doing the
following to heal eating issues (it does not work to try to lose weight then
heal eating issues).

 

Place a check mark next to the thoughts/behaviors that you practice on a consistent basis:

□   I know how to keep a food journal recording food, feelings and hunger/satiety.

□   I usually keep a food journal when I’m having a hard time with my food/weight.

□   I am in tune with my hunger and am comfortable beginning most of my meals hungry.

□   I am able to stop eating when physically satisfied, usually with no problem.

□  I am able to eat almost any food without beating myself up or feeling guilty.

□  I almost always take action to handle feelings and situations that trigger me to eat by:

□  making a choice between feeling uncomfortable or addressing the issue

□  making effective changes on my own when possible

□  reaching out for appropriate support from family and friends

□  engaging in counseling if I see my reaction to triggers not changing

□   My attitude towards my body is “if you can’t be with the one you love, love the
one you’re with.”

□   I practice numerous nurturing behaviors to fill myself so that I don’t need to turn to
food.

□   I usually know what my needs are and how to get them met by setting limits and
communicating directly.

□   I usually assert myself and rarely have to resort to yelling, arguing or withdrawing when
feeling frustrated with others around me.

□   I like my body most of the time.

□   I realize when I feel fat, an issue other than weight needs to be addressed.

□   I know that if I lose weight to feel better, that ‘feeling better’ is almost
always transient since it is not the weight loss that makes me feel better, but
what I think about the weight loss. I can feel better right now by changing the
way I think.

□   I have changed the way I think and feel content with myself most of the time.

 

If you are consistently practicing the behaviors above, some
weight loss may be possible. Make note of any thoughts/behaviors that you are
not able to do consistently and make them a priority. You may want to enlist
the help of a professional. Remember, never diet, it is the quickest
prescription to weight gain.

© Copyright 1999 Karin Kratina, MA, RD

Adapted from the unpublished work of Peggy DeMars, MS, RD

Download at www.NutritionTherapy.org Also visit www.NourishingConnections.com

 

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Jellyfish and the Boat

A colleague and I were talking the other day and were trying to find an analogy for the recovery process. I’ve heard a lot of analogies but I loved her latest one!

 

Let’s say that you’ve capsized off a boat in the middle of the ocean and all you have is your life preserver to keep you afloat. You see a boat in the near distance that you know will save your life but in order to be saved, you have to swim to it. You aren’t an expert swimmer and the water is full of jellyfish. You know you can’t just stay where you are forever because you will eventually drown. The journey toward the boat for safety will be terribly uncomfortable and scary. You will have to struggle to swim amidst the jellyfish. It is the only way you will be saved. You need to muster up an enormous amount of courage, hope, faith, and stamina. Then, you need to plow through those jellyfish one stroke at a time. Eventually you will be pulled out of the water, onto the boat and be led to dry land.

 

The only things that would hold you back are fear and lack of the essential ingredients of faith, hope, stamina and courage. Recovery is the same type of process. There is fear of the unknown, insecurity about the ability to do it, and desire to stay where it is familiar, even though it is a struggle in itself.

 

What enables some people to plow through the jellyfish, and swim to safety? Sometimes it is sheer will. Sometimes it is intrinsic strength. Sometimes it is hitting rock bottom. Sometimes it is the strong desire to have a fulfilling life. Whatever it is, it can be done. You can swim through the jellyfish. You can recover. Muster up the courage, strength, hope, faith and stamina, and move toward recovery!

 

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Who’s voice are you going to listen to???

How many times during the course of your life or during the course of your illness have you doubted what you were doing? How many times have you felt vulnerable and someone said something that completely blind-sided you and threw you into a tailspin? How many times has your recovery been set back by the voice…the words of another?

 

How many more times will you let it happen???

 

Your eating disorder wants to control you. It wants you to feel bad about yourself so it can soothe you, distract you, numb you out, or communicate for you. Your eating disorder takes advantage of things in your environment (like others’ comments) so that it can manipulate your thoughts and make you feel like you need “it” to get through life.

 

Several of my clients experienced the triggering voice of another person in the past few weeks. I too, experienced the triggering voice of another this weekend and completely understand how the words of another can make you question yourself, undermine your strength and self-esteem…if you allow it.

 

One thing that specifically upsets me (most definitely because I am a nutrition therapist) is when my clients hear nutrition or eating/dieting information from others…others who are NOT experts (and even sometimes from those who claim to be experts but who are not). These vulnerable individuals who are struggling to tune out all the triggers in the environment and stay focused on recovery, are easily impacted by information of all types…but particularly diet/weight loss/nutrition information.

 

I’ll give you a few examples to illustrate this issue.

 

A binge-eating patient (I’ll call her Sarah) recently went to the doctor for a yearly medical exam. She was already in a vulnerable place because she worried she would have to get on the scale and the nurse would say the number out loud. She has worked very hard at recovery and accepting herself and the body she is in. She has reduced the frequency and intensity of eating disordered behaviors and is trying to find a personal style of eating that fuels her and that she enjoys. She mentally prepared for the office visit and decided she would ask the nurse not to weigh her. All was going well with the nurse. But when the doctor came into the exam room, the first thing he said was “I see you haven’t lost any weight since your last visit. My wife just went on the XX Diet and lost XX pounds. Have you ever considered doing that diet? You need to cut out all XX and you will see great results.” All Sarah could think of was how to prevent herself from bursting into tears. She tolerated the rest of the exam, paid her co-pay and fled the office. On the way home, she drove to the drive-through at XX restaurant and used eating disordered behaviors for comfort and to numb her feelings of shame, guilt and powerlessness.

 

Another patient (I’ll call her Beth) who is in recovery from anorexia was at a family party recently. She was trying to eat what she felt comfortable with because social eating continues to be difficult for her. She got a plate of food and took it into the family room where several other family members were eating. A family member who doesn’t understand eating disorders and who thinks Beth is simply “attention-seeking”, yelled to Beth from across the room “Wow Beth! That’s a lot of food!” Beth immediately saw everyone’s eyes on her plate. She was speechless and just got up and walked out of the room, leaving her plate on the table.

 

This weekend, I received a gift from a well-intentioned family member. The gift was a book. The title and photo on the cover of the book expressed how terrible XX food is for health. She was very excited to not only give the book to me but also to explain how she had been following the guidelines for two weeks, had lost weight and felt “so much better”. She told me that I should use the book with my patients (clearly clueless about the nature of my work). Meantime at breakfast, while I ate the specific food the book was bashing, she explained to me the benefits of all the foods she was currently eating.

 

All of these examples illustrate how the words of another person can completely undermine your recovery, if you let it happen. In the case of Sarah, the doctor (person in authority) was perhaps attempting to “help” her by offering her advice but acted completely inappropriately and triggered her to feel a barrage of negative feelings about herself. With Beth, the person who commented on her plate of food was ignorant not only to what an eating disorder is, but also ignorant to the sensitivities of someone who is in recovery from an eating disorder. The family member who gave me the book was well-intentioned but also jumps on each new food bandwagon that comes her way, only to jump off a few weeks/months later.

 

 

What did I do in the situation? I thanked her for the book. I laughed with her about the irony that I ate the very food that the book alleged was dreadful. I told her that “balance” was key and I didn’t believe in the “all or nothing” principle. Then, in the rebellious fashion that I am known for, I ate that type of food several more times that day. I’m not sure whether I did that because I really wanted to, or because I was proving something to myself…probably a little of both. I considered the source. I love this person but I don’t consider her an expert on nutrition/food/eating disorders.

 

My advice is:

Take the “source” of the information into consideration. Remember that no one knows you better than you do, and no one else has the right to influence your actions except you. Also, think about what the “advice giver” has to gain by dispensing this information. Does he/she want to help you? Does he/she want to appear important or intelligent by doling out bits of information? Is he/she trying to undermine your recovery? Is he/she trying to exert power over you?

 

There is no right or wrong way to handle or process these types of situations or triggering comments. The goal of recovery isn’t to turn into a “perfect eater” or be a specific size or weight. The goal is to have a healthy relationship with yourself, other people, your environment, and your food/weight/body. If you experience the triggering voice of another, try to put it into context, speak up for yourself if you can. If you feel you can’t, then reach out to a “safe” accepting person who will understand and will help you process through your feelings.

 

 

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Owning My Recovery

The following post is from a client of mine. Thank you for writing this, PR. I think that many will find inspiration in your words.

A year ago I wrote a post titled Awake and Alive and I talked about the “pink cloud” I found myself in after committing to recovery. Today, I want to write about owning my recovery after a full year of struggling and fighting to stay “awake and alive”.

The “pink cloud” I experienced a year ago was the initial burst of good energy and happiness that followed my strong commitment to recovery. It was my first glimpse of how amazing my life could be without my eating disorder. It was the first feeling of freedom from the obsessions and rituals of my eating disorder. Unfortunately, the “pink cloud experience” didn’t last. It wasn’t that I gave up. It was just the natural evaporation of the cloud; as all clouds go. All was not lost though. Having the “pink cloud experience” showed me what my life could be like. It was a gift that gave me the opportunity to experience the beauty of life without my eating disorder. But gifts offer only fleeting moments of joy. True and lasting happiness comes from hard work and sometimes struggles through which one begins to establish ownership over their accomplishments. And that is what I’ve been doing for the past year. Struggling and fighting to own my recovery. Struggling and fighting to solidify my recovery and make it my own so that it could not and would not evaporate.

I will not whitewash the hard work of taking ownership of my recovery. There were times where I wanted to give up and times where I almost did give up. Then I would have to weigh the pros and cons. Did I really want to go back to my eating disorder with its obsessive, isolative nature? Or, did I want to continue on the road to recovery? I knew that the road of recovery was the only place where joy and happiness could be found. Yet, it was also a road full of obstacles, bumps, ditches, and boulders. Walking this road was tiring and sometimes I didn’t feel like going on. The battle of whether to continue the struggle or take the easy slide down was constant. And yet, amidst the tears I found moments of joy, beauty, and freedom which I knew I would never find elsewhere. By holding on to those nuggets of pleasure I managed to continue on.

There were days where bad body image skewed my ability to think clearly. Those were days where my perspective on life would become distorted and I would imagine that my happiness would only come from being a specific shape or size. On those days, I would cry and pound the walls in fury. I threw tantrums rivaling a two-year old. I hated myself and hid under the covers refusing to meet the world. And yet, despite the fear, terror, and self-hate that consumed me during those times I continued to walk on the road of recovery. Using reserves of strengths I never knew existed within me, I pushed onward.

Sometimes, the demands of my life overwhelmed me and I thought it would be impossible to go on. I needed my eating disorder to help me control my anxiety, and depression. I would dream about how nice it would be to use behaviors that would make me forget about everything else. Yet each time these thoughts surfaced I would force myself to see the bigger picture. Using behaviors and going back to my eating disorder was a packaged deal. Along with it, came the obsessions, rituals, and isolation. Later on would come the strong winds of depression and an inability to access the joys in my life. Did I really want to go back there? It was a question I faced again and again and again.

Owning my recovery meant learning to rely on myself for strength, encouragement, and love. This was perhaps the most difficult part of my recovery. When faced with challenges, I forced myself to go deep within and use my own resources to move forward. I built a support system for myself and wrote a list of activities that would distract as well as soothe me. Then, I made sure to use the list when the going got rough. I fought my eating disorder using every skill I could remember and created some of my own. I found the voice of my inner self and allowed it to speak against my eating disorder. I cried and laughed, learning to show and experience a range of emotions. I put words to my struggles and found new insight in every challenge. I made sure to learn from every mistake and used each experience as a stepping stone to greater heights. Most importantly, I learned to put the focus on myself. Recovering from my eating disorder was my responsibility. It was my fight, my struggle, my challenges. I was the most important person in my life and I came first. All the time, every time.

Today, I stand proud and tall on the top of the mountain. I see other mountains in the distance and I know that I must continue to climb. But today I am taking the time to notice and experience the joy of owning my recovery. I have scaled the mountain that is my eating disorder. I know there is no going back. The world stretches out before me, beckoning with all its beauty and hope. There is so much to live for and I am full of true joy and happiness. Life is beautiful. My life is beautiful. I hug myself and smile. I own my recovery. It is strong and solid beneath my feet.

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Are You a Casualty of Dieting? Tips for “Normal” Eating

No matter how many years or decades you have overeaten or how many diets have failed you, you still can learn how to become a “normal” eater—eating when you are hungry, choosing satisfying foods, remaining aware while eating and enjoying food, and stopping when you are full or satisfied.

 

Note: You did not fail on these diets. These diets failed you.

 

To succeed at weight management, you will need to:

  • Focus like a laser on eating “normally”
  • Stay persistent like a dog digging for a bone
  • Not expect overnight success
  • Switch your attention from the scale to your appetite
  • Learn effective life skills to manage stress and internal distress

 

Disregulated eaters can learn how to eat “normally.” Here are some tips to speed you on your way.

 

Using self-talk

Learn “normal” eating skills: Look in the mirror daily and tell yourself you can learn the skills of “normal” eating.

 

Think of foods as nutritional and non-nutritional: Instead of thinking of foods as “good” or “bad,” consider them as nutritional or non-nutritional, or nutritional or “fun”. “Good” and “bad” are moral terms that are best avoided in the food arena.

 

Give yourself praise: Do not put yourself down for the mistakes you make with food. Instead, lavishly praise yourself for your successes, even the tiniest ones.

 

Try a different approach: If experience tells you that diets do not keep your weight off, do not try to convince yourself that you should diet. Instead, give yourself points for trying a different approach.

 

Become your own cheerleader: Never say anything to yourself that you would not say to a young child you love, including calling yourself stupid, hopeless, bad, a failure, or worthless. Become your own cheerleader by generating positive thoughts about yourself and your progress.

 

Avoid all-or-nothing thinking: Do not use words like “never” and “always.” Remind yourself that most of life is not black and white, but gray. Think incrementally.

 

Do not dwell on untrue comments: Detoxify negative things people say about or to you that are untrue, rather than repeating them to yourself. Remember that what people say belongs to them, not to you, even if your name is attached to their words.

 

Connect to your emotions: Ask yourself often how you are feeling, so you can connect more easily to your emotions, but explore only with curiosity, not condemnation.

Stop judging yourself harshly: Develop self-compassion. Treat yourself lovingly. Practice speaking to yourself with extreme esteem.

 

Keep a positive attitude: Do not keep telling yourself that learning to become a “normal” eater is hard, because saying so only programs you to find the work more difficult. Instead, substitute words like challenging or doable.

 

Recognizing hunger

Rate your hunger: Check in with yourself often to see how hungry you are by using descriptions such as “not hungry,” “moderate,” “very,” and “famished” or a 1-10 scale.

 

Evaluate if you are hungry: Every time you think about food, ask yourself if you really are hungry enough to eat or if you actually need something else.

 

Consider having smaller meals: Experiment with eating smaller meals more frequently.

 

Think about hunger as a signal: It means that you need fuel, not that you have to go out and seek the most fantastic eating experience of your life.

 

Know what hunger means: Practice believing that hunger is for fuel and pleasure, not for meeting emotional needs.

 

Choosing satisfying foods

Choose for yourself: Do not get hung up on what other people are eating. Instead, ask yourself what you would like to eat.

 

Forget about good and bad: Remind yourself that foods fall on a nutritional continuum (high value/low value), not on a moral continuum (good/bad).

 

Make a satisfying choice: Never eat without first stopping to consider what you want. Spend time making your decision by tuning into your appetite.

 

Stay clear of guilt or shame: Refrain from allowing guilt or shame to contaminate your eating decisions. Avoid secret eating.

 

Choose foods that you like: Do not eat foods that you do not find satisfying or enjoyable. Eating them will make you think that you are on a diet.

 

Eating with awareness and enjoyment

Look before you eat: Before you eat, look at your food, its portion size, and presentation. Breathe deeply. Look again before taking a mouthful.

 

Chew every mouthful thoroughly: Chewing a lot helps to thoroughly release the flavor of foods.

 

Let food sit on your tongue: This allows your taste buds to absorb the flavor and transmit messages about your appetite to your brain.

 

Talk or eat: When you are talking, stop eating. When you are eating, stop talking.

 

Stay connected: Pay attention to your body’s appetite signals while you are eating.

 

Forget about guilt and shame: Push away guilt and shame while you are eating. Focus only on sensory pleasure.

 

Pause while you are eating: Think about how you are feeling about your food in terms of quality and quantity.

 

Know when to stop eating: Stop eating when flavor intensity declines, as it is bound to do. Do not try to polish off all of the food in front of you. Instead, aim for the moment when flavor peaks and you feel an internal “ah” of satisfaction—then stop.

 

Evaluate how full you are: Keep asking yourself while you are eating, “Am I still hungry?” and “Am I satisfied?”

 

Stopping when you are full or satisfied

Know the definitions: Think of “full” as having enough food (fuel) in your stomach and “satisfied” as reaching the high point of pleasure.

 

Quantify fullness and satisfaction: Use words, such as “nearly full,” “too full,” or “just right,” or a 1-10 scale to rate fullness and satisfaction.

 

Tell your body: When you feel full or satisfied, focus on that sensation, and broadcast it to your whole body.

 

Disconnect from food: When you are done eating, put down your utensils, push away your plate, and get up, if possible. At least mentally move on. Do whatever you need to do to disconnect yourself from the food.

 

Decide when enough is enough: Make sure you do not focus on food that is left in front of you. Recognize that you do not have to finish it or clean your plate.

 

Changing your beliefs

 

From: To:

“I need to diet to lose weight.”

“Diets do not work long term.”

“This is too hard.”

“I can learn to do this over time.”

“This will take too long.”

“If I do not change now, I will only end up back in this same place again, so I might as well get going on it.”

“Losing weight is the most important thing.”

“I will lose weight if I honor my appetite and learn to eat ‘normally.’”

“I am bad/worthless/ugly if I am overweight.”

“I accept my body as it is and still will try to improve it.”

 

Stopping emotional eating

Consider your feelings: If you have the urge to eat when you are not hungry, identify the emotion you are feeling.

 

Think of a different response: Remind yourself that feelings need an appropriate response—not food.

 

Know the emotions that trigger unwanted eating: Boredom, loneliness, anxiety, shame, guilt, disappointment, confusion, and helplessness can trigger unwanted eating. Look for more effective ways of dealing with these feelings.

 

Keep a feelings log: This will help you keep track of what is going on inside of yourself all day long.

 

Reduce stress: This will lessen frustration, helplessness, and the overwhelmed feeling you sometimes have that may drive you to eat.

 

Take care of yourself: Make sure you are taking care of yourself (with rest, sleep, hobbies, and fun) at least as well as you take care of others.

 

Learn from your behavior: If you find yourself eating when you are upset, do not take it out on yourself. Treat yourself with compassion and curiosity. Think about your behavior as a learning experience.

 

Find help: If you have a history of trauma or abuse, get help through therapy. A strong correlation exists between such a history and emotional eating and weight gain.

 

Take responsibility for yourself: Do not blame others for your emotional eating. Take accountability for your actions.

 

Build emotional muscle: Tell yourself that you can bear any emotion and practice doing so. You will find that the emotional muscle you build is amazingly strong and enduring.

 

 

References and recommended readings

Koenig KR. Nice Girls Finish Fat: Put Yourself First and Change Your Eating Forever. New York, NY: Fireside/Simon and Schuster; 2009.

 

Koenig KR. The Food and Feelings Workbook: A Full Course Meal on Emotional Health. Carlsbad, CA: Gürze Books; 2007.

 

Koenig KR. The Rules of “Normal” Eating: A Commonsense Approach for Dieters, Overeaters, Undereaters, Emotional Eaters, and Everyone in Between! Carlsbad, CA: Gürze Books; 2005.

 

Koenig KR. What Every Therapist Needs to Know About Treating Eating and Weight Issues. New York, NY: WW Norton and Co; 2008.

 

 

Contributed by Karen R. Koenig, LCSW, MEd

 

 

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Top Ten Diet Myths That Won’t Go Away!

The following are the top ten diet myths that I debunk on a regular basis! I don’t know why these continue to be perpetuated. Let’s set the record straight!

Myth 1: Fad or crash diets help you lose weight permanently.

Fact: A fad diet is the worst way to manage long-term weight goals. Most fad eating plans advocate cutting out certain foods to lose weight quickly. Although this may sometimes be true at first, in the long run this will prove to be unhealthy. By avoiding certain foods, the body may be deprived of nutrients. Also, people get tired of such diets fairly quickly and regain the lost weight all over again. Research has proven that eating healthy and exercising moderately will help you develop a healthier lifestyle and maintain the appropriate weight for you.

Myth 2: You can lose weight by skipping meals.

Fact: Your body requires a certain amount of calories and nutrients each day. When you skip meals, your body tries to make up for the lost calories by demanding more food. In all likelihood, you will end up eating more at the next meal! Studies have shown that people who eat a nutritious breakfast are healthier and maintain a “healthy” weight more than those who skip breakfast.

Myth 3: Snacking will make you fat.

Fact: Snacking will not make you fat. The total amount of calories is what matters, but you can split your food up any way that you would like. Some people enjoy eating three large meals/day, while others prefer eating six small meals/day.

Myth 4: Avoid eating after 8 p.m. since it causes weight gain.

Fact: It doesn’t really matter what time of day you eat! All that matters is how many calories you take in during the whole day and how much you lose due to resting metabolic rate, exercise and lifestyle.

Myth 5: You can burn fat by eating certain foods, like grapefruit and cabbage  soup.

Fact: No foods can burn fat. Celery, grapefruit, etc will not make you burn calories and lose more weight. “Negative” foods (foods that cause you to burn off more calories than the calories you get from eating the food) simply do not exist.

Myth 6: Foods high in fat are fattening and should be avoided if you want to be healthy or lose weight.

Fact: The body needs fat for energy, tissue repair, brain health, hormone production and to transport vitamins A, D, E and K around the body. Women need approximately 70g of fat a day (95g for men) with 30g as the minimum (40g for men). For example, although nuts and nut butters are high in fat, they have incredible health benefits. Also, most nuts have low amounts of saturated fat. Nuts contain protein and fiber. There is no such thing as a “fattening food”.

Myth 7: Drinking lots of water helps to “flush fat” out of your body and leads to weight loss.

Fact: Water has no real impact on weight loss, although it is important to overall health. Drinking ice-cold water also does not increase calorie burn.

Myth 8: Muscle will turn to fat if you stop exercising.

Fact: Muscle cannot turn to fat and fat cannot turn to muscle. It is not physiologically possible.

Myth 9: You should try to avoid carbohydrates/starches as they are fattening.

Fact: No matter what food group you choose, if you cut out the items from that group, you will reduce your caloric intake and lose weight. If you add foods, you will increase your caloric intake and gain weight. The problem is that if you cut your carbohydrate/starch intake, you also will reduce your nutrient intake. It is not necessary or desirable to cut carbohydrates from your diet. They are your body’s #1 preferred source of energy! Instead, make some of them complex carbohydrates. The best choices of carbohydrates/starches are whole grain breads and cereals, beans and legumes, dairy products, and fruits and vegetables like yams, turnips, and beets.

Myth 10: Eating spicy foods will increase the metabolism, causing weight loss.

Fact: If that were true, many people would be devouring chili peppers! Spicy foods do cause a slight increase in metabolism, but the effect is so minimal and short-lived that it does not make a difference as far as weight loss is concerned.

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Smash That Scale!

I know I have posted before on the topic of “scale popping”, but it’s worth a reminder to everyone who suffers from an eating disorder that the scale is NOT something that you want to embrace as a motivator, a measure of your success at recovery or your self-worth. Yes, the scale is sometimes useful for your “treatment team” to utilize as an objective criteria for level of care, sort of like blood pressure, blood work, and heart rate. It is NOT a tool for someone who is in recovery to use to measure their recovery. Yikes!!!! When you weigh yourself to “see” how you are doing, you are instantly giving your eating disorder power over you…plain and simple.

Weight will fluctuate, depending on many things that your treatment team will help you in understanding. When you are in your bathroom (or wherever your scale is placed), the only people you have to “process” the weight with, are you and your eating disorder. Hmmm….not a good idea. Your eating disorder knows how to twist facts to make you feel bad about whatever the number is. It is an expert on undermining your self-esteem, making you feel guilty, and making you question everything.

So, my recommendation to you is to leave the weighing up to your trusted professionals…your nutritionist, doctors, or therapist (unless you have discussed other options with them). Your eating disorder cannot be trusted to “help” you with this very delicate issue.

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Intuitive Eating

This topic is so broad it would take an entire book to cover all the characteristics. I just want to discuss appropriateness of this type of eating in recovery. I feel like so many of you want to try it but get worried because it is a concept that is foreign. So, first and foremost, when you are ready, you will hopefully know. Or, you and your treatment team will know. If you are not ready, there isn’t a “race” to get there. I think some people look at it as the end point of their recovery, a point of no return, and that alone brings up fear. Some people have asked me, “what if I go out of control because I can’t do it? What if I gain too much weight because I can’t trust my inner cues or they are wrong? What if I choose all the ‘wrong’ foods and then I can’t turn back? ” and the most common question is “What if my intuitive eating makes me gets me to my natural weight and it is higher than I like?”

What if, what if, what if????? All these “what if’s” are a huge obstacle but they sometimes also demonstrate a lack of readiness and fear. If you have a bunch of “what if’s” about intuitive eating, DON’T discuss it with the eating disordered part of your mind. Your eating disorder will turn it into a “fear fest”. Discuss it with your treatment team, especially your nutritionist.

If you have had an eating disorder for any length of time, your eating has been “from the neck up”. What do I mean by this? Your eating has been guided by your head only – your thoughts, your rules, your emotions, your past experiences, your disordered fears…not by your normal natural physiological mind-body cues. If you have restricted, binged, compulsively overeaten, purged, taken any appetite-suppressing substances or laxatives, overexercised, or a combination of these, you have “short-circuited” your natural means of detecting hunger, fullness and appetite. So, as a result of this short-circuiting, you will need to learn the skill that non-disordered people exhibit normally, until it actually becomes intuitive.

When are you supposed to do this and how are you supposed to do this??? It varies person to person but you can only expect to start the process when you are well-supported by your team. You cannot begin if you are at an extremely low weight or are using eating disordered behaviors regularly. You must be medically stable for a good stretch of time and should be eating consistently (perhaps on a meal plan). Also, you have to do this when you are confident that you have the ability to separate your emotions from your eating. You must also realize that you will make mistakes along the way. Sometimes you will eat too much and feel too full (scary) and sometimes you will undereat and want more (clearly a risk if you are not ready). This is an essential part of the process. No one learns how to intuitively eat “perfectly” without making mistakes.

Also, I like to look at the parallels between what you do with your food and where you are in developing your life skills as an indication of your readiness. So, as far as intuitive eating is concerned, when you are being more intuitive (guided by your gut instincts) in other areas of your life and trusting yourself with decisions regarding relationships, feelings, self-care, boundaries, etc, you will be more equipped to develop your intuitive skills regarding your eating. Overall, you will be living a more trusting relationship with yourself.

Please remember that recovery is a process (I feel like I say this so often!) and you need to know where you are in the process. I want you all to be able to trust your process and unquestionably get to the point where you can trust your true self! Just try to stay focused on where you currently are in your recovery and take the baby steps that are in front of you.

Below are the 10 Intuitive Eating Principles, by Evelyn Tribole & Elyse Resch, authors of Intuitive Eating

1. Reject the Diet Mentality Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily, and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet stopped working and you gained back all of the weight. If you allow even one small hope to linger that a new and better diet might be lurking around the corner, it will prevent you from being free to rediscover Intuitive Eating.
2. Honor Your Hunger Keep your body biologically fed with adequate energy and carbohydrates. Otherwise you can trigger a primal drive to overeat. Once you reach the moment of excessive hunger, all intentions of moderate, conscious eating are fleeting and irrelevant. Learning to honor this first biological signal sets the stage for re-building trust with yourself and food.
3. Make Peace with Food Call a truce, stop the food fight! Give yourself unconditional permission to eat. If you tell yourself that you can’t or shouldn’t have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, bingeing When you finally “give-in” to your forbidden food, eating will be experienced with such intensity, it usually results in Last Supper overeating, and overwhelming guilt.
4. Challenge the Food Police Scream a loud “NO” to thoughts in your head that declare you’re “good” for eating under 1000 calories or “bad” because you ate a piece of chocolate cake. The Food Police monitor the unreasonable rules that dieting has created. The police station is housed deep in your psyche, and its loud speaker shouts negative barbs, hopeless phrases, and guilt-provoking indictments. Chasing the Food Police away is a critical step in returning to Intuitive Eating.
5. Respect Your Fullness Listen for the body signals that tell you that you are no longer hungry. Observe the signs that show that you’re comfortably full. Pause in the middle of a meal or food and ask yourself how the food tastes, and what is your current fullness level?
6. Discover the Satisfaction Factor The Japanese have the wisdom to promote pleasure as one of their goals of healthy living In our fury to be thin and healthy, we often overlook one of the most basic gifts of existence–the pleasure and satisfaction that can be found in the eating experience. When you eat what you really want, in an environment that is inviting and conducive, the pleasure you derive will be a powerful force in helping you feel satisfied and content. By providing this experience for yourself, you will find that it takes much less food to decide you’ve had “enough”.
7. Honor Your Feelings Without Using Food Find ways to comfort, nurture, distract, and resolve your issues without using food. Anxiety, loneliness, boredom, anger are emotions we all experience throughout life. Each has its own trigger, and each has its own appeasement. Food won’t fix any of these feelings. It may comfort for the short term, distract from the pain, or even numb you into a food hangover. But food won’t solve the problem. If anything, eating for an emotional hunger will only make you feel worse in the long run. You’ll ultimately have to deal with the source of the emotion, as well as the discomfort of overeating.
8. Respect Your Body Accept your genetic blueprint. Just as a person with a shoe size of eight would not expect to realistically squeeze into a size six, it is equally as futile (and uncomfortable) to have the same expectation with body size. But mostly, respect your body, so you can feel better about who you are. It’s hard to reject the diet mentality if you are unrealistic and overly critical about your body shape.
9. Exercise–Feel the Difference Forget militant exercise. Just get active and feel the difference. Shift your focus to how it feels to move your body, rather than the calorie burning effect of exercise. If you focus on how you feel from working out, such as energized, it can make the difference between rolling out of bed for a brisk morning walk or hitting the snooze alarm. If when you wake up, your only goal is to lose weight, it’s usually not a motivating factor in that moment of time.
10. Honor Your Health–Gentle Nutrition Make food choices that honor your health and taste buds while making you feel well. Remember that you don’t have to eat a perfect diet to be healthy. You will not suddenly get a nutrient deficiency or gain weight from one snack, one meal, or one day of eating. It’s what you eat consistently over time that matters; progress not perfection is what counts.

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