Tag Archive | Emotional Hunger

Top Ten Strategies to Use at Meal and Snack Times

 

Until you are fairly far along in the recovery process, you may need varying degrees of strategies to help with your eating. Ultimately, you will be able to achieve a more peaceful relationship with food and your body, but until then, here are ten strategies to use. Also remember that you are very vulnerable to the “voice” of your eating disorder in the moments before, during, and after you eat, so mentally “arm” yourself for the possibility of hearing negative, critical, and catastrophizing statements during these times. Take your power back!

 

 

1.  Write down and use positive healthy statements for eating times, such as “I am going to do what is best for my recovery at this meal, no matter what negative thoughts I have.” “I need this food to help my body stay strong.” “By eating this meal, I am helping to gain clarity.” “There is no such thing as a perfect meal, but I will do the best I can to eat well.” “I need food for my organs to function at 100%.” “Even if I eat more than I set out to eat, I will not beat myself up because I am doing the best I can.” “Nothing bad can possibly happen to me by eating this meal right now. Only good things can result from giving my body nourishment.” “I will not base what my nutritional needs are on the negative feelings I have about my body. I will eat what I know to be the best meal for my overall health, and my psychological well-being.

2.  Try not to go longer than 4 waking hours without food. The body is designed to be fed at regular intervals and going too long without food may create heightened food obsessions, cravings, and extremes in hunger. By sticking to a fairly regular schedule of eating, you will be better able to think clearly and tune into your body’s needs better.

3.  Make sure you are in a calm emotional place when you sit down to eat. Eating while upset, angry, anxious, or in any negative emotional state can alter your hunger and fullness cues, and increase eating disordered thoughts, urges, and behaviors.

4.  If you need meal time support from a family member, friend, or other loved one, ask for it before you sit down to eat. Once you sit down with food in front of you, you are already too vulnerable. Sometimes a supportive person can distract you from the negative eating disordered voice and can help make the meal/snack a more enjoyable experience overall.

5.  There’s a saying that goes “if you fail to plan, you plan to fail”. Try to think about what your day is going to look like in terms of schedule, activities, places you will be, and people you will be with. Think about, and plan for how you will meet your nutritional needs. You don’t have to obsessively plan everything you will eat, but be prepared for the day. Clients often say to me “I didn’t have time to eat this food or that food.” “I didn’t have time to prepare my food.” “I didn’t have xxx food in the house, so I just grabbed something at the last minute.” “I didn’t know what I wanted so I didn’t eat.” “I didn’t have anything I liked to I just ate random stuff.” “I ran short on time so I just grabbed something and ate it in my car.” These are excuses, justifications that are not putting recovery as the top priority. Decisions like these will ultimately set your recovery back. Recovery must come first, and having a plan to eat well, and often, must be priority #1.  (I am very busy during the week, and I never ever go to work or anywhere without either bringing plenty of food with me or knowing where I can buy a very satisfying meal/snack. Planning to be well fed reduces my anxiety and assures me that I will be able to meet my needs as well as I possibly can.

6.  Try your best not to multitask while eating. Even if you need distractions while eating, try to be as present as possible. The more mindful you are, the more you can be attuned to what your food needs are. Try not to eat while driving, watching TV, on the computer, or working?

7.  Make sure the meal/snack “counts” psychologically. Too often, people with eating disorders make food choices based on rigid rules, not based on what they like. If you are on a meal plan, or if you are working on intuitive eating, choose foods that appeal to you. Choose foods that you are in the mood for, not foods that you think you “should” have. Eating the same exact foods every day, eating by strict rules, eliminating certain food groups or nutrients, eating less than you know is best for you, are all forms of restriction and will potentially backfire sooner or later.

8.  Make sure you are working on incorporating a wide variety of foods and all the macronutrients (protein, carbohydrate, and fat). The human body has a need for all the nutrients, to work optimally. It is best to have at least three or four food groups at meal time, and at least two food groups at snack time. By having a variety of food groups, and having foods that appeal to you psychologically (strategy #7), your body will be well fueled and you will feel satisfied. By accomplishing both physical and psychological satiety, you will also get food off your mind a bit easier, obsessions may diminish, and your mind will be freed up to focus on your passions and other pleasures. Remember though, that your eating disordered “voice” will try to beat you up for eating foods that give you pleasure. Tell that negative voice that by eating foods you like, you are getting stronger and closer to recover

9.  Eat sitting down at a table or counter, with as pleasing of surroundings as possible. Use appealing tableware, tablecloth or placemat, and utensils. It is optimal to have all the conditions possible to have a pleasant, mindful meal. You could even make your own special placemat, bowl, or plate. Try not to eat standing up. Food eaten while multitasking or standing up doesn’t “count” psychologically, sets you up for feeling dissatisfied, and increases urges to crave more food.

10.  If one meal or snack doesn’t go well, or if you have used an eating disordered behavior at any time during the day, don’t write the entire day off as a “failure”. At the very next time you need to eat, in order to maintain your structure, you have the opportunity to turn things around. Try to never, ever, end the day with an eating disordered behavior or disordered meal. Make sure you end your day doing something positive with your food. There is no stronger statement you can make regarding recovery than going to bed having done the best you could at the end of the day.

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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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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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Restriction vs Restraint

A client recently asked me what the difference between restriction and healthy restraint was. She suffers from an eating disorder where her eating behaviors range from severe restriction to binge eating. She rarely experiences times where her eating is comfortable, easy and pleasurable. I’ve been working with her on understanding that the periods of restriction are often followed by periods of bingeing and in order to reach the comfortable eating place, she cannot continue to give herself permission to restrict. She revealed to me that she knows no other way to avoid bingeing except to restrict. It’s “all or nothing” with her eating she says. She says sometimes it’s easier to not eat at all because once she eats she has strong urges to binge and finds it impossible to resist them.  Wow. This is such a powerful statement, yet one I have heard numerous times in the treatment of people with binge eating disorder. So, I have said to her on a few occasions that she may practice “healthy restraint” at times, because it has less of a chance of causing binge eating than restriction does. So…what exactly is healthy restraint vs restriction?

Restriction, in my opinion, is rule-driven deprivation of food that overrides the body’s natural intuitive hunger, its “starting point” for eating. It is a deliberate withholding of food despite the desire or appetite for it. It may include the withholding of overall food intake, of specific nutrients, food groups, times of day, time periods, etc. It is often painful and creates heightened obsessive thoughts of food. Restriction is quite common with individuals with anorexia, bulimia and binge eating disorder. Also there are numerous individuals who don’t have a diagnosed eating disorder who restrict their food in order to be a specific weight or size. It is not a matter of “will-power” or strength. Restriction is unnatural. It doesn’t make someone more powerful or “in control”.  It is counter-intuitive and often backfires.

“Healthy restraint” is different. It is a behavior that many healthy people engage in every day in choosing what and how much to eat. Restraint is not about rigid rules, but more about choice. It is flexible, based on the body’s intuitive cues of hunger, appetite and fullness. Restraint is a mixture of intuitiveness and choice. It is knowing you are full or you’ve had enough and then telling yourself it’s ok to stop now because you are satisfied and you can eat more later if you want to.

By giving you a couple examples, it might illustrate the difference better. Allison has an eating disorder. She fears losing control over her intake of food time and time again. She has convinced herself that she overeats every time she is in the presence of a food she likes. She has told herself that if she doesn’t limit herself from all pleasurable foods, she will overeat. She avoids numerous foods, opportunities to eat out with friends and family because she doesn’t want to binge. She keeps a very limited array of foods in her house. She has developed very strong negative feelings and opinions regarding foods other than the very select few she deems “safe” or “good”. If she eats a food that isn’t on her safe list, she is convinced she will binge. She inevitably does binge on these foods and then restricts them once again, making her theory that she can’t eat them even stronger.  On a weekend night, Allison goes out to dinner with her family. Her family orders a variety of choices off the menu. Allison orders a salad with grilled chicken, dressing on the side. She says she doesn’t like anything else on the menu. She refuses the bread that’s on the table, she doesn’t eat a dessert.  She orders a diet soda to drink. She spends the meal making small talk meanwhile she is preoccupied with all the foods everyone else is eating, telling herself they are crazy for eating those foods, the foods are horrible, if she ate one of the entrees everyone else chose, she’d go out of control, gain tons of weight and her life would be miserable. She tells herself she is much better off only eating her “safe” “healthy” salad. Yet, all the while, she really knows she loves the other foods. She wishes she could let herself have them and eat them in the amounts that “normal” people do.   When dinner is over, she feels sad, angry and deprived. Somehow she convinces herself that it was the right thing to do. A few days later, in a “moment of weakness” while at the grocery store, she buys a box of cookies along with the other groceries. She barely gets the car door closed when she rips into the bag of cookies and eats half the box before she makes it home. Clearly, in this instance, Allison experienced restriction which led her, in part, to rebound binge on cookies. Not to say that restriction always leads to bingeing or that there aren’t multiple causes for bingeing but restriction is NOT a positive or natural behavior.

Robin also has an eating disorder. She has spent months trying to achieve structure in her eating by eating three solid meals a day and eating exactly what she desires at each of these three meals. Her breakfasts are not the traditional breakfasts. She prefers dinner foods for breakfast. She no longer follows her old restrictive rules. She listens to her intuitive side and eats well. On an occasion recently, she was invited out to lunch with several friends. As they were ordering, she listened to the women all speaking about what foods they wouldn’t order off the menu, how they would never eat “this or that”. They all ordered salads. When it was her time to order, she ordered a hamburger and fries. They all looked at her like she was crazy. She told them she wanted the burger. She had to listen them all comment how bad her choice was. Lunch arrived and she proceeded to eat her burger and fries with gusto. About ¾ of the way through her meal, she was comfortably full. It tasted delicious and she told herself that she could have eaten the whole burger and all the fries, but she decided that she had eaten enough to satisfy her and if she wanted a burger and fries again for dinner or the next day for any of her three meals, she would have it. There was no “need” to eat it all at lunch and push past the feeling of being satisfied into feeling “overfull”. She was exhibiting healthy restraint because she offered herself the choice to have it all or have it again whenever she wanted it next. This took the power away from the food and enabled her to use her intuitive skills to determine when to stop.

Now, some people truly don’t have intact intuitive skills like this so they must look at their plate of food and make sure they don’t stop prematurely, before they feel they are truly satisfied or eat it all simply because it is there. They want to go into the meal with an open mind instead of a restrictive, diet mindset or a “rebound” mindset. If they aren’t mindful, they may end up eating less than they need or more than their body wants them to.

Just recently a mom came in with her teenage son (who was not diagnosed with an eating disorder) to my office. She wanted to discuss why her son gained a significant amount of weight in only six months. I asked her what the food was like in her house. She said that she never keeps “junk food” in the house because every time she does, her son eats it all and exhibits no control over it. Also, whenever he’s at his friends’ houses, he overeats on cookies and soda. I asked him if he felt deprived of these foods so whenever he got the chance, he would take the opportunity to overindulge on them? He looked at me with a sigh of relief and  began to cry because I had said exactly how he felt. He was restricted from having these foods at home and that set him up for craving them all the time. His mother agreed to have an abundance of these foods at home from now on and to never let them run out. He agreed that he would try to take the power away from these foods. I have seen examples of this type of power struggle over food many, many times. The people who have had foods withheld from them are those who often have strong cravings for them. On the other hand, it’s those who have abundance and variety of foods to choose from who are often those who do not feel deprived and therefore can choose foods without the emotional “tug of war”. In time, this teenage boy will be able to have a wider variety of food preferences. He will most likey choose “junk foods” sometimes and other types of foods sometimes. He will be able to exhibit healthy restraint because his preferences will change and be based on intuitiveness and choice rather than restriction and rebound craving.

Note:  I want to emphasize that many individuals who are in the throws of their illness or who are in early stages of recovery may not be able to differentiate between restriction and healthy restraint and therefore must ask their treatment professionals if it is a skill they can work on together. It is easy to convince yourself you are exhibiting restraint when in actuality, you are restricting. This especially would not be a skill that would be appropriate for the early stages of recovery from anorexia.

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Hunger and Fullness Scale

When you are determining when to eat and how much to eat and trying to get closer to intuitive eating, a good way to practice is by using the hunger-fullness scale. This scale will be difficult if you are in the early re-feeding stages of anorexia so if you are suffering from anorexia and at this stage of your illness, you will need to wait until you are a bit further along in your recovery to practice these skills. Intuitive eaters do these skills without even thinking, but disordered eaters will be able to use this tool as a “road map” to take them toward intuitive eating.

Hunger and fullness cues  may be foreign to you because perhaps you have overridden them over and over, or have developed so many food rules that you don’t know if your body is giving you the information you need to determine when to eat or to stop or if it is your rules that are at play. Also, if you have been using food in one way or another for emotional reasons, you may misinterpret the need for something else for the need for food. Finding your hunger and fullness will take time. You will make mistakes. It’s ok. Like any skill, practicing is essential. Just be patient with yourself and give yourself time.

Hunger and fullness can be felt on a scale of 1 to 10, 1 being the most extreme hunger and 10 being the most extreme fullness. The scale may give you hints to discover or uncover your cues. You may experience some of these sensations or you may feel others altogether. Keep track of what comes up for you at each level.

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  1. Starving State – I am so hungry I want to eat everything in sight. I feel urgency. I have severe hunger pangs. The feeling is intolerable. I may be shaky and lightheaded, weak, and/or sleepy. I am obsessing about food.
  2. Ravenous State – I am overly hungry but not to the point where it is intolerable. I have pain in my stomach. I feel energy drained and a bit lethargic. I have lack of concentration and significant thoughts of food.
  3. Solid Hunger State – I am solidly hungry. I have slight hunger pangs or twinges. The discomfort is mild. I definitely want to eat but I feel in control. I feel like I really know what I want to eat that will satisfy me.
  4. Mild Hunger State – I am not quite hungry. I feel slight sensations in my stomach but I’m not quite ready to eat. I have a bit of stomach growling. Thoughts of food are mild. I know I will want to eat soon.
  5. Neutral State – I feel neither hunger nor fullness. I really have no physical sensations at all. I have little or no thoughts of food.  If I eat now, food may not taste as good as I hoped it would.
  6. Mild Fullness State – I am a little full but I could eat a bit more to feel satisfied. I have slight sensations in my stomach but I feel it’s too soon to stop eating. I’m beginning to feel a bit more energized.
  7. Solid Fullness State – I am solidly full. I feel no hunger pangs. I feel slight sensations in my stomach but they are not painful. I feel satisfied and peaceful.  I feel like I have some energy in my body. It is a good feeling. Food begins to be a bit less appealing.
  8. Slightly Overfull State – I feel slightly overfull like perhaps I should have stopped eating a few bites sooner. My stomach feels like it may be distended a bit. I feel slight pressure on my stomach from my clothes.
  9. Overfull State – I am overfull. I feel physically uncomfortable. My clothes feel tighter around my stomach. I feel drained and sleepy. I am bloated.
  10. Stuffed State – I am exceedingly full. I feel extremely physically uncomfortable. Food no longer tastes good. I ate much more than I feel was good for my body. I have no energy. I feel like I could get physically ill.   

Now that you have a better understanding of the scale, it is time to give yourself an opportunity to experience it. As you go through your day, try to assess where you are on the scale. The goal is to stay between #3 and #7 as often as possible. Try to begin eating your meals when you are at #3 and finish when you are at #7. You will need to begin preparing your meals when you are at #4 though, to give you the time you will need to make sure you are ready to eat when you are at #3. Snacks should keep you between #3 and #7. They will help you manage your hunger between meals. There will be times of course, when you may slide below a #3 and go beyond #7, but at #1 and #2, #8, #9, and #10, you are in the “out of control zones”. This means that you will feel physically and emotionally uncomfortable. Your decision-making capacity will diminish and obsessive thoughts will increase. For a person with an eating disorder, these zones may give the eating disordered part of your mind strength, and your urges to use eating disordered behaviors may heighten.  It’s best to plan meals every 4 to 5 hours and plan snacks 1 – 3 hours between meals, or the likelihood of going into the “out of control” zones increases.

Protect yourself physically and emotionally by trying to stay in your safety zone! The more you practice, the easier, more comfortable and familiar your hunger and fullness will become.

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Honor Your Hunger


Many people who suffer with an eating disorder – anorexia, bulimia, binge-eating disorder – often either don’t “feel” hunger, don’t understand what hunger “looks” like for them, or won’t acknowledge its existence. They may experience pain, growling, nausea, headaches, a vague sensation in the stomach or nothing at all. Or, at the first signs of hunger, they may try to “override” it by using all sorts of hunger-suppressing rituals or mind games. Hunger is the body’s physiological need for food. It is driven by all things that are beyond your control like hormones, blood sugar levels, and brain chemicals. It normally comes at predictable intervals.

It’s not your fault if you don’t “experience” hunger healthfully at this point in your life or if you are afraid of it. If you have had restrictive, disordered, emotion-driven or chaotic eating, you may have overridden this primal physiological state over and over again. You may not recognize it if you were to experience it. Also, when it does emerge, it is probably frightening. Hunger for those who have an eating disorder feels out of control. Instead of it being simply a physical reminder that the body needs nourishment, it has become an emotional mine field. Should I eat or shouldn’t I eat? If I eat, will I stop? Maybe I should wait till later. The hunger will go away if I distract myself. What do I want to eat? What should I eat? Should I eat something “good” or “bad”? I shouldn’t be hungry, I’m fat. If I eat when I’m hungry I’m weak. How many times have you said any of these things to yourself in response to hunger? Hunger and eating have become so convoluted.

A positive step in recovery is to accept that hunger is a clue that your brain is providing you, to let you know your blood sugar is low and your billions of cells need re-fueling. It is truly nothing more, nothing less. It is NOT something you want to override because your brain will go to great lengths to keep reminding you that you need to feed your body. It will make you obsess about food, and it will continue to produce powerful “hunger chemicals” to create urgency so you will feed it. If you accept this fact, hunger may be a little less emotionally charged. Then you may be able to take the power away from the food and give it back to yourself to make healthy decisions regarding what and when to eat! In another post, I will write about the “hunger-fullness scale” to help you understand hunger and fullness better but you must take the first step… honor your hunger!

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The Bingeing Roller Coaster

“Why do I binge? I know I don’t want to. Most times I’m not even hungry. I can’t help myself. Something comes over me and I can’t stop. I know I’m going to regret it afterward but that still doesn’t help me while I’m bingeing. I hate my body but that doesn’t stop me from bingeing. I binge until I can’t breathe. I promise myself after every binge that I won’t do it ever again, yet it inevitably starts all over again and again and again.”

This sounds like turmoil that is unsolvable. It is torture of unbelievable magnitude. It feels unbearable yet unstoppable. I know some of you can imagine this very vividly.

“Why? How can I stop? Please tell me what to do and I’ll do it.” If the answers were simple, then no one would suffer from binge-eating disorder, no one would ever experience this type of eating, and no one would need support. So, are there any strategies that can help people who binge? 

Although the answers and strategies are complex and support is often needed to overcome binge eating, there are some steps you can take initially that may provide you with some insight and/or relief. First, you need to understand that your binge doesn’t begin when the first bite of food is put into your mouth. Just like an alcoholic’s binge drinking episode doesn’t begin when they take the first drink. It begins way before the food (or alcohol) is present. That is where you need to put your attention in order to develop insight. The time period that precedes the binge is where you can find a lot if information about why you are bingeing.

Take a moment to recall your last binge and slow down the time frame, the hours before you binged. This is essential to help see what the conditions were that set the stage for the binge. Were you overly hungry or deprived and your binge was deprivation-driven? Was there something stressful going on in your life that may have elicited a negative emotion. Were you triggered by a person, place or event? If you are not successful at feeling your emotions then just look at the circumstances that preceded the binge. What happened hours or moments before the binge? You need to develop an understanding of your triggers, your set-ups (so that in the future you can work through these things more effectively).

Now let’s understand urges to binge. A binge is most always preceded by urges to binge. People sometimes binge without strong urges but I am referring to those binges that are preceded by strong urges. Have you ever been on a roller coaster? Can you recall when you are on the track and you are slowly going up the hill? As you are going up the hill, the anticipation, excitement and fear gets stronger as you get closer to the top? Then there is a moment when you are at the top of the hill and then your car starts accelerating down the other side of the hill? That’s like an urge to binge. It starts off slowly. It climbs and climbs until it reaches a peak, and then, if left to run its course, it goes down. It may go up and down for a while, but it will subside, just like the roller coaster ride comes to an end. You have to be prepared to go for the ride. You need to withstand the urges, understanding that they will subside. You also need to understand that urges to binge are covering up emotions and the binge obliterates the emotions. The bigger and stronger the urge to binge or the binge itself, sometimes the bigger and stronger the emotion(s) you are trying to cover up.

Once you can see a bit more clearly what precedes your binge, you can decide to do one of three things. (1) You can binge. It is always an option. If you binge though, don’t let a binge episode happen without learning something from it when it’s over. Insight is essential when trying to understand the function of your binges. Look back on your binges with objectivity, like a detective trying to piece together a puzzle. (2) You can distract yourself, but you need to be prepared to do whatever is necessary to avoid the food, for as long as the urges last. I have a client who consistently gets her strongest urges on Sunday nights. She has identified the triggers as dread of going to work on Monday morning and facing a week of stress at her job, as well as loneliness that always seems worse on Sunday nights. Most Sunday nights, she has to leave her house and drive to a store, walk around for about an hour till the urges pass, then she can go back home. She has worked very hard at clearly identifying her triggers for these specific urges to binge but she still chooses to avoid the food on some Sundays or she feels she will binge. You may need to get out of the house. You may need to go to a public place like a bookstore, a library, go for a ride, or call someone. This is avoidance or distraction from the issues and obviously, the ultimate goal is to face and overcome the issues, but distraction is a temporary way to potentially avoid a binge.  The urge will pass! (3) You can decide to endure and tolerate whatever you need to feel during the time you would have urges to binge or be bingeing. When I tell people this, they want to jump across the room and tackle me. It sounds so harsh. People who have consistently given into their urges to binge are terrified of how they would feel if they were to take this step. Remember, that’s why people binge…to avoid what they feel! Bingeing is NOT about the food! It serves a function. The function is to numb out, avoid, stuff down feelings. One client told me she worried that she would just “disintegrate” if she were to allow herself to feel whatever she was going to feel during a binge urge because she feared her feelings would literally kill her. She felt they would surely be too powerful. Once she recognized that her feelings wouldn’t kill her, she took this step. She knew that the urges would pass in time. She was willing to devote the time to feeling the feelings. She felt anxious, angry, sad, scared. She felt these feelings intensely. She journaled for over an hour. Then, without doing anything other than feeling those feelings, the urge to binge passed and she didn’t binge. Ultimately, in order to avoid bingeing you not only have to feel your feelings authentically but learn to express them effectively. All these skills take time and patience

Another of my clients realized after months of working on her bingeing that she binged when she felt she was being taken advantage of by others like her friends, family and her husband. Instead of saying “no” and setting good self-care boundaries, she would say “yes” all the time and then become so resentful that she would binge to stuff these negative feelings. After she made this connection, she began to say “no” once in a while and her binge frequency decreased. The more successful she was at self-care, the less she needed to binge.

It is important to understand that the road to recovery has ups and downs, twists and turns, rather than being linear. Instead of expecting a steady line of improvement and change, expect that you’ll have episodes of bingeing and periods of calm with more comfortable eating habits. Instead of looking for a steadily increasing line of change, look for longer periods of calm, health, and acceptance between the more difficult episodes.

If you can understand that bingeing is (and was) an adaptive way of coping when other coping mechanisms are (and were) unfamiliar, fearful, or met with uncertain or negative consequences, perhaps you will be better able to accept and be kinder to yourself. You will find healthy ways of dealing with emotions, re-envision yourself and your role in your world, find your power and your voice. Healthier eating will follow. It’s about not looking at food, your eating habits or yourself as “good” or “bad.”  It’s about looking at yourself and your behavior with compassion and acceptance.

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Is there no way out?

A client of mine recently experienced a severe binge episode after a period of several weeks of restrictive eating. She binged for hours. She binged until she was in severe pain. She kept saying to me that she was weak, couldn’t control herself with the food, a failure. She questioned why she couldn’t stop, why she was such a “pig”, why she was so disgusting? She said she hated herself, couldn’t understand why anyone loved her. She said the most derogatory things about herself.

This client is a brilliant, beautiful, compassionate sensitive human being who suffers from a brutal illness that prevents her from seeing her positive qualities. She is so focused on her eating behaviors and her weight that she is blind to what others see in her.

A day prior to her binge, I asked her to journal what was going on for her and email it to me.  With her permission, I have pulled out some of the thoughts she sent me.

I hate my job.

I am tired of pretending.

I am in so much pain.

I get tired so quickly.

I want to be happy.

I don’t want to spend my days defending myself, my decisions, my work.

I definitely don’t want to put on an act every single day.

I hate not being able to be myself. 

There is nothing promising. 

I’ve been getting rejected for the past four years. 

I feel so disconnected.  

I feel useless. 

I miss us.

I am so scared that I am will not get A’s this semester.  

I wish I could tear myself from limb to limb…just to destroy the root of the problem. 

I know what I am doing is awful, but I can’t stop and I still get pleasure from it. 

I expect those whom I love to have higher expectations.  

I don’t want unconditional love.

I need to have control back.

After reading these thoughts and feelings, it’s palpable to me why she was bingeing. She is going through a very difficult time and the food is the only thing she feels gives her pleasure. The problem is though, that as soon as each morsel is gone, the negative thoughts and feelings come back. Of course, she needs to continue to eat in order to prevent the thoughts from penetrating her conscious brain. If she stops, she just beats herself up for bingeing. She’s in a ”lose-lose” situation. She either doesn’t binge and then feels her feelings or keeps eating to numb out and then directs all the negative feelings toward herself.

So, what is the solution to this painful cycle???  I wish the answers were easier. The answers are as complex as the problem itself but she first needs to be willing to see for herself that there is a function to the bingeing that is emotional. She must try to accept the possibility that she is NOT all the derogatory labels she has slapped on herself. She needs to recognize that the food is her “drug” to anesthetize her from all the negative feelings she’s been stuffing down. Then, she must be willing to look these issues directly and tackle them (with the support of professionals and trusted loved ones), talk about them, feel them honestly and authentically. She is so used to shutting down and not asking for help, not letting people in, that she is stuffing years of these types of feelings down. She needs to learn new, yet unfamiliar ways to tolerate her feelings, be kinder to herself and ask for help.

Sometimes my clients say “Donna, you make it seem so easy but it’s not!” I know it’s not easy, nor is it quick. It took me about 20 years to learn these skills and I still haven’t “perfected” them. Learning a new way to live is a lifelong process, but learning healthy coping skills is still better than the disordered alternative which is painful, ineffective and causes enormous short-term and long-term suffering. These skills will take time and patience but they are an integral part of the healing journey.  

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Appetite!

How many times have you said to yourself things like “I can’t eat that or I will go out of control” or “If I take one bite, I’ll never stop”? As a result of thinking these things and saying them to yourself over and over again, have you eliminated numerous foods from your diet, created extensive food rules involving what you can and cannot eat, what time you will allow yourself to eat, how hungry to have to be in order to eat, etc? You may have become fearful of your “appetite” and you need to rebuild trust in this very important aspect of eating.

Appetite is the psychological desire for food, or better stated as “emotional hunger”, and can be present with or without physical hunger. It is normally a pleasant experience. But, for you, is it an emotional mine field? Have you internalized that your appetite is too big, shameful, out of control, leads to weight gain, leads to bingeing, too powerful, or makes you weak. Do you worry that your appetite will always lead you to choose high calorie, “bad” foods? If these statements are true for you, you may be withholding pleasurable foods from yourself on a regular basis or only consuming them when you are bingeing or “using” food for emotional reasons.

Why have you become so afraid of your appetite and internalized so many negative thoughts regarding it? Why have you replaced such a wonderful part of the eating process with unfair rules?

I feel the answers, although complex can be better understood by looking at a few key ideas. First and foremost, the more you avoid certain foods, the more you crave them. For example, If you make a “rule” that you will not eat bread, you will inevitably crave bread, think about bread all the time, try to convince yourself you hate bread, get mad at others when they eat bread or you may look at people who eat bread as weak, just to support your choice to avoid it. You may have to make all kinds of “bread-avoiding” rules.

All this energy is spent obsessing about bread so you begin telling yourself “what’s wrong with me? Why do I think about bread all the time? It’s a good thing I don’t eat bread or I’d go out of control if I put a bite into my mouth.” We can use the “forbidden fruit” metaphor to further understand this. “Forbidden fruit” refers to an indulgence or pleasure that is considered illegal or immoral or harmful. If you have deemed certain foods illegal for you, you may have developed a ferocious appetite for them or you may spend an extensive amount of mental energy avoiding them.

Sadly, perhaps you have also been given messages from others (family, friends, and the media) that certain foods are “terrible”, “fattening” (see the recent post “a calorie is a calorie is a calorie”) and should be avoided. That is an entirely new blog topic for another day, but negative messages coming from others can be a powerful deterrent for choosing certain foods. Have you ever been in the company of others when someone says “I’d never eat that!”? That type of passionate comment may instantly “kill” your appetite!

A “healthy” appetite is normal! It is inspired by smells, sights, memories, or thoughts and has its roots in things like early experiences, religious beliefs, family or cultural traditions, even advertising. For some people though, appetite is suppressed so often that of course it emerges like a lion when it is unleashed.

If you can begin to trust that an appetite is normal, if you pay attention to it and honor it, it will begin to calm down. If it is nurtured, it will evolve into a wider variety of choices. Try to spend some time thinking about foods that once had special meaning for you. Think about the foods you have had good memories with and those that once gave you pleasure. Then, try to incorporate them slowly back into your life. Take your time with this process. If you can even introduce one food a month, you will have twelve new foods in a year that give you pleasure and help you restore your intuitive appetite!

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