Tag Archive | Restricting

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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The New Year: BEWARE of the Diet Propaganda

The New Year is once again upon us and the dieting industry will soon begin its massive onslaught of propaganda to convince consumers that they cannot begin the year without a firm resolve to change their body weight, shape, size etc.

Before we talk about how to fight back, here are a few insights into the way the marketing industry works.  Advertising is based on getting consumers to believe that they will NEVER be happy unless they buy this product, do this activity, eat this food, vacation at this place, and the list goes on.  When sellers look to market their product they seek to find a way to prove that “this” is where true happiness can be found.  Their message is that if you don’t buy, do, eat etc. this or that you will never be able to achieve real happiness. And of course you didn’t achieve this real happiness yet.  You haven’t tried this particular remedy.  So, the bottom line is, if you want to be happy do as the advertisement says.

Herein lie the dangers in New Year’s advertising.  New Year resolutions are often comprised of dieting and exercise promises.  The dieting industry goes all out in trying to convince their unhappy consumers that the ONLY way to start the year on the right foot is to buy new gym clothes, sign up to a gym, buy the diet pills and drinks, and begin a new and “all-improved” diet.  THIS year you are going to achieve REAL happiness by changing your body.

However, this is all a myth!  It is a lie perpetuated by the dieting industry, already a multi-billion dollar industry, in order for them to get richer on the backs of their trusting, vulnerable consumers.  This year, DON’T BE FOOLED!  The dieting propaganda is just that – PROPAGANDA!

Webster’s dictionary defines propaganda as “information, ideas, or rumors deliberately spread…”  It is information that is biased and made to fit their agenda; to get you to do as they say.  In order to make you feel like they have your best interests in mind they will promise you the ultimate happiness if you just buy, do, eat their product.

Here is the truth!  You CANNOT achieve any sort of happiness through trying to change your external body.  Extreme dieting, exercising solely for weight loss, or any disordered behaviors (diet pills, laxatives, etc) can never help you attain real happiness.  Happiness, true happiness, comes from within.  It is a synthesis of your inner self, your inner values, and your external actions and behaviors.  It comes while bringing meaning and compassion into your life.  It is an inevitability that stems from nurturing your mind, body, and soul with healthy behaviors, actions, and thoughts.  Attaining the ultimate happiness is NEVER dependent on the way your external body looks.  In fact, by focusing only on your external body you lose the ability to achieve happiness.  Your vision of the world becomes narrow and you become constricted to a disordered space where it is virtually impossible to find happiness.

So don’t be fooled.  Don’t believe the ads when they tell you that they have the answers for you.  THEY DON’T!  YOU DO! The answers are inside your heart and soul.  Look within and stay strong.  Nurture yourself.  That is the ONLY way to find true happiness.

 

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Parents, Kids, Food Fight!

Too often, parents and children get into power struggles over food which NEVER fosters a healthy relationship with food. Also, a parent’s own food issues can often distort their objectivity and sensitivity when it comes to their child’s eating.

The following is a great article on how parents can healthfully and positively approach the topic of eating with their children in order to teach them positive eating skills.

Things Parents And Grandparents Say That Can Cause Eating & Weight Problems

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Top Ten Ways To Eat Pretzels

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The Diet Nightmare!

When was the last time you can remember being in the company of other  women (and often men) without the conversation inevitably evolving into the latest “remarkable” diet someone is on, how carbohydrates are “fattening” or fats are “fattening”, how a low-carbohydrate diet is the way to stop “bloat” or how a lemonade fast is the best way to drop quick pounds, what the new secret is to drop weight while you sleep, what new-fangled pills are the latest weight loss magic that melt away the fat?

Someone will inevitably be compelled to argue how bagels are the devil, how she hasn’t eaten bread in years, how butter “sticks” to her hips like glue, how much weight she lost and then gained back, what body parts she gained it in, what times of the day she allows herself to eat, how much exercise she has to do or how much exercise she’s not doing and feels guilty about, why her thighs keep growing, where she has the most cellulite, how she can’t control the size of her  stomach? These conversations are epidemic! The irony is that these women don’t see this way of life as unusual or obsessive in the least, nor do they realize that their eating is not intuitive or healthy. If they didn’t discuss their dieting life with other women, they would have little to keep each others’ interest. Unfortunately, diet and weight topics of conversation are the common ground on which women reside. They seem to have lost touch with the other aspects of themselves and the other things in life that are more important than their dress size or the number they see on the bathroom scale.

This phenomenon is especially prevalent between January 1st and February 15th. During the first days of every year, many people embark on their “New Year’s Diet”, forgetting that last year, each and every single other time they embarked on one diet or another, the diet failed because diets always fail. It’s as if all the bad memories of all these failed diets were erased from their memory and they decided this time would be different. It WON’T be different. It NEVER is different. It CAN’T be different because it’s still a diet. It still isn’t normal or sustainable. It is rule-driven restriction, and it will fail.

The definition of insanity is doing the same thing and expecting different results. Just because a new diet seems different because it subscribes to eating certain different combinations of foods at certain times of day or eliminates certain “fattening” foods, or because a celebrity or doctor tried it and lost weight (temporary weight, I’m certain), it is still a diet and will inevitably come to an end and any weight lost will be regained. That’s how diets work.

But, because people get so excited just before and in the early stages of embarking on their latest, newest diet, they make you feel like they’ve “got it” this time. They surely have the secret. This time, they will keep the weight off. They are certain of it!

A few weeks or months later (if it even takes that long), they will be off their diet, and they will no longer be excited. In fact, they will not be talking about that specific diet because it will have failed. They will only complain about how much weight they have regained. The irony is though, that they won’t blame the diet for failing them. No, that’s not the way it works. They will inevitably blame themselves, saying they can’t “stick” to a diet, or they are weak, or some other derogatory self-critical comment. This negative self-talk will further exacerbate their rebound overeating, subsequent weight gain and quest for a new and better diet. PEOPLE DON’T FAIL DIETS. DIETS FAIL PEOPLE!

Dieting like this is a cycle that never ends. It’s like being a hamster running on a wheel. The hamster keeps on going and going and going, getting absolutely no where, until he finally decides to jump off or falls off (or dies, trying to get somewhere he can’t get to).

For those of you who are “enlightened” and have given up the dieting nightmare, good for you!!!!!  For those of you who keep thinking that there is a “good” diet out there, get off the darn hamster wheel! Please work with a trusted professional to learn how to eat more intuitively, stop the endless diet cycle, learn self-trust and heal your relationship with food, yourself, and your world! It is a slow process, but at least you are off the wheel and really getting someplace worth fighting to get to!

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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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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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A calorie is a calorie is a calorie

I always say “a calorie is a calorie is a calorie” from a weight standpoint. If you get your calories from donuts or broccoli, pizza or chicken breasts, calories coming from one food have no more or less power than those in another food of equal caloric value to cause weight changes. People become so afraid of certain foods because of what they read or hear in the media or what others say. Myths get perpetuated and people avoid foods unnecessarily. I recently read an article that was written by a nutrition professor. He embarked on a “junk food” diet (by the way, I hate the term “junk food”) to prove this exact point. He wanted to show his students that weight management is all about energy balance. If you need to gain weight, you need to consume more energy than you burn. If you need to lose weight, you need to take in less energy than you burn and if you need to maintain weight, you need to make these two sides equal. He wanted to lose weight and decided to forgo a calorie-reduced diet of “healthy” foods and ate Twinkies, brownies, Doritos, Ho-Hos and other foods deemed “junk” foods or “fattening” foods for breakfast, lunch, dinner, and snacks. He kept his calorie level at an appropriate amount for weight loss for his specific needs and lost weight.

I am not recommending anyone follow this professor’s diet. In fact, it doesn’t sound appealing at all. The issue it highlights though is that a calorie is a calorie is a calorie. Weight is about energy balance. There are NO foods that have power over others. If you need to gain weight, lose weight or maintain weight, eat what you like. Don’t be afraid of any particular food or category of foods.

Of course from a nutritional standpoint, there are some foods that are more nutritious than others. Peanut butter is healthier than a Snickers candy bar. But, we don’t necessarily eat Snickers bars for their nutritional value. We eat them for pleasure and enjoyment. Try to examine the foods you may be avoiding because of unrealistic fears or myths. I know this is a really challenging idea, not only because of the fear of their so-called “power” but perhaps because you have avoided them for so long you fear you will enjoy them too much or go “out of control” of them. It is normal to love something that you have avoided for a long time. Give yourself a chance to explore new foods. Over time, you will become more in tuned with your preferences and your eating will balance itself out. Practicing this a little at a time will get you closer to intuitive eating!

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“I feel fat!” – Lessons Learned from Sondra Kronberg

 I feel fat!

When you say those three words to yourself, what are you really saying? What other words can you use in place of those three words? Are you “fearful”, “anxious”, or “threatened”? Are you being “fake”, are you “acting” or not “trusting”?

Feeling “fat” may be a metaphor for another feeling. Don’t let a “fat” feeling end there. Use it as an opportunity to uncover more feelings. If you feel fat and don’t explore it further, you are likely to do something with your food that may be unhealthy, in order to make the feeling go away. If you realize that you are feeling something else, you can use your fat feeling as an opportunity to get closer to your true feelings and embrace them…no matter how bad they feel.

Remember, feelings can’t hurt you. They may be uncomfortable, but if you learn to let them run their course, you can become your authentic self and begin to heal!

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Eating Disorder Voice vs. Healthy Voice

Have you been able to distinguish your healthy voice from the voice of your illness? When you hear your thoughts, how do you know if you should listen to them or not?  If you listen to the “wrong” ones, you will be further enslaved by your illness and it gains more power over you.

 Here are a few ideas for how to tell the difference. Once you can tell the difference, then you can be better equipped to listen to the “healthy” thoughts and act opposite of what your eating disorder wants you to do. This is an important step in recovery!

Your “healthy voice” is compassionate, kind, flexible, forgiving, helpful, positive, and empowering. The thoughts may sound like this: “You are doing the best you can. Small steps will lead to big changes in the long run. You don’t have to do this perfectly. Recovery is a process. Be proud of yourself.”

On the other hand, your “eating disorder voice” is rigid, inflexible, black and white, all or nothing, unforgiving, catastrophizing, minimizing, and demeaning. The thoughts coming from the eating disorder may sound like this: “You are disgusting. If you eat that you will never be able to stop. You will never fit into your clothes. You can’t be happy unless you are smaller.”

Clearly, these two sides are polar opposites of each other. If you hear thoughts coming from the eating disorder, you must challenge or ignore them, act opposite of what they say and replace them with healthy thoughts!  Healthy thoughts are the ones that help you stay more positive overall, help you take healthy steps and get you better!!!

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Alcohol Abuse vs. Eating Disorders

How many times have you heard people say to you “why don’t you just start eating?” or “why don’t you just stop eating?” Oh…if it were just that easy then no one would have an eating disorder. Eating disordered behaviors are addictive, just like alcohol or drugs are. There is no way you can just eat, just stop eating, just stop purging, or just stop any addictive behavior.

When someone is an alcoholic newly into their sobriety, they need to be abstinent from alcohol or they will be in their illness. But they can live without alcohol and still survive. With an eating disorder, the very thing that is your drug is the thing you need to consume to survive. So, you obviously cannot be abstinent and recover!  Recovery then involves having to navigate through all the situations, times, places you are in contact with food and attempt to make a “recovery-focused” decision about what to eat, how much to eat, with whom you will eat etc. You have to face your addiction multiple times a day, every day! Not only do you have to face the addictive substance every day but the negative thoughts that go along with it (aka: your eating disordered voice)

Imagine bringing an alcoholic to a bar, lining up shots of alcohol in front of her and telling her she can have only 1 sip. It would cause her tremendous anxiety and she would most likely not be able to do it. She would either have to bolt out of the bar or she’d be likely to drink all the shots. Now imagine bringing a person with an eating disorder (anorexic, bulimic or binge eater) to a buffet and telling her to figure out how much to eat, and expecting her to have a good time and enjoy the food and the company. A situation like that would cause her significant anxiety and she probably would have extreme difficulty in navigating her way through the meal.

In your recovery, there may often be expectations put on you by loved ones regarding your eating either because they are scared about your well-being, they don’t understand the degree of your suffering in the presence of food or they simply have such a “normal” relationship with food that situations like the one mentioned above (eating out) are pleasurable and they can’t imagine the notion of a buffet being an emotional battlefield! It’s so difficult to know what the “right” thing is to do in situations like this because you want to be able to challenge yourself but you also have to communicate to others that they need to keep their expectations realistic.

Think of food challenges on a scale of 1 – 10 of difficulty, 1 being the easiest and 10 being the most challenging. You want to start your challenges at a 1, 2, or 3 and build up your confidence first before you challenge a 4, 5, or 6. Then, after you have had some practice with these more challenging meals, you can try a 7, 8, 9, or 10. Don’t start with super challenging experiences or you will set your recovery back. Feeling a sense of accomplishment for something you did well is so much more empowering than trying something too difficult and scaring yourself from trying it ever again!

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Behaviors

As nutrition therapist for people who have eating disorders, people who don’t really understand eating disorders often wonder why I don’t just try to change my clients eating behaviors.  Why don’t I educate them about the negative complications of their behaviors and discourage or shame them into not doing these unhealthy things with their food? Why don’t I “make” the restrictors eat more, “make” the bingers stop bingeing and the purgers stop purging? Why don’t I “make” people stop weighing themselves, stop using food rituals, stop overanalyzing their bodies, stop over exercising or under exercising? Isn’t it my job to get people to “behave” more normally with their food??? After all, aren’t I the one whose job it is to “fix” the eating?

An eating disorder is a mental illness that manifests itself in these food/exercise behaviors. I can’t rip the behaviors away from a client if he/she doesn’t understand how to live without them. As a recovered anorexic and bulimic, I didn’t know why I restricted or binged and purged. I needed to learn why I did these things so that I could learn how to replace the eating disordered behaviors with healthy coping mechanisms. Then, eating could become “just eating” and not entangled with all my emotions. Without a fundamental understanding of why someone uses these behaviors and without the ability to cope using healthier coping skills, an individual who has an eating disorder will not be able to make a full and complete recovery. Trying to “fix” these behaviors without this understanding and skill-building would be like putting a band-aid on a gaping wound. Psychologically, it would be like throwing him/her out of an airplane without a parachute.

I am not saying that if someone’s illness is putting them in medical danger that they can or should sacrifice the work necessary to restore their physical health. Nutritional and medical rehabilitation is an essential component of recovery that cannot be minimized or overlooked. As a nutrition therapist, I am there to guide my clients each and every step of the way as they are challenging their disordered thinking and attempting to eat more healthfully. I’m emphasizing that we must also look beneath the restriction, the bingeing, the purging, and the multitude of other behaviors to achieve lasting recovery. We must do this in a kind, compassionate empowering way so we can be a part of the solution, not part of the problem.

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