Tag Archive | Tips

Dr. Glenn Gaesser Tells The Truth About “Carbs”!

Dr Glenn Gaesser, exercise physiologist, professor at Arizona State University, and author of Big Fat Lies, posted a fantastic YouTube video debating Dr Oz’s claims that carbohydrates make us “fat”. Dr Gaesser is a well-respected pioneer in the “health at every size” movement, an approach to health that includes intuitive eating and pleasurable movement. Health at every size demonstrates that people can be fit and healthy at any size and that size alone is NOT a predictor of health. This video, debunking the myths about carbohydrates, is the best source of information I’ve seen!

Last week, Dr Gaesser was a guest on the Dr Oz show debating the “obesity epidemic” issue with Dr Oz.

I personally feel that our society has become so “fat obsessed” that we are missing the real truth of the matter, that wellness has much less to do with size and weight and much more to do with fitness, the quality of the food we eat, and overall lifestyle. One individual can be perfectly healthy and yet be considered “obese” by medical standards and another can be unhealthy and be considered “thin” by medical standards.

 

It’s time we place our focus on the goals that will truly make us healthy instead of trying to diet our way to “health and happiness”. These goals are:

  1. Trying to achieve an improved overall level of fitness
  2. Eating a balance of foods – some healthy, and some just for fun (I believe in the 80/20 guideline – 80% healthy food, 20% fun food)
  3. Practicing healthy and effective coping mechanisms and communication skills
  4. Maintaining good overall physical, mental, and spiritual self-care

 

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Top Ten Diet Myths That Won’t Go Away!

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

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

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

Myth 2: You can lose weight by skipping meals.

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

Myth 3: Snacking will make you fat.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Intuitive Eating

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

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

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

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

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

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

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

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

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Snow Days!

 Wow!  There has been so much to write about in the past few days, I don’t know where to begin. This post is going to be a stream of consciousness post because I don’t want to censor it or water it down.

I can imagine for many of you, these past few days have been quite challenging to say the least. Mixed in with all the joy of the holidays, there are always challenges. And for those of you who live in the northeastern part of the US, there was a blizzard to top it all off.

Holidays mixed with snow days are a breeding ground for struggle if you have an eating disorder. I have gotten numerous emails and texts from people who are going “crazy”!  So, as many of you may be experiencing, there is an enormous amount of unstructured time, the inability to get out of the house, and food, food, food everywhere! Normal routine is completely lost and unhealthy distorted thoughts run rampant!

I have been snowed in, as many of us have, for the past couple of days. I am so glad I took this week of from work because I would have been off anyway since my street has not been plowed out. I have spent the past three days without any routine. I have been in my pajamas for the past two days, taking breaks from my couch only to shovel some snow (in my pajamas) and reheat leftovers from Christmas. I have not worn a stitch of makeup; I haven’t blown dry my hair. I have eaten cookies for breakfast…way too many. I’ve played electronic games, ping pong, watched lots of TV, and haven’t done any laundry or other household chores. I’ve gone to bed late and gotten up late. My routine is completely upside down. It feels great but very abnormal. I feel comfortable with it for a number of reasons but one of the main reasons is because it is only for a short period of time. Next week, I will have to get back to my regular routine. I want to enjoy these few days to their fullest. Once those cookies and Christmas leftovers are gone, I will be eating my usual fare. I will be back to work, chores will resume and my sleep-wake cycle will be back to normal.

Why am I talking about this? Because many of you have such a difficult time with a lack of routine, worried that you will go “out of control” or that you will never get the routine back again. Yes, being around holiday foods and having a snow day can be stressful. You can’t do what you would do on a “normal” day.

What is the best thing to do with this type of time period? First off, remember that it will end. It is not forever. Structure will resume soon. Try not to catastrophize it, because it is not your norm! Don’t let your thoughts become distorted! Try to enjoy the time. Do things that you can’t do during other times. And then, before you know it, you will have your daily routine back…whatever “healthy” routine you have as a person in recovery.

So, tomorrow, presuming I can get out of my driveway, I will pry myself out of my pajamas, drive to the mall to partake in the after Christmas sales. I may go to the grocery store to get a variety of foods since I am a bit sick of Christmas food. I surely will not do any laundry or household chores. I may play a few more games of ping pong. I’ll write some things for the blog and overall, just enjoy the unstructured time!

Please, try to have a healthy perspective on this time. Get pleasure from it and embrace it. It will pass soon enough…

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Holiday Parties with ED

Holiday parties can be stressful for people who suffer from eating disorders. Below are my top 10 ideas to help you negotiate through some of the difficulties you may face. Ultimately, it’s important to prioritize your self-care during the holiday season and try to make it as stress-free as possible.

  1. Try to stick with a routine of eating as often as you can. This doesn’t mean restriction; it means a comfortable yet structured way of eating…a routine. If you need to attend a party or family function, eat as normally before it as possible so that you stay as “regulated” as possible.
  2.  Before you go to any type of party, get as much information about it in a advance as possible, including what will be served, how it will be served (ie: buffet or sit down dinner) and when. This way, you can mentally prepare yourself for the food aspects.
  3. If need be, bring something with you that you are comfortable eating. Bring enough for others to share with you. It could be an appetizer, side dish, or comfortable dessert. The hostess will think you are very thoughtful and you will be more comfortable with that particular food.
  4. Inform a trusted person in advance that you may need their help during the party. Ask them to help you if you need it. Develop a “signal” that only the two of you know that means you need them. It may be that you need their help in an awkward social situation or with a food issue.
  5. Never go to a party or event overly hungry. Excessive hunger will heighten obsessions about the food and may cause you to feel “out of control”.  Again, eat on a regular schedule the day of the party.
  6. In terms of the food, do the best you can at the party. Remember, it is one meal of one day. Try not to catastrophize what you eat or how much you do or don’t eat while at the event. Once you leave the party, move past it. Try not to dwell on what you did or didn’t eat.  Once it’s over, it’s over.
  7. Spend as much or as little time at a party as you feel comfortable with. Because social events can cause anxiety for numerous reasons, plan your time according to your comfort level.  Also, try to have flexibility built into your plan in case you want to stay longer or shorter than initially planned.  
  8. Try to remember that the food is only one aspect of a party. There are other aspects that you may want to focus on. There may be one or more people there that you’d love to catch up with. There may be kids who you can play with to give their parents a break. There may be elders there who would love to share stories with you. 
  9. If someone comments to you about your eating, weight or size, try to immediately change the subject to something related to them. People like to talk about themselves. Take the focus off of you and put it onto them. For example, if someone says “Wow! You look like you lost (or gained) weight.” You could say “More importantly, how are you doing? What’s new in your life?” Also, try to realize that people who don’t understand eating disorders don’t realize that discussions about food and weight are very personal. They are usually just curious. Put a mental “protective barrier” around yourself and don’t let comments penetrate it.
  10. After a party is over, get back to your routine. End the day on a positive note. Give yourself a “pat on the back” for doing the best you could.

 

These are just some of the things you could do to make holday parties less stressful for yourself. Do you have any tips and tricks on coping with stressful holiday functions?  I’d love to hear your suggestions.

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The Holidays are Coming!

As November gets into full swing, I brace myself for the onslaught of stress that the upcoming holiday season brings. I love the holidays but they are a time of increased exposure to family issues, excessive spending, depleted bank account, shopping during every free minute, pressure of getting the “right” gift, decorating the house, making the “perfect” holiday meals etc. But, alas, I try to focus on the things I love about the season so I don’t get buried by the stressors.

Ten things I love about the holidays:

  1. I can eat leftover turkey sandwiches and pumpkin pie for a few days after Thanksgiving.
  2. Clients bring me Christmas cookies.
  3. I have a month off from teaching my college class.
  4. I can wear the coziest sweaters and there is a chance of snow.
  5. There are Christmas carols on every radio station.
  6. Starbucks has red cups.
  7. Williams Sonoma has free samples of peppermint bark.
  8. My kids are home from college for a month.
  9. I make the best Christmas buffet dinner.
  10. I can enjoy the scents of our Christmas tree and holiday candles.

I will post a “survival guide” for the holidays in a few days, but meantime, since I am trying to focus on the positive aspects of the upcoming season, I’d love to hear your ideas on how  you plan to make your holiday season a recovery-focused happy one!

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Carbs, Carbs, Wonderful Carbs!

You are a human. You are not a plant. Therefore you cannot photosynthesize to get energy to live. You must get your fuel/energy from food. The “essential” nutrients in foods – carbohydrates, proteins, fats, vitamins, minerals and water, provide the “raw material” to give your body life! The reason these nutrients are called “essential” is because life ceases without them!

Today’s post is on the topic of carbohydrates. Bashing carbohydrates is OLD NEWS. In fact, it never should have been news in the first place. Carbohydrates are your body’s NUMBER ONE source of energy. There are between 75 and 100 trillion cells in the adult human body. All those trillions of cells need carbohydrates to thrive.

Carbohydrates are essentially carbon (C), hydrogen (H) and oxygen (O) organized in teeny little carbon rings, either by themselves or bound together with another similar ring or in longer chains of rings. They are found mostly in foods of non-animal origin.

This is glucose. It is the only carbohydrate your cells can use. All other carbohydrates you eat have to eventually convert into this cute little molecule in your body. So no matter what food your carbohydrates come from, they ultimately will become glucose to give your cells energy.


Carbohydrates are the PREFERRED source of fuel for most of your body’s trillions of cells but they are the ONLY type of fuel that your brain and central nervous system can use. They cannot use any other type of nutrient as their energy source. They need carbohydrates to survive. Have you ever felt a lack of concentration, brain fog, from eating too little carbohydrate? After going long hours without carbohydrates, have you gotten weak and shaky, your muscles begin to tremble and your heart begins to race? Ever wonder why that happens? When your brain is “starved” of carbohydrates, it senses that it has no energy to survive. It sends messages to your muscles to tremble to release any stored fuel (carbohydrate) to send to the brain and it makes your heart beat faster to get the blood quickly to the brain to prevent the brain cells from “dying”. This isn’t a pleasant scenario and your brain is obviously showing you it is in danger.  Your brain is telling you it is desperate and has no fuel to work!

You need carbohydrates all day, every day for sustained energy for your brain and body. So, every time you eat something, whether it is a meal or a snack, it would be ideal to include a carbohydrate source with your other nutrients.

Also, contrary to some peoples’ beliefs, carbohydrates are NOT “fattening”. This concept is misleading and incorrect! Remember, from another post on this blog that a calorie is a calorie is a calorie. Calories coming from carbohydrate-containing foods are no more or less able to change an individual’s weight than calories coming from other foods. That is a MYTH!  The more you avoid them though, the more you will set yourself up to crave them. If that has happened to you, the more consistently you are able to include them into your daily meals and snacks in a “safe” way, the more comfortable you will become.

In addition to the energy you will give your body and brain by eating carbohydrate- containing foods, you will also give it other fabulous nutrients, depending on which foods you choose. For example, if you choose to eat whole wheat bread you will also be giving yourself fiber and B vitamins. If you eat yogurt, you are also getting calcium, protein and vitamin D.  If you eat fruit, you are getting fiber and antioxidant vitamins. Or you could have a fun food like a candy bar and you will benefit from the energy from carbohydrate and a side benefit of pleasure (an essential ingredient in my opinion)!!

So, the next time you are considering what to eat, remember that carbohydrates are essential!  Your trillions of cells will thank you!

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Pizza!

As you all know, I am a nutrition therapist who specializes in the treatment of individuals with eating disorders. And as a nutrition therapist, I don’t spend a considerable amount of time “educating” my clients on nutrition. What I do is more like “therapy” around eating, food and weight. Very often however, my clients’ food choices are based on fears, diet propaganda, misinformation, myths and misconceptions.  It’s during conversations revolving around these topics that the “nutrition educator” in me comes out!

Since I have a strong background in nutrition and physiology, I thought I’d add some posts to the blog discussing specific foods, providing nutrition tidbits and dispelling some myths and misconceptions about certain foods and diets. Many of you may avoid certain foods or nutrients that you truly like but have been “brainwashed” into believing they are “poisonous”! I hope you enjoy these posts.

The first food I want to discuss is pizza. Pizza is an emotionally charged food. I can’t tell you how many discussions I’ve had over the years about this controversial “delicacy”. Most of my discussions have involved listening to and understanding people’s aversions to pizza and helping them challenge and overcome their fears of this very simple food.

Pizza is basically four ingredients – dough, shredded mozzarella cheese, tomato sauce, and herbs. Yet, people describe it as “greasy, fattening, bad for you, etc”.  How could these basic four ingredients get such a bad rap? Would you feel the same if I suggested you eat a pita with 1 ounce of cheese, and a few slices of tomato? Probably not. It’s basically the same thing, just heated up! One slice of pizza is 2 ounces of dough, ¼ cup of shredded cheese and probably a tablespoon or two of sauce. That’s it. The reason it looks a bit shiny is because when cheese melts in a hot pizza oven, the small amount of oil inherent in the cheese rises to the top. 1/8 of a large pie is only about 250 calories! Pizza is a “social food” that is served at parties, at restaurants. It is a fun food!

The next time you are thinking “I can’t eat pizza. It’s so bad!” remember that it is actually good for you. It’s got protein, calcium, vitamin C, and other healthy nutrients! You can even have it topped with your favorite veggies for added flavor, nutritional value and excitement! If you are nervous about ordering a whole pie, just start off with ordering an amount you feel “safe” with and prove to yourself that you can do it!

I’d love to hear some stories from you about positive experiences you’ve had with pizza!

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Trail Mixes


Trail mix is typically a combination of some type of dried fruit, grains, nuts or seeds, and sometimes chocolate or other candy. It was originally designed to be a snack food to be taken along on hikes. It is an ideal snack food  because it tastes good, is non-perishable, easy to store, nutritious, and energy boosting!  The combination of the complex carbohydrates found in dried fruit and grains and the   mono- and polyunsaturated fats in nuts and seeds provide wonderful energy for your brain and body to help sustain you between meals.

 

These are some of my favorite combinations! Try them by themselves or mix them in yogurt for a yummy snack!

Dried cranberries, almonds and white chocolate chips (my absolute favorite!)

Peanut butter “Puffins” cereal, chocolate chips, peanuts and mini marshmallows

Chocolate “Cheerios”, peanut butter chips, and peanuts

Peanut m&ms, mini pretzels and raisins

Popcorn, golden raisins and honey roasted peanuts

Walnuts, m&ms, dried strawberries, and pretzel nuggets

Cinnamon “Life” cereal, dried apple slices, cashews and white chocolate chips

Fiber One” cereal, dark chocolate chips, mini marshmallows, and dried cherries

Popcorn, wasabi almonds, and garlic wheat thins

Raisins, “Go Lean Crunch” cereal, and banana chips

Sesame sticks, sunflower seeds, and wasabi peas

Granola, toasted cinnamon pecans, and dried blueberries

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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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Risk Taking

Two seeds lay side by side in the fertile spring soil.

The first seed said “I want to grow! I want to send my roots deep into the soil beneath me, and thrust my sprouts through the earth’s crust above me…I want to unfurl my tender buds like banners to announce the arrival of Spring…I want to feel the warmth of the sun on my face and the blessing of the morning dew on my petals!”

And so she grew.

The second seed said “I am afraid. If I send my roots into the ground below, I don’t know what I will encounter in the dark. If I push my way through the hard soil above me I may damage my delicate sprouts…what if I let my buds open and a snail tries to eat them? And if I were to open my blossoms, a small child may pull me from the ground. No, it’s much better to wait until it is safe.”

And so she waited.

A yard hen scratching around in the early spring ground for food found the waiting seed and promptly ate it.

The moral of the story is:  Those of us who refuse to risk and grow get swallowed up by life.

 

Written by Patty Hansen and published in Chicken Soup for the Soul: 101 Stories to Open the Heart

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Inside-Out Beauty

Recovering from an eating disorder is a tremendous challenge, one made all the more difficult in a society with such an extreme fixation on external appearance. We are bombarded with messages telling us that we can only be successful if we are beautiful. Unfortunately, the definition of beauty in Western culture is very narrow: to have “arrived,” we are told, you need to be below a certain age, under a certain size, have a certain skin tone, etc. Yet no matter how many ads we see for miracle creams and Botox, we all know that this brand of beauty doesn’t last forever. Does it make sense to invest so much time, energy, and money towards something that will inevitably degenerate?

I believe that beauty is important, and that working towards it is a worthwhile endeavor. I just choose to define beauty differently. It may be partly about external appearance, but it’s about what’s inside, too. And what’s wonderful is that when you work towards enhancing your inner beauty, you are left with beauty that is eternal. 

Think about the beautiful people in your life. Are they all under age 40? Do they all have model’s figures? Perfect skin?  To widen your definition of beauty, reflect on these tips for timeless beauty by Audrey Hepburn:

  • For lovely lips, speak words of kindness.
  • For lovely eyes, seek out the good in people.
  • For beautiful hair, let a child run his or her fingers through it once a day.
  • For poise, walk with the knowledge that you’ll never walk alone.
  • People, more than things, have to be restored, renewed, revived, reclaimed, and redeemed; never throw out anybody.
  • The beauty of a woman is not in the clothes she wears, the figure that she carries, or the way she combs her hair. The beauty of a woman must be seen in her eyes, because that is the doorway to her heart, the place where love resides.
  • True beauty in a woman is reflected in her soul. It is the caring that she lovingly gives and the passion that she shows. And the beauty of a woman with passing years only grows.

This  post was written by a guest blogger, Dina Maierovits, MS, RD. Dina works in private practice in Toronto, where she provides nutrition counseling for individuals with eating disorders and other nutritional concerns.  She received her Bachelor of Science from Charter Oak State College and her Master of Science in Dietetics from Eastern Michigan University.

Prior to her career as a registered dietitian, Dina worked for several years as a high school teacher. She is passionate about eating disorders prevention and combined this dedication with her love for teaching by developing NUTRITION, a high school curriculum covering a range of topics related to nutrition and body image. She is also the designer of ReClaim, a bi-level community education program to reduce the incidence of disordered eating in high school students. She is currently producing a documentary to promote media literacy in teens with the goal of promoting positive self-image. Dina can be reached at dina@totalnutrition.ca.

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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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Triggers – Part Two

Here are just a few common triggers for my clients and how they cope with them. Hopefully you will be able to learn about yourself from these examples and can use them as a starting point to challenge your own triggers! If you like this post, I will add more examples at another time. Remember, these examples are from clients who have all types of eating disorders. What works for one client, may not work for another.

Grocery Store
I try to shop early in the day after I’ve had a good breakfast. I feel strong and more positive in the morning.

I keep my time in the store to 30 minutes and go with a list that I can stick with in that amount of time. If I spend too long, I either get too overwhelmed by the choices or I spend too much time reading every label on the shelves and then begin judging my choices!

Doctor appointments
In the past, sometimes I would put off going to the doctor because I didn’t want to be weighed, I didn’t want to be judged, and I didn’t want a lecture. Now, I set the tone of the visit by saying I don’t want to get weighed and that I’m working with a nutritionist on a meal plan that seems to be making me feel good.

I asked to get weighed backwards without seeing my weight. I ask them not to tell me the number so that I don’t fixate on it.

Restaurants
When eating out I try to make safe choices for myself, ones that don’t prevent me from enjoying the meal but ones that I feel won’t make me obsess before, during and after the meal. If I am not very hungry or if I am too anxious, sometimes I will order an appetizer and soup or salad. If I really want dessert, I split it with someone else.

Buffets are difficult for me. I don’t like to watch other people overload their plates because I feel very uncomfortable, almost as though I’m the one who has eaten too much. There are so many choices. When I’m faced with this type of situation, I try to stick with food I really want in portions that I can handle without getting too full. I find that feeling too full is a trigger for me and I may be tempted to use a behavior afterward.

I try to remember that portion sizes in restaurants are sometimes large. If there’s a small portion available on the menu, I’ll order that size or the “lunch” portion. I want to feel satisfied but not overwhelmed.

I feel safer minimizing my choices on menus. I’ll only look at certain sections of the menu.

Restricting myself on menus only leads to bingeing, so I allow myself more freedom.

At home
 If I feel the urge to binge, I go to sleep or sometimes I’ll even make myself leave the house, even for a short period of time. I have to do something to pass the time until the urge passes. It usually passes. It may come back again, but it will pass again.

I keep my refrigerator stocked with “safe” foods and snacks. “Safe” foods are those that I am at less risk of bingeing on but are enjoyable.

I try to only eat at the kitchen table. I have a special place mat I use to remind me that I am trying to be mindful while I eat.

I keep positive quotes around the house as reminders of my value and self-worth. The most important place I keep kind loving words is in the kitchen.

In order to not feel self-conscious, judged or criticized by others in my family, I try to pay attention to things other than my food or their food. I try to keep the conversation light-hearted and not about food.

People
Other people’s food boundaries – I’m very careful now to set clear boundaries and not let other people cross that line. When I’m in a restaurant, I hate it when someone else reaches over to try something on my plate. Don’t touch what is on my plate unless I offer it to you! When I was first trying to get comfortable with this new idea, I became very possessive about what was mine. My husband does the grocery shopping and I used to feel guilty about spending extra money on my own food. I realize now that no one knows better than I about what I feel like eating.

People’s comments – It drives me crazy when someone says, “You’re losing weight” or “You’re gaining.” I hate it when someone comments on what I eat or what I don’t eat: “I didn’t expect you to eat that.” “I thought you were on a diet.” “Come on, try this. A little bit won’t hurt.” Nowadays, when someone comments on my food or weight, I simply ask them a question about them. People love to talk about themselves more than they like to talk about others. It works well!

I avoid people who make me feel powerless or lousy about myself. I’ll politely excuse myself or explain that I need to speak to someone on the other side of the room. I’ll plan to spend time with someone who makes me feel good about myself, someone I’m comfortable with.

I avoid extremes in people. I don’t hang out with someone who severely overeats in public or with the person who constantly talks about dieting or calories. I find these extremes too triggering for me emotionally. It is difficult to regulate my thoughts and eating afterward.

Parties
At parties, I find that there’s usually foods I find challenging and food is served at times that are not my normal times. Also, they involve eating in full view of others. I want to eat “normal” amounts so I appear “normal” but I have no idea what normal looks like. I usually end up feeling deprived, stuffed or crazy obsessed. I usually don’t leave a party feeling like I have enjoyed myself so I try to get as much information about what is being served and at what times so I can feel prepared. I also usually bring something that I know is a comfortable food for me so I can eat it with no negative emotions.

 I’ve learned to say no. Sometimes I just don’t go. I know now that I need to make decisions for myself, to protect myself. It took me a long time to realize that this was okay.

 If it’s something I can’t get out of, I make sure I don’t go into the situation thinking that it’s going to be awful. I try to find something good to focus on or something to look forward to. I find that going to the event with a positive attitude is a big help.

Before I even leave the house, I make sure I have “safe” snacks at home so I don’t come home and binge.

Sometimes if I want to go to be around people, but I’m feeling vulnerable, I find ways to keep myself busy. I bring my camera and take pictures, I help out in the kitchen washing dishes, I play with the children, or I go for a walk. I try to eat something that I’m comfortable with but also try not to make the event about the food.

When I get home, if I’m feeling stressed, I do something “normal” to get myself back on track. Even if I’ve overeaten at the social event, I eat a meal or snack that I feel comfortable with to get myself back to my regular routine.

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Understanding Your Triggers

Triggers are those situations, feelings and/or other conditions that cause you to want to use eating disordered behaviors.

In the work that I do with clients, I have found that “triggers” can be categorized to make them easier to identify. The categories you may want to look at are:

Environmental – examples may include home, school, work, grocery stores, clothing stores, the beach, restaurants, the car
Physical – fatigue, injury, illness, hormonal changes, weight changes, the way clothing fits
Nutritional – long periods without food, excessive hunger, excessive fullness, certain “unsafe” or “fear” foods, deprivation of a type or an amount of food
Emotional/Psychological – sadness, anger, disappointment, humiliation, fear, joy, overwhelm, frustration
People – husband or wife, girlfriend or boyfriend, family of origin (mother, father, siblings, aunts, uncles, cousins), boss, authority figures, dieters, small people, large people, people with no physical or emotional boundaries
Time of Day/Month/Year – morning, afternoon, evening, late evening, after school or work, middle of the night, quiet times, hectic times, weekends, holidays, seasons, pre-menstrual times

This, by no means, is a complete list. You may want to think for a moment about each of these categories and try to look at possible triggers that might affect your urges to use eating disordered behaviors.

By looking at and understanding your triggers, you can be better equipped to cope with them so that you can have the most supportive conditions possible for your recovery. If you can identify the conditions that cause you stress, you can take the proper precautions to protect yourself. Learning to protect yourself is an important step in attaining self-care and lasting recovery from your eating disorder.

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