One Jewish Dyke has posted a very personal and honest blog entry about her recent experiences battling ED-NOS that you should go read. She has already taken what may be the most difficult step for many with an eating disorder to make: the decision to seek out help for her problem.
Yet like so many other eating disorder sufferers, OJD faces an obstinate medical professional who doesn’t entirely *get* the nature of an eating disorder and how to treat it. Because OJD was considered obese six months ago and now teeters in the overweight category, she fears her doctor will encourage her to continue to lose weight, but through a program like Weight Watchers. And yes, her doctor is aware that she has an eating disorder.
After hearing so many of your own health care horror stories, I’m not surprised by OJD’s account but I am appalled and so very angry. Encouraging and advising an active eating disordered person to embark on a weight-loss plan – and yes, WW, you are still a diet – is like handing a loaded handgun to a child. It’s irresponsible and dangerous.
Eating disorders are complex beasts, often relative to influences –biological, societal and emotional – that vary with each eating disorder sufferer. However, as Carrie pointed out at the blog ED-Bites, a starving brain doesn’t respond well to therapy:
I’ve learned that an eating disorder IS about the food as long as you are starving yourself, bingeing, purging and/or underweight. Your brain isn’t functioning right.
My recovery had to begin with weight gain. That is still the foundation. Think Maslow’s hierarchy here. If you’re not eating right and taking care of your basic needs, learning how to handle setbacks isn’t the most useful of things.
OJD’s post started out as a comment to an entry over at Shapely Prose in which she added that she physically and mentally cannot eat anything but a few specific foods. One of the great misunderstandings posed by lay people to an eating disordered person is “Why don’t you just eat something?” Although well-meaning, I’m sure, they don’t understand that it’s not an unwillingness on the eating disordered person’s behalf; it’s often an inability to do so.
So, it’s somewhat of a conundrum: You need to eat in order to restore health and the necessary frame of mind to fight the disorder, yet you quite literally cannot eat. I’m not a medical professional, but I’ve compiled a list of baby steps that helped me as I tried to focus on restoring my own physical health.
Focus on foods you can eat: Everyone with an ED has their own personal lists of “bad” and “safe” foods. Start with foods you can eat and slowly add to your diet as you work on the black and white thinking in therapy. And don’t be afraid to break the rules: If broccoli is among your list of safe foods, don’t think you can’t have it for breakfast.
Eat slowly and frequently: Eating slowly allows you to pay attention to your body’s cues signaling it’s full and satisfied. Eat smaller amounts frequently throughout the day helps avoid the physical and mental shock that comes with eating again. And for bulimics especially, it’s important to never let yourself get hungry or too full.
Watch your liquid intake: When I was actively eating disordered, I drank 60 fluid ounces of water first thing every morning for “breakfast.” Liquids help fill you up, but they do little to replenish much-needed vitamins and minerals to a starving brain. Be sure to drink plenty of water, but not so much that will make eating food uncomfortable.
Eat with someone who understands: The flavor of food is always enhanced by good company and conversation, and for an eating disordered person, this may provide an added level of distraction from the real task at-hand: eating. Be sure to eat with someone who knows and understand your disorder and who won’t draw attention to how much or what it is you are eating.
When you finish eating, distract yourself: Those who purge and over-exercise will understand this tip, but it’s also useful for those who don’t try to compensate for calories. Find an activity you can at least mildly engross yourself in so that you won’t dwell on what it is you have just eaten. This will be difficult to impossible at first, but it gets easier with time.
Think of food as fuel not calories: Try not to see food in terms of calories – yes, also impossible to do if you’ve memorized the caloric content of most foods – but rather as fuel your body needs to perform at its most optimum. Tell yourself that you are providing your body with the nutrients it needs, even if you don’t believe it.
Avoid negative influences: We will all have to deal with those negative influences that trigger disordered behavior sooner or later in therapy, but focus on restoring your physical health sooner and your mental health later. For me, eating around my family was a negative influence – I’m the only vegetarian in the family and as a eating disordered vegetarian, would admittedly eat some pretty odd things. Raw cabbage with spray butter anyone? My family would always make fun of what I ate and it made me really self-conscious to the point I would just not eat anything around them. So for me, avoiding family events involving food was a must in my own journey to “normal” eating.
Talk to your doctor: Since many eating disorders are, to some degree, biological in nature, there may be medications available that will help you. I’m not sure about medications available to anorectics before they reach a healthier weight, but I know there are medications that help curb urges to binge. You should talk to your doctor about options available to you.
Give yourself a break: If you relapse, accept it for the minor setback it is and immediately resume your commitment to healthier eating again. Bulimics, especially, tend to have very black and white thinking and one tiny misstep can very easily lead to an all-out bingefest.
These ideas may not work for everyone and every disorder and as always, I encourage you to discuss them with your medical provider. Anorectics, particularly, need to be mindful of an additional obstacle, refeeding syndrome. Also note, this list is meant as just a start to combating an eating disorder. An eating disordered person is not “cured” once they reach a healthy target weight.
So, what’s worked – and what hasn’t worked – for you? Post your own tips and experiences below.