Eating Disorders: Eating 101

4th January 2008

Eating Disorders: Eating 101

posted in Eating Disorders |

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.

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This entry was posted on Friday, January 4th, 2008 at 11:58 am and is filed under Eating Disorders. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

1 On January 4th, 2008, Jeanne said:

Awesome list, Rachel!!!

The last one is the one that I’m working on today – giving myself a break. Recovery isn’t linear – there is no “perfect.”

Thank you!!

posted on January 4th, 2008 at 2:44 pm

2 On January 4th, 2008, Josie said:

This is fantastic advice Rachel!!!

I’ll add on some:
- work on one thing at a time, don’t take on too much at once
- if you’re gaining weight as part of recovery, wear comfortable clothing and hide mirrors if neccessary
- make sure you have a new focus in your life – new aims other than “lose weight”, and a new identity to match
- write a list of every reason you want to recover and keep it with you for when the temptation to slip is strong
- when you find a new joy through recovery (and there are some!), record it (writing, art, poetry, etc) so you can remind yourself of why it’s worth it

It’s sad that your story of OJD doesn’t surprise me. It seems that one can only get medical help with an ED if you’re either about to die, or you fit the diagnostic criteria for anorexia or bulimia perfectly. And apparently, even if you do fit the criteria, the help isn’t that great.

posted on January 4th, 2008 at 3:00 pm

3 On January 4th, 2008, Rachel said:

Those are great suggestions, Josie, especially the tip about mirrors.

I would also suggest that people get rid of their scales. This is a pretty big step though, so that’s why I didn’t include it in this particular list. I got rid of mine a few years ago but several months later I had a mini-relapse and just *had* to go out and buy another one -at 2 a.m. no less. I still have that particular scale, but it’s stashed away and doesn’t have its former place of prominence in either my bathroom or my life.

posted on January 4th, 2008 at 5:04 pm

4 On January 4th, 2008, Josie said:

Rachel – i’m actually looking for someone who’s recovered to tell me how they dealt with their scales. I was fortunate that at the time i was recovering i was going through a phase of scale-phobia (from the knowledge that i had gained weight), so that was no problem.
So when someone who weighs themselves multiple times a day asks me for advice i don’t know what to suggest!!!

posted on January 4th, 2008 at 5:24 pm

5 On January 5th, 2008, Vanessa said:

rachel- great post. seriously.

josie- i can give some advice on that question, i think. i’m currently a scale addict and have always been one when my disorder was bad. in recovery i had to face giving up the scale and it was literally the hardest thing i ever tackled. for me, having it in the house wasn’t possible, if it was in the house i’d use it. also, cutting down didn’t work, it had to be cold turkey. so i would suggest that if the person has supportive people in real life they have someone who understands take their scale and keep it for them. could be friend, or a therpist, whoever they trust. that’s what i did, and it helped a lot to have someone do that for me. if there isn’t someone who fits the bill, then it must be thrown away- there’s no way around it.

i needed a bunch of support to do it, and i had a tough couple days afterwards. i also continued to be weighed by my nutritionist and see my weight, i think that’s a different question and it depends on the individual whether it is best to completely not know, or to have weighing be a weekly rather than multiple times a day event.

posted on January 5th, 2008 at 12:37 pm

6 On January 6th, 2008, Jackie said:

I read the article. I know of a good way to distract yourself, video games. Yes it’s costly, but these days with new technologies, it could take up to a year to finish a game. The latest Mario game, Super Mario Galaxy has at least 100 different levels to try and beat. It’s not exactly Space Invaders anymore.

Also PC games are very rich in gameplay as well. I mean, mostly the ones you have to buy off Amazon. Not to say, if you find yourself obsessed with a game like Diner Dash, from one of those online download game sites, it’s a bad thing. It just isn’t the same as playing something that is more like a RPG or something. Also MMORPG games can be distracting, but VERY addicting. I’d advise against playing those, especially if you already have an addictive behaviour. I’ve heard stories of people staying up for days playing those type of games, seriously.

I hope I’ve been of help. If you ever get stuck on a game, you can try http://www.gamefaqs.com. They have free strategy guides made by other gamers. If you are more of a visual learner though, you probaly should buy the strategy guide.

posted on January 6th, 2008 at 4:21 am

7 On January 6th, 2008, george said:

hi. my wife is struggling with an eating disorder for 5 months now. the books i have learned about from this site have been very helpful. It is hard to find people in my situation willing to discuss what is going on and to be as open as some of you. I have learned a great deal from this site and some others. thank you.

posted on January 6th, 2008 at 7:23 pm

8 On January 7th, 2008, littlem said:

@Josie – I’m not Rachel, but I am recovered, and I threw my scales out.

I refuse to be told what I weigh at the doctors, although at my annual physical I request a full blood panel and results. I measure when I get new clothes (twice a year at most; I HATE shopping and LOVE buying clothes that last years; perhaps I’m a closet Prep) and monitor my physical energy levels, for bodily health.

I decided I could live without the scale. Half the time, they’re not right anyway, so I wasn’t going to torture myself with numbers.

posted on January 7th, 2008 at 5:01 pm

9 On January 8th, 2008, CEDquiz said:

Alot of the discussion in this thread is about recovery. One of the first steps to recovery is finding out what the exact problem is so that you can get the right professional help you need. If you think you might know someone with an eating disorder, pass along this quiz developed by the Center for Eating Disorders at Sheppard Pratt(www.eatingdisorder.org/about_eating_disorders/resources/quiz.php) to help them identify if they are just uber-healthy or may need help dealing with an eating disorder and can get them on the road to recovery.

posted on January 8th, 2008 at 12:10 pm

10 On January 9th, 2008, I think that yoga has said:

definitely been a huge help to me. Finding a healthy medium for exercise when recovering from an eating disorder can be difficult and I think that yoga is one of the few environments that does not trigger any red flags. It is non-competitive and attracts everyone and anyone, all shapes and sizes. It stresses personal growth and improvement, rather than comparing yourself to others. It also places a strong emphasis on meditation and finding inner peace, which has been a huge help to me. Thanks for the post.

posted on January 9th, 2008 at 11:28 am

11 On December 8th, 2008, Holiday Eating 101: How to negotiate the holidays when you have an ED » The-F-Word.org said:

[...] 3. If you struggle with binging types of disorders, distract yourself after eating so that you’ll be less likely to binge it back up. Check out my more general tips on how to reduce binging urges here. [...]

posted on December 8th, 2008 at 2:27 pm

12 On January 13th, 2009, Olivia said:

I don’t know if this was mentioned, but I used to binge/purge and one thing that has helped me stop is brushing my teeth after I eat. Sometimes when I feel very full my reaction is to throw up, and I feel disgusting and gross after eating a lot, so brushing my teeth/washing my face/taking a shower helps with that. I also try to wait the bloated-ness out.

posted on January 13th, 2009 at 7:55 pm

13 On November 25th, 2009, Emily said:

Something I’m working on that I find really helpful is realizing that I can ALWAYS start over. If I binge and purge I tend to think, “Well, today’s already messed up, so I might as well keep binging and purging and start over tomorrow.” But that is really illogical! Binging and purging once is SO much better than doing it many times, and even if I slipped, I’m really working on trying to learn from the mistake and then MOVE ON- don’t eat again until the next meal or snack, and at that meal or snack, eat healthy portions and keep it down. I can ALWAYS start over.

posted on November 25th, 2009 at 6:17 pm