Sunday, February 21, 2016

Pet Peeves. Just in Time for Eating Disorder Awareness Week.

We will all rest more easily if we air
these 'pet' peeves.
Radio show host, Brooklyn Kitchen store owner and foodie Harry Rosenblum wants to know my food related pet peeves. He'll be interviewing me on March 16th on Feast Yr Ears about eating disorders and recovery with a particular interest in Cate and my book, Food to Eat: guided, hopeful & trusted recipes for eating disorder recovery. Pet peeves. Funny he should have asked; 'Thursday's patient' was just suggesting this for a blog post.

We all have them. Pet peeves are those things that drive us crazy that people and companies say and do that make us want to scream. But most of you don't scream, or even express your outrage. You might be annoyed, infuriated even, but you just keep it quiet and say nothing. Maybe you ruminate about it, or binge eat or don't eat at all. "I'll show them" may be your thinking. So readers, here's your prompt to share those things that piss you off. Ok, ok, not so fast. Let's narrow the focus to food and eating disorder related topics, okay?

I'll start us off with a few.

  • People who ought to know better, that assume weight loss is a good thing. Think doctors and nurses. Just 2 days ago a pre surgical nurse interviewing a family member asked if there was weight loss of more than 10 pounds in the past month. Yes, was the reply. "That's great!" she  moronically responded, naive to any underlying vomiting, pain, growing cancer, or depression that might have contributed. Brilliant. Or the pediatrician who praised the boy's weight drop from his high BMI, failing to ask the critical questions that would have diagnosed his eating disorder.
  • Food companies that sneakily shrink their packaging, thinking we just won't notice. 1/2 gallon of ice cream? Nope. Now it's just 1.5 quarts (vs 2 quarts). Kashi cereal boxes--same height, just a fraction of the content, with skinnier boxes. Call a spade a spade. Increase the darn price but keep the package size the same. Don't insult my intelligence, please! I'm waiting for them to fill my dozen eggs with just 10. Just you wait. 
Stop insulting my bread.
And please call it bread, not carbs!
  • Nutrition misinformation that people can't let go of--belief that gluten, or carbs make you fat. Not so my friends! There's no evidence to support this. It's like global warming for a particular US political party. They hold on to these beliefs in spite of all the science to the contrary. Ughh!
  • Food labels that shout out "high protein" or "low fat" or "gluten free" as if we should care. (If you  need to watch your gluten since you have celiac you'd better look for more that the shout out gluten text; you'll need a legitimate stamp identifying foods that have a measured low gluten level through careful factory testing).
  • People that think their food choices or diet type raises them to a higher moral ground. Choose to be vegan if you are concerned about the planet or animals or both. But don't wear it like a designer label because quite simply, I'm not impressed.
This is steak. It contains protein.
And fat. And other nutrients.
  • Calling food by its nutrient. As in "I'll have some protein with that" referring to meats or fish, for instance. Can't we appreciate and select foods for their other characteristics, too? For their flavor, or texture, their smoothness or crunch? The simple pleasure they give us?

What are your pet peeves? Let's put them out there and circulate them. And maybe we will raise awareness and create change.

Friday, February 5, 2016

So you think you're recovered from an eating disorder? Take this quiz to find out.

1) Recovery is about weight gain. Period.

The simple answer? 
It just might not be going the way you planned. 
False. Now don't let your eating disorder get all excited, saying "See! I told you so!"

Weight restoration is surely a must for those who have fallen from their usual weight or in the case of kids, their weight for age and BMI curves. That is, their expected pattern of gain based on their age and their weight history. For kids, falling off their usual growth curve suggests a problem. It shouldn't be praised or rewarded, but evaluated. (Pediatricians, did you read that?!) But if someone's weight was high due to unhealthy behaviors such as binging, emotional overeating, or general disregard for satiety, and weight dropped with improved eating and coping, weight gain is likely unnecessary.

Simply reaching a healthy range based on the charts also isn't enough. Perhaps your restrictive eating and suppressed weight began as a young teen, and you've lived for years with eating disordered behaviors. Did you rely on cigarette smoking or other substances? Was your appetite suppressed by ADHD meds? As you recover, weight gain may be essential regardless of what the BMI charts say. Focusing on the weight is misguided!

Your weight may be technically in the normal range, but your behaviors may indicate a problem. You know, like restricting, binging, purging, laxative abuse, compulsive exercise.

Weight is just one component of eating disorder recovery.

2) If I get a period (and I'm not a guy) then my body is healthy.


Surely losing your period when you're of age and sex to be getting a period is cause for concern. But getting your period is not evidence that all is well and you have recovered. You may get what seems like a period when you're on the pill, or start to get periods back without all the hormones being back to normal. Or maybe like one adult patient I used to see, in spite of her struggle with anorexia, she managed to conceive and deliver 5 children, never missing a cycle. Similarly, weight may be restored to the appropriate place, but it may take several months for menses to resume. For guys, low testosterone level is a more silent red flag that things are amiss; is resolves with adequate eating.

3) If I can take in enough calories, then I've recovered.


Can you eat foods you used to enjoy?
Sure, you will need enough calories to get your body bad to normal function--with a healthy heart rate and blood pressure, without major drops in pressure when you go from lying down to sitting or standing; with normal body temperature and energy level; with better sleep and mood. But full recovery means eating a range of foods and nutrients. It requires eating enough carbohydrates and fats-- not just protein. Recovery, true recovery, demands you include foods that seem scary, foods that you used to love, so that you aren't controlled by them. Like eating some pizza or an ice cream if the spirit moves you.  It means eating bread that may be whole wheat, or white, sourdough or french, without relying on ‘sandwich roundsor high fiber, low calorie flatbreads, or “Ezekiel” bread. If you’re truly recovered you can eat foods even if you can't justify them for their nutritional value, even if you don't think of them as "good for you".

4) I've stopped using laxatives, vomiting, and I'm eating better. I'm healthy now that I'm exercising every single day. So surely I'm recovered.

False. Replacing one behavior with another-- in this case, having to exercise to allow yourself to eat-- is also not healthy. Be careful that you aren't just swapping one behavior with another-- even a 'socially acceptable' behavior like exercise. If you feel you can't eat if you don't exercise you have work to do!

Ok. So I am doing fine with all that. But I need to be the one preparing the food. I'm still recovered, right?

I know. This is a scary idea. I will
settle for nourishing you
with words.
Not quite. Full recovery includes some flexibility and acceptance of what you can't control.
It means eating meals out without having to look up the calories before hand, and without having to modify the entire meal according to ED (that said, being vocal about your preferences doesn't have to be disordered. While Sally didn’t have an eating disorder in "When Harry Met Sally" this scene is worth viewing for some comic relief. Recovery is being able to eat a meal without watching the food be prepared, fearing the secret addition of ‘toxic’ ingredients.

Recovery acknowledges that people you know diet or overexercise or are losing weight, and it is what it is. (see husband triggering) And that you stay the course with eating and avoiding behaviors because it simply has to be; because you can be a great dieter-- but it didn't serve you very well being in that place before. And because you simply deserve to feel better.

Not as far along as you hoped? 

Then move your frustration to action. If you've just started on this path, hooray for improving your intake and taking steps toward recovery! Perhaps you're finding other ways to cope, so you're freeing yourself from unhealthy disordered behavior. Maybe reading this post helps you realize that more recovery pieces are in place than when you started. Progress! The point of this piece is to raise your awareness to help you keep going and reach fuller recovery. And to shake up some denial that stands in your way.
Yes, there's hope. See some of the links below.

Any changes to your thinking or eating you still need to make? Perhaps the post below will help to motivate.

Please share your thoughts!

And thanks for reading.