Saturday, October 29, 2011

Setting the Record Straight. Shifting Your Perspective Toward Recording.

Here's what she had to eat. Take a look. Then write down your assessment and tell me what you think. You know, as if you were the nutritionist working on helping her improve her diet and her relationship with food.


Bread and jam, 2 slices
Freshly juiced red grape and berry juice, ~8 oz.
Coffee with whole milk
Vanilla yogurt with fresh peaches
Semolina cake with plum topping
1 fried egg
Bread and jam

12:30 PM
Medium gelato,

~2:00 PM

Wine samples and bread sticks

3:30 PM

½ a thick cheese and tomato sandwich, on white Italian bread
½ a thick pesto and roasted veggie sandwich, same bread

Wine tasting, approximately 6 oz, and a few bread sticks

7:45 PM

Cheese samples, approximately 1-2 oz.

8:00 PM

Bread, 2 slices
Large vegetable salad (enough for 2 or 3 people) with olive oil and vinegar
Wine, approximately 5 oz.
Gnocchi and sauce

~9:30 PM
A couple of cheese bites from around the world.

Nectarine with hazelnut chocolate sauce--day two's breakfast!
So what did you think? And have you figured it out yet? The she is me, and you are seeing an entire day of my eating while vacationing in Italy, unadulterated.

I'm not in the habit of sharing my food intake in such detail, in part because what's fine for me is not necessarily right for you. And I don't have a ton of personal experience with recording—the last time I tracked my dietary intake was for a grad school project, a good 25 years ago. But I decided I needed to address the topic of recording because it can have great value.

For most clients, recording is the bane of their existence. I say for most, because I have seen that rare person who loves recording. It suits their need to do things perfectly, completely, meticulously, so they follow the recording recommendation to the "nth" degree, including every sip of water and every bite of food they eat.

Do you know how many times I heard "I left my food records in the car" this week? No, you are not alone. They’ve been eaten by dogs, whirled away by hurricanes, and inadvertently used for fireplace kindling. Yes, I have heard it all, the most creative excuses. It reminds me of a NY Times article on North Korean doping (July 17, 2011). Following evidence revealing their soccer team’s use of steroids,

“A North Korean delegation told FIFA (the world governing body of soccer) that the steroids had accidentally been taken with traditional Chinese medicines based on musk deer glands to treat players struck by lightening on June 8 during training.”

You can do better than that, I'm sure.

The egg course--day 2!
More about record keeping in a bit. But first, I want to say a few words about this day's eating, a real day last month in Tuscany.

This is 100% honest. I neither overestimated nor underrepresented my food intake. It is a description of a day we spent in the town of Bra (no, not a typo), the home of the Slow Food Movement and the international, biennial cheese festival which we attended. I don't usually eat quite like this. And I certainly don't drink like this. But we were in one of the most amazing regions for red wines, home of Barolo, Barbaresco and Barbera, and so we did a good deal of tasting.

When you evaluate your intake, please ask yourself  "is this typical?" Perhaps you need to view the day in the context of your usual intake, recognizing that there are always exceptions to the norm.

Here's my take on my day's eating:

The evening before the breakfast at Villa La Favorita
The breakfast meal was crazy. Crazy good. And endless. We stayed at a bed and breakfast called Villa La Favorita  where the breakfast was served in courses. Multiple courses. The broken lines show the breaks between items served. 

Unfortunately, I did not have the benefit of knowing what was coming next, nor how much was coming my way. And the food was wonderful. By the second of our two days there, I knew enough to leave the bread and await the more exciting baked item, to skip the items I cared less for, and to pace myself.

Not knowing what awaits you is most difficult. If you struggle in such situations, obtain as much information about what will be served as you can, so you can prepare yourself. But let's say you didn't, as occurred on day one at the B and B, and you, too, ate more than you needed. What's the worst thing that will happen?

Have you seen enough gelato yet in these posts?
In my case, I didn't get hungry until later than usual. But by 12:30 I needed to eat something. Imagine my pleasure at finding a gelato shop en route to the car! And so I had my second gelato of the trip (see post gelato diet). And it was good. I thought about ordering the small, but had the medium instead. My husband got the small (he is so well trained), but then I shared mine when he was done. So, I think that counts as a smedium?

After a wine tasting in a lovely castle!
 The additional "snack" of some wine (quite little, truly—we paid for these tastings by the sample) and some bread stick pieces resulted in a rather late lunch. It wasn't until late afternoon that we got hungry, quite hungry, in fact. That gelato and wine tasting just didn't cut it. By then I couldn't decide what to eat, and so we ordered two different sandwiches, sharing them both evenly. (It was, perhaps, the best food per euro we had anywhere, in a nothing special seeming little spot.) Thankfully, my husband is accommodating and enjoys similar foods.

Dinner reservations were secured for 8 PM, so we decided to start our cheese tasting before the meal. As for dinner? There was nothing I yearned for more than vegetables! After the preceding week in Switzerland where I ate much less of them than I am accustomed to, I was thrilled to find a large salad as a starter to the meal. It was truly the best part of this meal for me. Then I ate a portion of the gnocchi— although I found them a bit too rich—but had enough room for some more varieties of cheese bites, as we strolled around the lovely town of Bra late night. And did I mention these cheese samples were not low fat?
Bra during the cheese festival 
By the way, my activity for the day was largely eating and wine tasting. There was minimal walking around some quaint medieval towns, but this was not a high output day, by any means. No biking and drinking for me.

What can you take from this?

Get as much information as you need to feel comfortable, and where appropriate, ask for foods to be prepared how you need them. But when the situation prevents that, trust it will be okay—because it will be. And work on being flexible. In the situation above, perhaps I could have asked about the breakfast menu. But it honestly didn't cross my mind. And so in spite of the breakfast being excessive for me, I had what I wanted, and left part of the foods that I was indifferent to, like the egg. It likely was more than enough; I could have had less, perhaps, and felt just satisfied. But I didn't. 

The fuller breakfast meal sustained me, removing the need for an AM snack. (If you are someone following a meal plan at this point, don’t get any ideas about skipping meals or snacks because you don’t “need” them. When your body and your mind are working to keep you healthy and safe, of course you can and will use these cues. But for now, stick with the program and use your meal plan.) Really the gelato met that need—just a bit later than I'd usually need a snack. The source of my calories at 12:30 was hardly relevant, as long as I had enough, and I ate what I wanted to eat. And I enjoyed every creamy bite.
Gotta expect the unexpected! Sculpture from a wine
tasting town in Piedmont

If a struggling client had recorded this day, and was self assessing his intake, here's what they'd likely say, and what I would have countered with:

Client: Nutritionally, this day was way too high in saturated fat, as well as in alcohol calories.
Me: This is quite atypical for your eating. You rarely graze on cheese with such frequency, and you never drink in the afternoon, never mind multiple times in one day. Given the frequency of this type of eating, then, nothing to worry about.

Client: Breakfast is too big.
Me: It may have been more ideal to distribute your food better, spreading this enormous breakfast through the morning. But you couldn't. And so it was. Radical acceptance.

Client: I shouldn't have had the gelato; I should have chosen something healthier.
Me: No, you chose what you felt like eating, and that's appropriate.  And you had as much as you needed. You started to share when you were feeling you had had enough. Perhaps the small gelato dish might have done the trick. Maybe next time you’ll try the small. (Wow, a next time? What a thought!) You never do know how much will be enough, until you explore the options and learn to titrate.

Client: I consumed a lot of calories from beverages, including alcohol.
Me: If you are working to increase your calories, the benefit of beverages (non-alcoholic, I mean) is that they move quickly through your gut, and the feeling of fullness passes fast. But if you’re looking to feel more satisfied from your intake, I'd vote for fruit over juices. Again, it really depends on your need. As for alcohol, it's important to identify the impact drinking has on your awareness and mindfulness of your eating. Some can manage modest amounts, others simply cannot.

Client: I should have limited my dessert to once a week, not twice a day!
Me: Once you set arbitrary limits on your "indulgences" you'll set yourself up for trouble. If cake can only be eaten on birthdays or special occasions, you will certainly find yourself eating more of it on the one and only day you allow yourself to have it. If you are only allowed to eat before 8 PM, you'll find yourself eating a lot more before the time is up. Ultimately, these rules fail you.

Client: I ate so much and should have exercised.
Me: The food doesn't turn to fat because you didn't exercise. While I absolutely do recommend exercise for health and disease prevention, it is essential that you consume enough food to support it. Your body is quite forgiving. A larger intake on some days doesn't result in weight increases that day or that meal. Of course over time, if you exceed your need for maintenance, whether you exercise or not, you will gain weight. And for many of you that really is a good thing! You know who you are.

Benefits of Recording

Recording gives you the opportunity to view things differently, to gain insight, while letting go of the self-criticism and self-loathing. Inevitably my view of my clients' eating is way more compassionate than their perspective. So writing things down and debriefing about it with a knowledgeable provider may truly help shift your opinion of yourself and your eating.

Rather than seeing this as a report card, or a confession, consider yourself a detective, with the goal of uncovering some answers, solving the puzzle of your eating struggle. This helps you break down the barriers to implementing dietary change. Including information such as your hunger rating and other eating triggers, along with the location food is eaten, is enormously useful.

Recording avoidance is common, for individuals dealing with all kinds of eating, regardless of their weight. Record keeping makes us more aware of our eating, which ultimately helps us make change. It's an in your face reality check. And that benefit may be the very reason you may flee from writing down what you eat. It is easier to not confront it. If you don't see it, you don't have to acknowledge it.

But if you don't acknowledge what you are doing, you don’t have to make peace with it. Hence, eating while on the computer, while watching TV, reading, driving, multi-tasking really do the trick to keep you stuck.

If you no longer record, but still consider what you eat, whether you are hungry, or simply satisfying a range of other needs, than putting it down on paper may not be necessary anymore. If that awareness starts to fade, you may want to resume recording.

What Should I Include When Recording?

Let’s start with what you shouldn’t be recording—calories, fat grams, fiber, and any specific nutrient content. Why? Because that leads to relying on external information, versus internal cues. Internal cues? Hunger and emotions, for instance. Here’s a list of what you ‘d benefit from including:

Don't go by this clock, though!
·         The time you ate
o   This helps you see your eating pattern and understand why you ate as you did. Too long between eating? That will lead to trouble. Eating every hour? Is there something other than hunger driving your eating?
·         Your hunger rating
o   I’ve come to like the scale 1-7 best, with 1 meaning starving and 7 meaning stuffed. But use whatever works best for you, including word descriptions.
·         Your thoughts and feelings
o   This helps you see your obstacles to eating, and to then work with strategies such as CBT (cognitive behavioral therapy) to change them. Food rules and misinformation may come to light, best addressed with your nutritionist.
·         The location food was consumed
o   Does the location support mindless eating? Are you eating in bed for comfort? Would you sleep on your kitchen table?
·         Any other diversions while eating?
o   Distracted eating is mindless eating. For those trying to get their needs met and not know it, this can be useful initially. But ultimately, we all want to be in control of our eating and our weight regulation. So try to separate eating from distractions.

So if you choose to stay stuck, skip the recording. If you want support, and a new perspective, record and share with your providers. Or, self assess as if it were your sister’s or your best friend’s recall; this will likely give you a more compassion perspective. If the only result of recording is more preoccupation with food and eating, and changing your perspective isn’t helping, than please do yourself a favor and don’t record your food. But even assessing these other components, minus the actual food items, can be quite useful. So give it a try.

And please let me know if it was helpful. As always, I welcome your thoughts, comments, reactions, and corrections to my assumptions!

Sunday, October 23, 2011

Healthy At Every Size?

Read first, then decide.

Today I saw a 12 yr old girl, I’ll call Gabrielle, whose weight was off the charts. She was referred by her doctor, supported by her concerned parents. And here's what I told her, because I believe it to be true.

Her place on the weight chart is likely the right place—for her. Since the age of 2 yrs she has paralleled this curve at just above the 95th percentile, (in spite of being only 5 ft tall, much shorter than average), resulting in a very high BMI. She is an active, healthy girl—more active than most thin girls and boys I see, with no apparent suggestion of health issues. She eats well—appropriate portions, as I'd expect for her need, a healthy balance of foods, including those I'd call "junk" food, and she eats the same when she is alone and when with others. In other words, she’s got a healthy relationship with food. Most importantly, she feels good about herself, and the last thing I wanted to do was add mental health issues to any perceived, but non-existent risk of physical health issues.

Gabrielle is one of several patients I’ve seen recently, fitting this description. Some individuals are larger than average size, some smaller, kids and adults, males and females. And we should not assume that’s a problem, as several bloggers are sharp to point out. Health At Every Size, The Fat Nutritionist and others enlighten those who don’t know better, who don’t ever question their assumptions, that large people can be healthy, fit, and in fact happy.

End of story? 

Not quite. The key word is can be. While we cannot and should not assume that an individual’s weight is causing them medical or emotional problems, there are overweight individuals who are not healthy or comfortable at their size, for whom weight loss may help. I question the belief that striving to lose weight, in all cases, is bad. And I am not talking fad diets, mind you.

I am not simply projecting here. I speak on behalf of the patients I have seen over my 25 years of practice. Just as we cannot assume that they’re distressed at their current weight, we cannot assume they are very comfortable or healthy at their state of health and size either.

There are kids, and adults, like Gabrielle described above—always large, but healthy and fit. Many are self-accepting, many self-loathing, perhaps due to society’s discrimination and learned messages they need to unlearn. And I do my best in my sessions to convey this very message, that they are just fine as they are—their eating, their activity and their weight. I am not addressing these “Gabrielles” in the remainder of this post.

Rather, I am speaking about those for whom obesity, or the degree of obesity they are living with, is not their norm, the men and women who have gained weight outside of their comfortable and usual weight range. This includes individuals struggling with compulsive overeating, as well as those without any emotional baggage. It applies to those who no longer take time to meet their needs for exercise, or who might have suffered an injury, which forced a decrease in activity, without adjusting their food intake. I’m describing those who don’t know how to prepare a healthy meal as well as those who eat many meals out, juggling the modern life of working and parenting, soccer practices and carpooling. And those who minimally eat throughout the day, only to eat excessively at the end of the day.

I am not judging them, merely conveying what I hear from them day in and day out. They put off travel because airplane seats feel too tight, and European cars fail to accommodate their size. They want to be off the medications they now take daily, for hypertension, high cholesterol and joint pain. They want to be free of their sleep apnea and their heartburn. 

Sure, there are plenty of normal weight people, thin even, who also develop such conditions (count me in—thin with high blood pressure). But as a population, increased weight increases the odds of developing such conditions. The damage to their knees may be already done, but it is easier to move a body with a lower mass versus carrying surplus weight, particularly when you’ve got pain.

I’m not picking on the obese. If you read any of my posts you’d clearly see my philosophy. Similarly, I do not believe there can be health at every size at the low end of the spectrum. While not all slim individuals have eating disorders, (some are naturally thin, always were and always will be) I can tell you that a low body weight that contributes to loss of menstrual periods, low body temperature, a very low pulse, distorted thoughts and preoccupation with food similarly would benefit from a change in weight. 

And if you think these individuals are immune to society’s judgment, think again. There is equally little sensitivity to those struggling with weight issues on this side of the spectrum. Yes, sometimes the very people who preach size acceptance are all too quick to dismiss, insult and disregard the opinions and insights of someone who is thin, simply because they are thin.

A rabbi friend once said jokingly “Anyone who is more religious than me, is a fanatic. Anyone less religious, a heretic.” Sometimes that’s how I think we all behave around the issue of weight. It’s fine if you are my size, but thinner or fatter we accuse of needing to change and have a difficult time accepting.

Ultimately, the primary focus should not be on losing weight. Yes, even for those who truly care to lose weight, for whom a high BMI was not the norm. Rather, they need to address their behaviors and experience tangible benefits—a sense of accomplishment, having set a realistic goal and achieved it; better sleep; better endurance; better concentration; less irritability by honoring their body’s need for fuel; and a better relationship with food. As these changes occur, weight loss also follows.         
Where do you fit in all of this?

Does your activity need to be addressed? Are you even at a healthy enough place to be exercising? What modest goal can you set that you’ll be able to achieve?

Do you allow yourself to eat when you need to? Or do you push this to the limits, thinking you are too fat to be eating? Everyone, 
regardless of her size, needs and deserves to eat throughout the day.

Do you give yourself permission to eat foods you enjoy? Do you even remember what those foods are? Or are you so stuck following everyone else’s rules (including your own), absorbed from years of dieting and denying yourself?

Yes, allow yourself to eat whatever you’d like—no single food makes a person fat. And have it when your body needs it—when you are hungry, any time you are hungry. But learn to have just as much as you need (do read through the many older posts that address this topic).

In fairness, the palpable anger I feel from those who blog about fat acceptance is understandable. They have been mistreated by our society, including those that should know better, such as the medical community. They include those, like Gabrielle, for whom weight loss may be inappropriate. They are repeatedly told to change, when change is truly not necessary.

But let’s not over generalize. There are also those overweight individuals who would like nothing more than to be accepted for who they are but have medical conditions that may be assisted with weight loss. And they deserve to be supported on their journey to a healthier place.

Tuesday, October 18, 2011

Weight Management Gelato Style

The first time I traveled to Italy I was 19. I recall marveling at marble fountains, being seduced by sculpture and impressed by massive stone architectural creations while touring through Rome and Florence. But perhaps as memorable as Michelangelo’s larger than life David (, with which I fell in love, was the smooth and creamy gelato. Twice daily I would indulge in such intense flavors as nicciolo (hazlenut) and espresso, midday and late evening. 

In fact, I would purchase a scoop regardless of the hour, whenever I had an excuse to pass through the famous square the gelateria occupied. I had purchased it fearing I’d never, ever, see gelato again. It was now or never, as gelato doesn’t travel well in luggage. This, by the way, was the early 1980’s.

During my recent trip, however, I was older and (somewhat) wiser. I had gelato only twice in 7 days. (Okay, I did share some bites of my husband’s on a third occasion, I admit, but does tasting just a bite on those tiny plastic spoons really count?). It was not because I was watching my weight (I was not), but because I trusted this time; I knew it wasn’t my last chance to get this fabulous Italian ice cream. Boston has great gelato, as does NYC, which I visit not infrequently. In fact, you can even purchase some good stuff from the supermarket these days—at least where I live (check out Whole Foods). Or, as I’ve done, you could make it at home with an ice cream maker.

But back then, I harbored many a diet thought. As a teen, I had dabbled in the Scarsdale Diet, and wasted my time at Weight Watchers (Now you understand my vengeful post! (

My thoughts about food and eating and my body have changed enormously over these years. At the age of 19 and by the end of college, my BMI was out of range and it was not okay—I was sedentary and hardly fit—and I was rather disconnected from my body’s signals and needs. And I was not a large-size person from early childhood, genetically predetermined to exceed the BMI charts, justifying this above average size.

I’m older and wiser now at 48. On my return trip to Italy, I savored the rich and flavorful, slow cooked meals of the Piedmont, filled with mushrooms and truffle oil—but I didn’t fear it was my last supper; I lingered over multicourse meals, filled with flavors I adore. And I stopped when I had had enough—even though it was delicious. 

I skipped desserts when they seemed unnecessary, but took advantage of the aforementioned gelato when I needed a snack.  I sampled many a local Pecorino cheese in Tuscany and savored the hearty Tuscan Ribollita soup filled with beans, bread and vegetables. We enjoyed divine meals artfully prepared with local ingredients, served by Italians passionate about their culinary art. 

Among the very best meals was at La Coccinella, located in the small town of Serravalle DiLonga in the Piedmont. Fabulously prepared fish, as you can see from this photo. But like the gelato of old, I will never forget the dessert lovingly prepared with local hazelnuts, a delight of textures and flavors I can never duplicate.

I write this not on behalf of the Italian tourism department—no one is advertising for your clicks here. Nor, to brag about my travels I feel fortunate to have taken, along with my husband who enjoys great tasting food as much as I. Rather, it is my hope that this will inspire you. 

You may never care about great olive or truffle oils, perhaps. And traveling may be the furthest thing from a reality for you right now. But enjoying food can start at home, wherever you live. Sure, it may require some prep time (although good gelato, like fine chocolate, could easily be obtained and consumed). It requires you to start asking yourself “what do I feel like eating?”, when you are hungry, not just “what am I supposed to be eating?”, yearning later for the very items you’ve prohibited yourself from having.  It necessitates giving yourself permission to eat now, and again later—even if what you choose to eat later is ice cream. Because when you know you have permission to eat it again, you can stop when you’ve had enough. You’ll begin to trust this is not your last chance.

And after doing this for some time, and really trusting your body, you’ll note something strange. Sometimes, there may be times when you’ve truly had enough gelato, and there’s nothing more desirable than a fresh, juicy piece of fruit. And that’s ok to eat too.

Monday, October 10, 2011

Making Enemies 101: Tips From the Blogosphere

Anger. All I could feel was their anger. Their perhaps valuable messages got muffled, but I was left with my tail between my legs. That was my experience of reading a couple of blogs I respect and frequent often, one with a focus on eating disorder recovery, one on size acceptance of the obese. No doubt this post of mine may provoke more anger—that is not my intent. And while these two topics may seem vastly different, I hope to show that they have many commonalities.

Laura's Soap Box

I have learned a lot from Laura’s Soap Box:

It has, more than anything, strengthened my stance that we have no time to waste, when it comes to recovery; that the ever-hopeful practitioners that patiently wait while engaging in therapy often do so for way too long. And especially for the young anorexics and those new to their eating disorder behaviors and thoughts, those with a narrow window of time for weight restoration for growth and development, for preventing hard-wiring of their approach to eating. The parenting style, more loving tiger mom than most of us like to approach, has its merits. Yes, for survival and health, it takes a tough parental stand.

Yet when I read the post I was struck not by this very appropriate message, but by the anger and frustration at parents and practitioners who haven’t mastered the art of (eek) Maudsley? Family-Based Therapy? Modified? I’ll refer to it as Maudsley-style from this point forward, so as not to incite more anger.

I’m guilty. 

It's a long way to travel to get to where we need to be.
I admit it. In my 25 years practicing as a dietitian, I have never formally been taught this approach. (Nor, for that matter, was I formally trained in an academic setting on eating disorders; they were only minimally covered in my graduate studies). I have learned what I know by educating myself through eating disorder conferences, literature, as well as more recently through blogs like hers. And, through seeing vast numbers of eating disordered individuals over my career. From my understanding, in this approach, nutritionists/RD have no place. But that’s another story. In my version, RDs play a very valuable role.

Anorexia recovery is not one-size-fits all.     

Many families I see are not candidates for this approach. Some are quite dysfunctional, frequently making supervision at mealtimes disastrous; it would take years to educate them about their inappropriate messages, to correct their nutrition misinformation—I could go on. And we just don’t have that kind of time. Caution: I am in no way suggesting that these dysfunctional families caused their child’s eating disorder, merely that they are in no position to take charge of the recovery.

Some families aren’t candidates, as I see it, as they have too many other demands, such as caring for another family member—a parent, a child with special needs, a newborn, working multiple jobs, etc.
Some families certainly could learn to use a Maudsley-style approach—if they were prepared to take the time. Yet I find many parents want their kids fixed—they bring them for care with an unrealistic perspective on what recovery entails, how it is measured and how long it might take. And most importantly, they have no idea how important a role they play as parents, Maudsley-style or non-Maudsley-style.

I say some intentionally. Many parents couldn’t be further from this description. They are present, physically, and emotionally for their kids; they are anxious to know just what they could do to help their child, and how best to do it, and they adjust their schedules to make treatment appointments a priority. They are scared, but they work on accepting that treatment is a process and takes time. 

In such families, some of the kids with anorexia may be supported by their parents, without the parents having the level of supervision and involvement I understand a Maudsley-type approach to have. They set appropriate safety limits, from a health standpoint (ie—they respect and enforce the outpatient team’s recommendation that there is to be no physical activity, for now). But their children are able to make progress, measurable progress with weight restoration and vital sign changes, that enable them to continue in this setting, without their parents taking charge of their food plating or supervising their snacks. And they are able to engage in therapy, both mental health counseling as well as nutritional counseling in the process.

But then there are those for whom the Maudsley-style approach is perfect. A willing family, with the time it takes to be an active player, to be intimately involved in refeeding. Parents willing to shift the relationship to that of supportive team members, fighting the anorexia along side their child, taking charge the way their unhealthy child can’t, at this time. And I have seen recovery with both these approaches.

Treatment for eating disorders needs to be as varied as the individuals with the eating disorders. As health care providers, we too are not a homogeneous group, not by specialty, not by style and approach. We also get frustrated and angry, when we encounter patients and families, as well as other medical providers who fail to support our stand, to set appropriate limits to ensure recovery. We too recognize that it takes a nourished mind to engage in the process of recovery and decision-making, a role many starving anorexics simply cannot do.

I believe we all share the very same goal—to foster recovery and normalize life for the individual as well as the family dealing with anorexia. And we need to stand united in this goal. There is no single best treatment for all individuals. But educating with a consistent message about the seriousness of eating disorders of all types and the need for treatment and support is essential.

We put our heart and soul into doing the work we do.  But few will respond well when faced with angry rants—by me, by parents, or by Maudsely-style bloggers. We, too, are works in progress.  

And yes, I will soon address the other angry blog in an upcoming post.

Tuesday, October 4, 2011

This Time It’s Simply About The Calories

Piedmont: Great Wine, Great Challenges
I’m a snob. I admit it. When it comes to food, it’s got to taste good. Because I intend to really taste it. To enjoy it. To savor it. Every bite of it.

But Thursday, after many long, hot hours biking the grueling hills of the Piedmont region of Italy, we were hungry. Really hungry. The hills took us much longer than expected; we had no idea what it really means to be in shape for riding hills!  And the snacks we carried? We downed those within the first couple of hours.

So we rolled into a tiny town, known for its hazelnut production. Now give me a dessert with hazelnuts and chocolate and I would’ve been just fine. But that didn’t happen—no bakeries in sight. But it didn’t take us long to identify the only eating establishment around. Think retro, stale, cigarette-smoke-filled air luncheonette before it turned quaint and chic.

In our broken Italian we ordered the only Panini that sounded acceptable. Oh, and a salad.  What comes to your mind when you think salad? Fresh, crisp vegetables? A brilliant assortment of colors, flavors, and shapes? Think again. They offered what is known as Russian salad—a heaping mass of mayonnaise, containing diced potatoes, peas and a speck of carrot.  We had it along with the white bread sandwich packed generously with cheese. And I neglected to mention (how could I forget?)—that there were two rolled up sardines with olives. At least they added some color.

Well, I ate at least 90% of this lovely meal. And I hated every bite. (Although given my sweating from the unseasonable heat, the sodium rich sardines and olives were much appreciated.) This was so far from the fabulous cuisine I had heard so much about and had begun to enjoy my first day in the Piedmont (more posts about those meals to follow). The Piedmont, after all, is know for the Slow Food movement, amazing wines (Barolo, Barbaresco and Barbera) and white truffles (these are intense mushroom like fungus, not chocolates, my friends), with their distinctive flavor which embellishes foods with a mere drop of a truffle infused oil.

At this point, exhausted and overheated, depleted of energy, it was strictly about the calories, the fuel. I wasn’t going anywhere without eating this awful meal. I had no other options. I couldn’t find my voice in this language I barely spoke, and I suspect there were no other options, given the appearance of this place. Yes, mayonnaise-laden salad with a bland cheese sandwich was the only answer. Simply non-negotiable. There was nothing else to do but eat it.
Provence, not Piedmont!
What’s the meaning of this post? It’s not about my disappointment, of things not going as planned—that could be a whole other post. It’s not about adjusting expectations, because who could have expected this? Never mind that the biking was a total drag, nothing like our fantasy rides through Provence with climbs we could manage and stunning varied vistas to distract along the way.

No, the meaning is much more literal. Sometimes it comes down to Nike’s message—Just Do It.

For those of you who undereat—I know there are times when you are not hungry, and eating seems totally unnecessary. And when a fat-containing food may overwhelm. Or you question why you have to eat more than everyone else around you. Or the uncertainty of a meal’s content leads you to want to choose the safest route—food aversion. Or the allure of not eating, or restricting, promises a pleasant disconnect which might be so welcomed at this moment.

As for the overeaters and binge eaters (and anorexics, too)—skipping meals or snacks certainly sounds promising. Why take in those extra calories when a coffee will suffice? Because sometimes, you need to just do it. And when you’re feeling hungry even if no one else is, you need to just eat—because you need to begin to listen, to trust your body and its signals. Because you so deserve to be well nourished. Because your size has nothing to do with your need for nourishment in the moment. Yes, you too, need to trust it’s okay, it’s necessary to eat. And that you deserve to eat, regardless of what others’ glances may suggest, in spite of the messages from family members you hear or replay in your head, regarding your need to lose weight. Be in the moment, and trust that you should eat.

A cool drink after a long day of unmanageable hills and bad food!

I won’t be heading back for another Russian salad-filled lunch in the Piedmont. But I’m pleased I was able to fuel up for the challenging ride back. In the end, we enjoyed a lovely meal at dinner, and a refreshing drink just after unclipping from our pedals.