Monday, March 5, 2012

Are You Still Thinking It’s All About Your Weight?

You’re a mixed crowd, dear readers. You are patients, current and past, local and those I Skype with overseas. And you are Anonymous followers whose identity I’ll never know. You are largely female, but include many a loyal male reader. You cover most ages from late teens to into your 70s. On a recent day you visited from all 50 US states (a first!). And you regularly read from all continents. 

I love this! 
I certainly don’t know you well, except for what you share in your comments and emails. You may struggle with an eating disorder of any variety or strive to maintain your sanity in a world of over focus on food rules and misinformation.

You may be underweight or overweight—whatever those terms have come to mean—and you may or may not have come to terms with the work that needs to be done. You may be simply contemplating change or you may be working on maintenance and relapse management.

Yet here’s one thing I know for sure: your weight is not a valid measure of your progress nor of your effort, of your commitment to change or your need for change.

The past couple of weeks I’ve had many an encounter that convinced me I needed to share these thoughts with you.

Here’s a sampling of what I heard this week:

  • She was frustrated by her stabilized weight—it was nothing like those weight loss ads promise! Yet she realized that she is now capable of eating a couple of Oreo cookies. Just a couple—and feeling satisfied. And, she was able to talk about it, as opposed to keeping this info a secret. No more Oreos in the closet.
  • There was the realization that food tastes good! From someone who has spent the past umpteen years eating while barely using her senses (similar to how she was living life) this was a giant accomplishment. She now appreciates what she likes, and can follow her preferences. And she can allow herself this pleasure long denied.
  • “Do you mind if I eat in our session?” she asked me, as she nonchalantly pulled out her McDonald’s French fries. “I haven’t had time for lunch yet”. Long ago when we started our work together, reliance on a meal plan was absolute and deviating from the plan was a non-option. Food was restricted and binging was common. Think what you might about fast food, seeing this meal enjoyed, and eaten normally, made me happier than I’ve ever imagined a McMeal might!
  • He is learning to reframe his actions. Instead of, “I only walked 3 times this week, for only 10 minutes”, I can, with a mere raise of an eyebrow have him shift his focus. “I walked three times this week! I’ve started to make walking a priority to help my blood sugar! And it’s feeling good.”
  • Black and white thinkers may still struggle with what I refer to as the what the heck effect, that sense of why bother I’ve already ruined it. Yet even their acknowledgement that the thinking is the culprit, not the food item, is a major and necessary shift.
  • And finally there was this list I received from Dana just yesterday:

First I'd like to begin with the positive changes I have made since under your care:

    -I'm not starving myself
    -I'm throwing up TONS less
    -I do NOT exercise, ever
    -I incorporate risk foods into my diet
    -ed thoughts no longer consume 100% of my brain
    -buffets are "manageable"
    -I allow myself to eat after dinner
    -I no longer consume bottles and bottles of diet coke/day, just 1 or 2 glasses
    -I only drink 2 cups of coffee/day - not 2 pots
    -I DRINK calories!!!!!!!!
    -I allow myself to snack in between meals
    -I can go to dinner with my friends now with very little anxiety
    -I eat in front of people with more ease
    -I can control binges with much greater power
    -I recognize and honor my hunger now
    -I have learned to speak up a little more
    -I am present
 I know there's a LOT more to that list, but those were the ones at the top of my head.

Proud Tiger Mom and her cub, taking her
French pastries home after a satisfying brunch.

I feel like a proud Tiger Mom. Really.

In each of these cases, focusing on weight as the end point would have been absurd. In Dana’s case, weight has been around the same for probably a year. Why probably? Because honestly I rarely obtain it. But the times I do, it never surprises me. I’m not blindsided by positive talk without substance. And I ensure my patients are following up with their physicians for medical checks when necessary.

Weight can be stable or in a normal range while binging and purging. It can be stable while restricting followed by rebound overeating. And weight can be outside the “healthy” BMI range with either healthy or unhealthy diet and behaviors. What a disaster it would be then to focus on weight without attention to the damaging behaviors!

Just the setting for enjoying a pastry out!
Weight assessment certainly has its place. A progressive shift in an unhealthy direction (for an individual’s need) is clearly a red flag. But without assessing the underlying thoughts as well as the behaviors, obtaining and focusing on weight is nothing short of damaging.

I'd love to hear how your thoughts and actions have shifted, so please share!


  1. The most significant one for me lately is that I allow myself to eat things that I haven't allowed myself for years, like cream-based sauces or salad dressings. As far as I've come in my recovery from bulimia, there are still little sticklers like that one that I keep trying to chip away at.

  2. Lori. Just thanks.

  3. I needed this today! I have my weigh in tonight and sometimes I get so stuck on the weight that I forget about all the progress I have made. Gaining weight still scares me, but I remind myself that my goal is to be healthy and free of ED.

  4. Thanks again for a brilliant..clarity-inducing post Lori. Perhaps a sign of progress for me is the realisation that years of restricting do take a toll...not only on the body, but on the brain as well..and that continuing with such behavior makes one slower, less effective mentally as well as physically. Reading this important post makes me realize that to truly profit from life and wake up to the myriad possibilities within it..we need to nourish ourselves.

    I think that, a positive direction I've noticed in myself is that I'm trying to decide on a job that will not be too taxing physically..whereas before the job decision would have been purely based on its taxing quality/potential calories burned ( a standing/moving around position versus a sitting down/lower physical expenditure position. Thank you for your impressive support to national and international followers/ are very appreciated and your sage words have a strong impact...know this!

    1. Lori...I don't know if you had a chance to read my comment...but know I have passed this one to my TCA team...they are true backers of your philosophies with regards to healthy relationships with our bodies and food.

      On the road to wellness and awakening to listening to one's true nutrion requirements...when can one truely "trust" that the body will eventually return to a "normal" state with regards to metabolism? In post anorexia..I find it quite frustrating to not know "when" the body will finally "believe"..and let the metabolism "kick in" as before, pre-illness, so that the extra energy via calories can be truly enjoyed...Would love to see a post on this!..Thanks in advance for any insight...Many of us reading, I'm sure wish to stay attentive to their cues for healthy nourishment...but sometimes a severely slowed metabolic rate makes this so very difficult..Any tips to stay the path?

    2. Hi Donna,
      I did not forget about your comment. I hope to send you more than a quick response and haven't yet had the time. But I promise tomorrow!

    3. To start with, if your pulse is low or body temp is low you most likely are still in a low metabolic place. Typically, appetite is suppressed as well, then, but not always.I suspect what you are really asking has more to do with your thoughts, with your mind, than with your body, if I can take the liberty to separate the two. Your hunger may increase and if you respond to it, you'll physically feel better. But you may doubt yourself and not trust that it's okay to get hungry and to respond. And so you'll restrict further, or buffer hunger with non-caloric beverages, vs responding with proper nourishment.
      When you finally allow yourself to truly get enough, the obsessive thoughts settle down, and hunger normalizes. You may have made progress, but may still be withholding adequate intake. Without knowing your details, I certainly couldn't say for sure.

      I hope that helps.
      Thanks for reading, for commenting, and for sharing with your team.

  5. I've been listening to my hunger cues lately (and honoring them!). I eat when I'm matter what the clock matter how long ago breakfast was.


  6. I'm so glad this message resonates with you and supports you as you move forward. Now if only we could spread the message to those who are still stuck in the numbers game! Thank you for your comments!


    1. Always glad to assist. Thank YOU for reading and commenting.

  8. Ok Lori, brace yourself for this one - you might like to sit down. As I was dressing this morning I realised that I felt slimmer than I had in a week - my period has returned with annoying regularity and I was feeling very bloated because of it. But today I felt quite slim and more comfortable. So I weighed myself - just to prove to myself that I was slimmer. And I had put ON 0.5kg. But do you know what - it doesn't matter. I felt better. Who knows why the scales said that. I looked better, and I felt better and the scales were just a number that really wasn't relevant to how I was feeling. So I wore exactly what I was planning to anyway and went on with my day.

  9. Struggling back from a recent, nonsensical relapse, this is exactly what I needed to read today. Thank you.

  10. I just found your blog and look forward to reading more.

    1. So glad you found it! And thanks for your comments. Hope you find it valuable and share it with others.

  11. Spring has come. The weather is no biggie, mostly overcast, it's not particularly warm either but there's more daylight and it smells of spring. I suffer from horrible SAD and I spent most of the winter sitting at home and the utmost exertion was walking downstairs to find some more chocolate. I know that the next winter will be very similar to this one and many other but now, I'm just walking around the town to see what new shops opened or which have been here since forever but I never went there - our department store is closed for repairs and I needed pantyhose, file organizers and other mundane stuff I'd get under one roof. And I was now pushed to go and investigate.
    I found a bike repair shop so I'll get my bike checked and enriched by a basket so that I don't need to bother with a backpack. I'm allowed to cycle only on the flatland as per orthopedist's orders so I got some maps and I can't wait for the sunny Saturday promised by the weather forecast.
    I still eat rather awfully but there was the praline incident requiring that my mattress, sheets and bed linen be cleaned, I stopped eating chocolate in bed, which means that I hardly eat any.
    So far, I prefer cooking to eating which means that I don't cook much, there're no enthused eaters. Had a few binges lately and my feelings were torn between To hell with it, it's just a kilo of ice cream and Oh noes, the end of the world is coming.

    I have a wager with my friend: a carton of decent wine if I fail to lose 10% of my body weight until the end of April. It's nothing, five kilos or some such... but I started moving and as usual, I started gaining muscle mass. Well, give it a week or two at maximum and there'll be botanizing and nothing will keep me home. Those resulting 96 kilos will be still a lot for me but hey, baby steps. Says me. Hey, I would be able to lose 10 kilos in two months, easy peasy.... but I don't want to try it again.

    The bad thing is that this feeling will last only until October. But meantime...

  12. Ok coming from recovering anorexic.... nutritionalist told me to eat 4500 calories a day because.... I do work out but I do things I like .... like dancing and yes im a male...anyway is this too much a day.... because she also said im hypermetabolic because I wake up sweaty or sometimes drenched in sweat.... btw im 15

    1. I can't say what your specific needs are, but I certainly have seen individuals needing that much! Being male, hypermetabolic, active, still growing, and needing to gain weight--it wouldn't surprise me at all!
      Trust your RD! Hope this helps.