Sunday, December 2, 2012

Thinking the Work is Complete Now That Your Weight Has Changed?

Lessons from co-writing Food to Eat: guided, hopeful & trusted recipes for eating disorder recovery.

Last week I saw a new patient, a 50 something year-old overweight woman who presented with the stated goal of improving her health—and taking control of her escalating weight. Her body language and her attitude shouted ambivalence—or more accurately, defensiveness—and within the first quarter hour she had me on the defensive, too. Not too much rocks my boat, given 26 years seeing patients, including those who'd rather not be there. But the accusatory tone in which she asked about my weight history startled me. While not speechless (imagine what it would take for that to happen!) I was certainly at a loss to articulate my credentials to help her in a way I thought she could hear. Perhaps even expecting that she would hear was setting an unrealistic goal.

Can I ever REALLY know how difficult his life is? Or what he's thinking?
What could I possibly know about her weight struggle, was what she implied. How could I—a slim appearing, seemingly confident person  know about her challenges? Who am I to be giving advice? Well it wasn't the first time I had heard such questions, but for some reason her's threw me off guard. How do I begin to explain that my weight has nothing to do with my knowing, and with my ability to help? (Do I need to share my personal struggle with weight—which I openly discuss in my new book, Food to Eat, coauthored with Cate Sangster—which should have no place in our session about her?)  

What does weight have to do with it?

And if I had been a fat nutritionist, would that have validated my skills in guiding her on her recovery path? I suspect not, as I have heard many a criticism of dietitians' weights that has made me cringe over the years. That is, unless they were able to look past size and weight bias and hear the value of my words, as the Fat Nutritionist proves worth doing.

For those of you struggling with an eating disorder, you may feel similarly. Just because you are weight restored or nearly so, doesn't mean your disordered thoughts have abated. My co-author Cate, even when in a physically healthy place, is no stranger to these intrusive thoughts. And she shares them so openly with raw emotion—exposing her fears and her wishes relating to food and eating. But what does the public know when they see Cate or you on the outside? No, it's not just the stereotypical 60-pound-anorexics that suffer from eating disorders.

And what assumptions, what projections do you make, about what they are thinking about you? Do we have any idea what anyone struggles with unless their appearance is extreme? Would people know I live with MS when I am not wheelchair bound nor walking with assistance? Do they know about your closet eating? Your food hoarding? Your bulimia? Your obsessive calorie counting and weighing and body checking?

Being exposed.

In a similar way, completing the book leaves us both vulnerable. How will it be received? Will it look good? Will it be criticized and viewed as flawed? Will it be taken seriously? Will it have been worth the struggle to do the work? Will readers, like last week's patient, wonder what we could possibly know about the struggle to improve your relationship with food?

Can you even see the distortions?
I think not. Cate and I have been painfully honest, sharing—perhaps for the first time—about our own histories and relationship with food. We are not naïve enough to believe that this one book will solve your eating disorder—your bulimia, anorexia or compulsive overeating.  But we believe deeply that it is immensely valuable in changing your thinking and getting yourself eating with more peace. In spite of our fears, we've put ourselves out there and have taken the risk of exposing ourselves.

Quite frankly, I never dreamed that experts in the eating disorder community would take the time to thoroughly review our book. And then to provide valuable criticism that would really enhance it. I certainly didn't expect to receive the praise we got. Really, I am humbled and flattered beyond words.

I owe thanks to Laura Collins, author of Eating With Your Anorexic and a leader in supporting families living with eating disorders, for pointing out our blatant omission of families—both as a target audience for the book, and in their role supporting those struggling to prepare food and to eat.

And to Dr. Lydia Shrier of Boston Children's Hospital Adolescent Clinic and Harvard University, for highlighting our need to think more broadly about genders and partners and spouses in the book.
To have virtual strangers and mere professional and cyber acquaintances—Dr.Cynthia Bulik, the well-published researcher, author and public speaker; CarrieArnold, author of Decoding Anorexia, known to me from her ED Bites blog; Dr. Suzanne Gleysteen, with whom I've shared so may eating disorder patients; Dr.Therese Waterhous, a dietitian at the forefront of the eating disorder field; Dr. Wendy Oliver-Pyatt, from Oliver Pyatt Centers; and MEDA, the Multi-service Eating Disorder Association—think enough of Food to Eat to write fabulous, glowing reviews, exceeded all of my expectations.

Getting exposure?

Flying high, but feeling rather vulnerable.
Won't you provide the safety net?
I believe in Food to Eat and its value like I believe that recovery is possible. I regret that, due to its beautiful printing is full color, it needed to be priced to cover the large costs of production and distribution to Amazon and bookstores. (Purchases of the print version outside of Create Space and Amazon yield a shared profit of $.04, for the record!). We do not expect to get rich on this project, which has taken the two of us almost a year to complete. But we do hope to make a difference.

Can you help? If you buy a copy via Kindle or Amazon, will you kindly write a review? And if you buy it through Create Space please add your review to our comments page on
Can you demonstrate the power of social media, and share a link or a comment on Facebook, or Twitter, Pinterest or Google Plus? Or even on your blog if you write one?

And please contact me or Cate with feedback on the book, any feedback. Yes, we all need to be prepared for criticism!

Thanks for listening!


  1. I've read and really enjoyed the book - looking forward to my paper copy!! I've already tried some of the recipes and changed my pantry ingredients inspired by the book!

  2. I would love to review a copy for my Psychology Today blog, One More Bite!