It Doesn't Matter Why. Resolving to Change Your Eating Before the New Year.

We all want answers to what's unknown. Why did he have to die of cancer? Why did she get diabetes at such a young age? Why am I struggling with an eating disorder?

Forgive me for being harsh, but it doesn't matter.

Sure, it's great to understand what causes diseases so that we may find a cure and prevent them from targeting and harming more people. And if there were something we can do to protect ourselves from getting sick, wouldn't it be valuable to know. But on the personal level, it doesn't matter why or how you developed your unhealthy relationship with food. Practically speaking, it changes nothing. You still need to eat.

If a child is diagnosed with Type 1 diabetes, requiring regular insulin injections, it doesn't matter why. And it doesn't matter if they hate the treatment—the frequent injections to remedy the body's failing production of insulin. It's simply non-negotiable.

For nine years I had to self inject with a medication for my MS. Three times per week I administered those painful injections. I had no idea why I developed MS and there remains no cure but quite frankly, it didn't matter. What did matter is that I needed to do whatever I could to preserve my health. I could complain about it, and I could feel upset, but the fact remained the same—I just had to do it.

You know where I'm going, don't you.

If you're stuck ruminating about who caused your eating issues, it's time to move on. If the focus of your treatment is about simply understanding the why, it’s time to redirect. I’m not suggesting that these aren’t interesting questions to ponder. Being aware of how your disordered behaviors meet some needs may contribute to long-term changes in the way you use food to cope. For instance, it may be valuable to recognize that food restriction is your drug of choice—that it allows you to numb out and disconnect and avoid feeling those things you’d rather not feel— and then to learn more constructive ways to manage in challenging situations. Perhaps you identify that you never express yourself and share how you feel, so food restricting becomes the way you bottle up those feelings. There is certainly value is making connections between your thoughts and your feelings about food and your eating.

That said a poorly nourished brain fails to allow you meaningful insights. You look through your distorted lens, with rational thought left behind. Yes, it’s a bit of a catch 22; you need to eat to gain insight and understanding as to why you struggle to eat, which you struggle to do in the first place. This is where accountability is key—to your treatment team, family member or a close friend or partner. (And if you aren’t holding yourself accountable with this support, you may need a higher level of care.)

If you binge eat, following restricting, you can’t expect that you will be able to use much insight when you’re ravenous. And your belief in your ability to take charge of your eating will be quite low. You can’t blame yourself for your lack of willpower when you place yourself in unreasonable situations, such as expecting to eat mindfully when you are starving! Normalizing your eating needs to be the highest priority!

For binge eaters who don’t restrict, insight into how you’re using food is essential. And learning alternative strategies to manage in difficult situations and to endure challenging emotions will help you break out of your food fog.

But regardless of which group you fall into—restrictors, restrict/bingers, or binge eaters, you can start by recognizing how in the big picture, your eating disorder is quite ineffective in getting you to a better place in life; it has little positive impact—except in the moment to help you disconnect—managing your stress, anxiety, social issues, work and school trauma, to name a few. And that benefit is short-lived! In fact, I think it’s fair to say it only compromises your ability to cope! And if you were to make an honest list of the pros and cons of continuing with your eating disorder, you’d see that the cons far out weight the benefits of holding onto your disorder.

Even if you hate food records, consider recording just your thoughts, feelings and hunger level—along with the time that you ate. Yes, you can even omit what you ate in your record, because that’s really beside the point. But eating remains the key ingredient to recovery! Without eating adequate amounts of food, you will stay stuck.

Does this sound like a New Year’s approach you can live with? If so, make a point of starting today. Yes, if you’re really ready to move on, you can start on the December 31^st!

But if it’s already 2013 when you read this, it’s still not too late!

Measuring Progress with Gingerbread & Other Tales of Eating Disorder Recovery

But only if you do your part!

It was the shortest day of the year, the winter solstice, and it was a dark and rainy day here in the Boston area. And I was home sick with a bad head cold. It was enough to put me in a rather gloomy mood, if it weren’t for some bright spots from this past week that lightened my mood. Perhaps they’ll brighten yours, too.

Hannah had not had the easiest time these past several months. Besides her eating disorder, which ranges from anorexia to binge eating, she’s been struggling with depression. Yet after many months of working with her team her progress shined through.  No, I’m not talking about measuring her progress in pounds—her weight fails to reflect the recent progress that’s just starting to emerge. 

Ahh, the feeling of eating and trusting it's going to
be okay...

Rather, I heard her describe for one of the first times, her interest in food—in its taste, and in its texture. I heard her say that she realized that she actually didn’t like some of the things she had been eating, and I heard her talk about her food passions and preferences. Yes, Hannah is finally allowing herself to taste what she’s eating, and to select foods she enjoys the taste of. This is progress!

Then there was Sammie, who bought my book last week—Food to Eat, co-authored with Cate Sangster— and at her follow up visit on Tues. this 20-something-year-old came in all excited. She had prepared about 7 of the recipes, from Cate’s Muesli Bircher to the gingerbread. But more than that, she actually ate them all! (Not all at once, I’ll add!) And she reported loving each and every one of them.

Rye Pixels Copyright. 

She told me about her love of baking—something I knew nothing about—but confessed that she had not previously ever eaten the baked items she labored to prepare. No, not since she’s struggled with her eating disorder. But this week was different. And having broken the ice and done so once, she’s increased her confidence that she could do so again. She trusted, she told me; she felt like she knew what we were saying was true and that it was okay. And it worked.

Are you ready to challenge yourself and break with your routine? Bring a little light into these dark days by challenging yourself and trying something different. I’m attaching the gingerbread recipe—I baked it Friday with the lemon icing and it was divine! But with or without the glaze, you can’t go wrong.

It’s not too late to start to change. All it takes is the first step.

Let me know what you think.

From the recovery cookbook Food to Eat, one of 25 sensible and tasty recipes.

Overeat, Restrict, Over-exercise—Just for now?

It may make you happy for now but...

Dana used to tell me she'd allow herself to eat "whatever", just until the holiday season was over, and then she'd buckle down and resume her restrictive approach to food management again. 

Rob cancelled his November appointments, preferring to wait until after January 1^st to begin to improve his eating and his cholesterol level. And Stacy continued to restrict—in part because she knew that after her next doctor visit in a few weeks, she was going to be held accountable for her actions. Yes, she was going to need to turn her eating around or she'd be finding herself in a rather unhealthy predicament.

If you're like my patients and thinking you'll get by just for now, whether you'll continue to drop a few more pounds before you start normalizingyour eating or you continue on your path of overeating, it's time to face the facts—you're not really planning to change. At least, not for long term.

I know, I know, you really do want to change. You may, like Dana, hate how challenging it is to do the simplest tasks, and how incompetent it makes you feel being foggy headed and spacey. Like Rob, you may be savoring what feels like your last supper, your last chance to get it all in before you take your diet seriously and have to give it all up. Or like Stacy, you may fear the consequences of eating enough—even if you know it's the right thing to do, for both your physical and mental well-being.

The truth is, this approach of just for now will do nothing to improve your relationship with food. If you continue to feel like it's your last chance to indulge, then plan to refrain from your favorite foods, you'll find yourself deprived. Sure, you'll do fine for a while—even a few weeks—until you're exposed again, or have a weak moment, a triggering situation. And then once your guard is down you'll overeat, again determined that it will neverhappen again.

And if you starve yourself or restrict your intake, fully intending to get your self back on track—once you drop the weight, that is—the behaviors that result will be anything butnormal.

Putting off change-now that's a big mistake!

If you're serious about change, it can't wait until Monday—or for January 1^st. And when you have a slip, you need to wrestle with it now and learn from it.  Ask yourself  "What happened here and what can I do next time to prevent this from happening again?"  But then you've gotta move on. (I say when not if you slip, because the truth is, slips do happen—so brace yourself.) You can't make it a slide until the first of the year, thinking you've already ruined it.

Please don’t wait until 2013 to resolve to change. Because if you're really serious, the change can and should start now.

I know it's hard, and I know you're struggling. But its not going to get any easier with the passage of time. So use your resources and start moving forward, won't you?

Thanks for reading.

Body Wraps, Toxin Removal and More: What I Learned at the Gym Today

I'd much rather be hiking...

It's hard enough starting at a new gym. Generally, I dislike going to gyms, preferring instead to enjoy a long bike ride, a hike or a cross-country ski or snow shoe when weather permits. But living in New England, there are times, like now, when conditions are simply not favorable for either of those activities.

So off to the gym I went, attending my first spin class of the season, at a new gym with a new instructor. And I could barely get through it. No, I am not that out of spin shape—although those cycling muscles certainly needed a workout. Rather, I was feeling my blood pressure rise as I sat through the marketing pitch and endless misinformation by this supposed promoter of health—the spin instructor.

I'm still headachy from it, so in truth, I am blogging to air my annoyance and frustration.

You know me be now—I am not shy to share my opinions, particularly those I feel strongly about. But this was a challenging setting. Jane, I'll call her—no, Barbie better suits her—stood before the class of about 35 cyclists confidently spewing her crap. Misinformation spilled from her mouth with no objection from the group, until I, a newcomer there, just had to speak up. But it was hardly the forum to debate in, and my rebuttals could be endless if I countered every outrageously false claim about weight loss.

No, neither body wraps nor green
powders will remove body fat.
Sorry!

She endorsed a powder she was selling with her personal testimonial about how she believed it really helped her, as it releases the toxins from the body, those horrible things which fester and cause disease. (Toxins, by the way, are released from our bodies every day, with no need for a product to make it happen.) And it gave her natural energy and promotes weight loss. (For the record, calories are the form of energy we get from foods; a product with no calories has no energy, although you may get a short-term boost from stimulants such as caffeine.) Then I heard her endorsement of the body wraps for sale, which essentially shrink your body a size or so overnight! All without dehydrating you! And finally I learned that you should be drinking half your body weight in ounces of water each day. 300 lbs? That's 150 ounces each day of water, about 5 liters or quarts per day.

So why am I all upset, you ask? Where shall I begin?!

• because while for me it was simply an irritation (and a big one at that), I know how others will be lured by this misinformation, sold products with false claims, sucked into unhealthy thinking and potentially dangerous supplements; more misinformation makes sensible thoughts a challenge;
• because she was speaking to a group of completely normal weight individuals, none of whom could afford to lose weight;
• because no one should be sucking down water or non-caloric beverages instead of eating when they need fuel, simply to mask their hunger;
• because she's setting people up for failure and unrealistic goals, luring them for her personal financial gain, to buy a product, in the case of the wrap, that at best may contribute to a decrease in hydration for a temporary appearance or short-lived sensation of lightness;
• because if we each spoke up every time we heard something we know to be false or inaccurate, then maybe we could make a difference!

Yet another gym promotion. Uggh!

There, I feel so much better now. I think I'll go have dinner, now that I can more calmly and peacefully enjoy it.

Thanks for letting me rant!