Smart. Easy-to-handle. Attractive.

And practical minded too. Will do it all but cook for you.

I'm talking about my new book, “Food to Eat, guided, hopeful, and trusted recipes for eating disorder recovery”.

Lori Lieberman, RD, CDE, MPH, LDN, and Cate Sangster may seem like unlikely coauthors. Lori, a 26-year veteran of eating disorder counseling and a blog author in the Boston, Massachusetts area and Cate, a soon-to-be-published coauthor (with eating disorder author June Alexander), and recovering adult anorexic in Melbourne, Australia created a novel recovery tool. Part cookbook, part CBT-styled guidance and support, this book gently and thoughtfully assists readers, allaying their fears and misconceptions they may be ruminating over when contemplating eating.

It addresses head on the barriers to change, including perception and fear of nutrient content, GI issues and the consequences of change. Nutrition myths are broken down and justification and support for renourishing is provided.  It builds on a transference of trust like that which propelled Cate forward in her own recovery—from connecting with Lori's writing and learning, for the first time, that recovery is possible, to moving to increasing her own range of foods consumed beginning with this project collaboration.

No, it's not out yet, but it's coming soon, and Cate and I are so excited to share it with you. “Food To Eat” will be available as an ebook and in print—details to follow.

We've gotten enthusiastic thumbs up from eating disorder professionals, and valuable input from those struggling with eating disorders and disordered eating to help us perfect it.

We'll keep you posted when it's ready for release!

Supersized Disaster

Yes, that's a 44 oz individual serving of soda!

I never recommend soda to my patients or my family members. And I cringe when I walk into fast food restaurants (only to use the bathroom, of course) or a movie theater and see single serving cups in the range of 32-44 ounces. It’s obscene. That volume of sugar devoid of other nutrients, consumed at a single sitting is crazy. Our society has a distorted sense of what normal portions are—not just for beverages, but for food as well. The only place I’ve been able to find a true juice glass, a 4 or 6-ounce size, has been at antique stores. Really. So I support NYC’s Mayor Bloomberg’s recent ban on the sale of supersized sodas, right?

Not at all. While the mayor is desperately trying to change a growing trend of overconsumption and obesity, his new policy restricting the sale of sodas larger than 16 oz is absurd on so many levels.

While I take my freedom for granted, having never lived anywhere that restricted my personal choices, including what I eat, the thought of a law limiting the size of my portions feels, well, un-American. Mark my word; if they try to restrict my purchase of cupcakes after 8 PM, for instance, I’ll start hoarding them at 7. I mean it.

Who decides what you're allowed to eat and how much?

It’s quite a slippery slope. Who decides that Sprite is out, but grape juice is fine? Or that 24 oz smoothies are ok, but soda is not?  Maybe they should halt the sale of those cardiac-inducing hot dogs sold on food carts throughout NY, instead? Sure, there’s nutritional value in the smoothy, but if the driving force behind this policy is obesity and health—why would 24 or more caloric ounces of anything accompanying a meal be appropriate?

Next, will NYC next set limits on who can buy these large caloric beverages? Will we need to weigh-in at the food carts on 5^thAvenue—high BMI? You get the under 16 oz regular soda or the diet one; low BMI? Youmay choose the supersized drinks—but ONLY those drinks with calories—no diet beverages for you. 

Should we perhaps ban the sale of large portions of diet beverages, given that they displace the calories and nutrients desperately needed by those with eating disorders and those simply underweight?

And what about cost? Can we not buy a bottle of soda at the deli to share with others, resulting in a smaller portion and less cost per person? Bloomberg’s ruling prohibits this.

The unforseen consequences

What message does it send if 16-ounce beverage portions—regular or diet—are considered the norm? Our caloric needs vary; for some, 16 oz of juice is absolutely appropriate. For others, it’s excessive for their need. But a law stating that 16 ounces is fine or distinguishing between soda and juice as healthy versus unhealthy creates a hierarchy people will believe is valid—when it’s not. If we are talking about weight management it's about calories, and a Coke is no different than a bottle of 100% juice. 

Should those with high blood pressure be forbidden
 this heavily salted popcorn?

I understand that simply educating the public to improve health is at best challenging. We are impacted by visual stimuli and sensory prompts to eat, as well as our perception--not just information about what and how much is healthy to consume. Prompted by the suggestion that you can size up for only 75 cents more (which I overheard at the movies yesterday), most of us will go for it. If you perceive that you haven’t eaten much you will continue eating, regardless of your fullness. And if you believe that 16 ounces is appropriate--because the Mayor believes it's fine for your health-- you may be more inclined to select the 16 oz size than something smaller.

If they’re going to set rules…

Perhaps there are better alternatives than Bloomberg’s to reduce our excessive intake—if or when it is unhealthy for the individual. How about a pricing policy removing the financial incentive to size up? If ordering the 32 oz soda vs the 16 oz adds $1.20 vs 20 cents, I suspect there’d be more thought before supersizing.

Yes, this is for real. And financially more sensible that the 32 oz
 which was more expensive per ounce!

Or what about a rule allowing individuals to bring their own snacks into a movie—maybe healthier popcorn from home? Or limiting movie-theater food to a specific eating area as opposed to in front of the screen? Can we not go 90 minutes without a feeding? Why are we encouraging distracted eating, when all evidence supports mindful eating helps us better regulate our intake and our weight?

Yes, something needs to be done to improve the health of our nation. But setting arbitrary boundaries on portions, about good beverages and bad, is hardly the answer. And the fallout from this perhaps well-intended policy may only result in more problems.


And I thought I lived in the liberal Northeast...

"At Least I'm Better Than I Used to Be!"

Are you just settling for partial recovery?

Saturday's breakfast. But after this, I did have another waffle,
because it really wasn't enough for me.

Daniella, a regular blog follower in her 20s, recently asked me for advice about fullness, about eating enough. So I’m responding to her concerns, addressing in more general terms what might be your fears as well. She writes:

“I have struggled on and off with an eating disorder for 9 years, before finally seeking treatment last August. … Since then, I have come a really long way.

Minus slips here and there, I am no longer actively restricting. I have also moved up from following a pretty strict meal plan to working on intuitive eating. After many years of completely losing touch with and ignoring my hunger signals, they are finally back and I actually listen. I ...no longer wait until I am beyond starving to eat something. Although I am no longer on a meal plan, I pretty much still follow a loose version of the 3 meals and 3 snacks plan…

And now the problem, fullness. I am scared to death of feeling full. ...I am not actually allowing myself to eat enough in one sitting to where I physically feel full. ... (but) I am not actively choosing to stop eating like I used to. (In the past) I would set aside a certain amount of food and only allow myself to eat that, nothing more no matter how hungry I was. But that isn't the case anymore. Stopping when I do just feels natural to me. I don't feel like I am depriving myself at all. I don't leave the meal/snack frustrated or wanting more or even continue to think about food. I think I have just conditioned myself after all of these years to stop eating when I no longer feel hungry, instead of when I feel fullness.

I can recognize that this is still eating disordered ...I also know that the uncomfortableness and anxiety is much more mental then physical. The best way to judge my fullness is really by noticing when I get hungry again next and how soon it is. And I know that this means that I am still not completely in touch with my body.

Any suggestions of how to get passed this? I have allowed myself to stay stuck in this place for a while because of fear and convenience. I've justified where I am by telling myself that I am eating so much better then I used to …”

It seemed like the right amount, but it was a bit too much.

First, kudos to Daniella for the incredible strides she has made in her recovery, and for her honesty and insight into this issue.

So what do I think?

Well, it depends. Not knowing Daniella's (or your) full situation, I need to ask the following:

• Are you now in a healthy weight range, to support normal body temperature, blood pressure and pulse, and menses?
• If not, your frequent eating is still inadequate, necessitating an increased intake.
• Are you limiting your food selection because of this fear of fullness?
• True recovery provides the freedom to consume a wide range of foods.
• Is your pattern of eating interfering with your life?



Feeling full--I had had enough.

• From what Daniella adds, her work-at-home schedule allows for frequent eating to accommodate her need. But her schedule will soon be changing, and she won't have this luxury any more.
• And is getting hungry frequently interfering with your thoughts, your anticipation of getting to eat, your preoccupation with feeding yourself? 
• Then clearly this needs to change.
• "Scared to death" is not a good place to be.

Convinced? Then here are some strategies to move forward.

• Take baby steps. Make a small addition to one or two meals or snacks, and see how it goes. Did any bad come off it? Then it's safe to continue. Any perceivable benefits? Then use these to justify continuing on this course.
• Add foods that are quite safe, to start. First goal is just getting enough. Work on variety later.
• Reality check. What's the worst that can happen by adding, let's say, a fruit, a yogurt, toast, for instance? Nothing. Remember it takes at least 3500 surplus calories over and above your need to gain a single pound.
• Read an old post on this topic which discussed titration—figuring out justhow much it takes.

Over time, you will discover just how much your body tends to need for its standard routine, and it won't take so much work.

And remember your goal. Full recovery.