The Door to Change is Open. Learning about eating disorder recovery from Let’s Make a Deal.

So you long to be at your old weight, the lower size, the place where everything was fabulous? Like the amnesia when recalling an old boy/girlfriend—you know, that selective memory that favors only the good times (not how miserable they made you feel or how unhealthy your relationship was with him/her)—you remember longingly how great it was to be thinner, and you strive unhealthily to get there. Remember how happy you were, how you loved your body then? Don’t you recall how great you felt—physically and mentally? No?

Was it as good as you recall or did you feel trapped?
The door is open for change!

Likely not! What was that disordered relationship with food really like? How great did/do you truly feel and function? Perhaps, as I hear from so many...

• Your mood was off. Depression crept in, as did anxiety. Thoughts might have become obsessive. As a result, you were not truly present. Rather, your thoughts were racing, removing you from engaging in conversation and interacting in a healthy way.
• You were emotionally removed—perhaps that was helpful—but not feeling the negative stuff also meant not enjoying the positive experiences either. Were you missing the connections with friends and family? Did you miss out on those early years of your children’s lives, or the later years as your parents were aging? Present, but in body only?
• You were dragging, deprived of energy from truly getting enough fuel throughout the day. Maybe you made up for it later, but that didn’t help you function throughout the day. Ok, so the coffees or diet Cokes gave you that caffeinated illusion that you were energized, but the headaches and preoccupation about your next meal surely told you otherwise.
• The lightheadedness and fatigue were bad enough. But the disturbed sleep during the night might have been more than you bargained for.
• You hated feeling cold all the time, especially when nobody else was.
• And having to attend all those appointments—with your doctor, your therapist, psychiatrist, and that darn nutritionist. Bad enough to have to take all that time, and copays, but having to be held accountable every visit? Uggh!

Yes, there is another way...

• The missed periods (for you women) were a bit worrisome, never mind the impact that would have on your bone density.
• It was so challenging and overwhelming planning meals and trying to be social, when so much centers around eating!
• Your thoughts became so distorted.
• And you felt so trapped and helpless.
• You were not even happy then, as you were still striving, against your body’s best interest, to lose more weight.
• It was like living two lives. The one everyone else saw. And then the real you, the you you struggled with.

Let's make a deal

Remember that old TV show, Let’s Make a Deal? I guess it still airs, but decades ago when I last watched it here’s what I remember. There were three curtains, and behind each one there were items—some desirable and some, so-called zonks. Contestants would have to make a decision to trade what they were shown behind one curtain with the unknown contents hidden behind

Have you read all the posts this cup mug is on? Just checking!

another curtain. They had a chance to reneg on their decision—offered money to trade back, still site unseen— restoring the hope and promise of possibilities behind the alluring curtain—which of course could turn out to be a worthless dud.

This show somehow seems like eating disorder recovery itself. In spite of knowing that we are living with a zonk, which in the grand scheme of things has so little value, it is challenging to trade for the virtually unknown. Virtually, because we have all but forgotten how much better, how much more value that former non-disordered self had.

If you’re stuck in a pattern that you know isn’t working, why not take the risk, so to speak, and try what’s behind a different curtain? Could it really be much worse that what you are living with now? You knew what the other curtain held—the benefits of listening to your body, of nourishing yourself, body and soul. So why not make a deal and trade up?

Maybe you won’t like all the offerings behind a curtain. So toss or trade back the parts you could do without. Perhaps you'll need to learn to tolerate some parts of the package that aren’t your favorites—you’ll learn how to make due. Yes, with support and experience you can become more accepting of the full package.

"How do I start?"

Ready to trade up? Make a list of what you dislike about your current situation—physically and emotionally. What is it stopping you from doing? What harm is it doing? What would you be able to do if you didn’t have this disorder? What was it like without it?

And what positives do you get from your disorder? A strange question, perhaps. But on some level you must be getting something positive from your current situation. It may be your drug of choice, or allow you to not have to make decisions about your future. There may be all sorts of positives you attribute to your disordered lifestyle.

Now put them together. Bring them in to discuss with your health professionals—your therapist, dietitian, or MD.

Do the math, adding the pros and the cons. Then make your voice heard and make a deal. Yes, it’s time to peak behind the next curtain.

Lying And Eating Disorder Recovery. What Do You Do Now?

First, myconfession: I lied to a patient yesterday, and I feel the need to come clean; it’s not my norm to lie. I told this new client struggling with an eating disorder that I have never lost a patient—and that I am determined to do all I’m able to keep my patients safe.

The truth is a bit different. I’ve lost one patient in the 26 years supporting patients with anorexia, bulimia and binge eating disorder. And while statistically one patient is a tiny percent of the thousands of individuals I’ve seen over the quarter century, one lost patient is one too many.

I think about her every time I open my dresser drawer—she gave me a gift just two weeks before she left this world—following my compliment of the shirt she was wearing. She knew I’d get a kick; she wore it to amuse me, for sure. I don’t think it was a parting gift; her death was rather impulsive.

And I think about her whenever I bike ride past the train station upon whose tracks she ended her life. She was being treated by a qualified eating disorder team and by all accounts she was doing quite well—based on what she shared with us, at least. 

Objectively, her eating had normalized and medically she was stable. I can’t recall now just how long it had been since she had purged, but she was doing well enough that we were spreading visits out a bit.

I’m not quite sure why I lied. Perhaps I wanted yesterday’s patient to know how determined I am to keep her safe and to know that one way or another I’ll support her and work with her to recovery. Maybe it has to do with my sense that Dahlia’s death was not because of her eating disorder, but her depression. Was it even a lie when her cause of death was not directly due to her eating disorder? Regardless, it made me think about this topic of lying, particularly as it pertains to recovery.

Years ago I had a new patient who, after introducing herself, immediately shared that she is a pathological liar. And that she steals. It’s a bit of a conundrum, then, to know if I should believe her. And should I hide my purse when I head out to retrieve some materials from the next room? Do I trust her—ever?

But more typically, I encounter patients whose lying is slowly revealed and we both need to make sense of it. And we both need to learn to move on after they’ve lied or mislead.

Daniel found himself in a bind several months ago when I proposed he increase his intake given his inappropriate weight loss. He looked me right in the eyes and emphatically swore he’d stuck with the recommendations from the preceding week—every single one of them. Yet he was well aware why he had lost weight. And he didn’t want to admit that he was struggling with following through with my recommendations. He silently hoped that his method of skimping on his intake would still hold his weight steady—even though I advised him otherwise. And now, if he agreed to my new add-ons, he’d have to lie again—because he had no intentions of eating more. Now he regretted lying as things had gotten quite complicated.

When this happened againsome weeks ago, I knew that his eating disorder was at work and could not be trusted. Yes, Dan wanted to recovery, to head off to college, but his eating disorder had a voice all its own. I made sure that he was returning for medical assessments to help verify his progress—as his eating disorder was not tolerating his being honest with me. Surely he didn’t like not feeling trusted. Yet this was the only way I could begin to trust him again and keep him safe.

Sometimes lies aren’t so apparent. You know, like the lies of omission. “So you had the sandwich and the glass of milk?”, I’d confirm. “Yes, and the fruit”, she’d add. But only when I probed further with “And how much of the sandwich did you manage to get through?” did I hear “less than the half”. Or, when I asked about how the exercise limits were adhered to and told that she stuck with the agreed upon 30 minutes, for example. But when I asked “And what was the maximum time spent exercising?” I heard “Well, 40-45 minutes—on most days”.

And then there’s the lying to your self. You look at the cereal and you think surely that’s about the right amount, when truly you know that your portioning falls short. Or you ignore the fact that gardening and compulsively cleaning count as exercise too. You underestimate the number of planned binges or your need to throw out food so no one knows you even bought it and ate it, and you eat mindlessly so you can even fool yourself about your eating.

Your therapist can better explain the role lying plays for you and why you rely on it. But from my perspective, your feelings of shame about eating, of not being deserving, and of needing to be in control are just a few of the contributors. You want to please us providers so we won’t abandon you and truly you’d like to believe you’re doing as well as you state you are.

But like the boy who cried wolf, you leave us struggling with trusting your word. It makes it hard to know just when we need to offer more guidance and support if things always sound great.  I worry when you say that things are always going perfectly—really I do. How will you learn to pick yourself up when you slip if you never share your struggles?

I know this is hard. Nobody talks about it. But as a provider who is determined not to lose another patient to an eating disorder and its comorbidities, I urge you to push yourself to be honest—on your food records, in your sessions, about your difficulties. Volunteer the answers—even if your doctor or your other providers don’t know enough to ask. Tell your supports when your struggling. Hiding beneath your binging, your restricting, or your purging with vomiting or exercise or laxatives is only lying to your self.

I came clean. Now it’s your turn.

Thanks for your honesty. And thanks for reading and commenting.

The 'Life’s Too Short' Diet

Perhaps a little something with that coffee?

Do you fear you’ll be dealing with eating issues in your next decade—when you’re in your 30s, or 40s, 50s or beyond? Yearning to just be normal again? (Again—because at some point in time, perhaps way back when you were a child, you lived free of all these food concerns, never counting calories or giving a thought to when and how much you consumed).  Wrestling to release your self from the hold of anorexia, binge eating or bulimia, and the preoccupation with your weight and the diet du jour? Ready to be free of carb and fat phobia?

Scared? No surprise. You don’t yet trust the next step, but know it’s time to change. Seemingly damned if you do, damned if you don’t change your relationship with food.

There comes a point, a tipping point, when you realize that the cost-benefit of staying stuck is not in your favor. Don’t be fooled into believing that you’ll be happier if only you weighed a few pounds less, because it’s simply a moving target. And the toll that restrictive eating and disordered behaviors takes on your body and your mind is a steep price to pay—even if you thought you’d be happy. It’s not worth the ruminating, the fatigue, the loss of social activities, the isolation, or simply the risk. It’s not worth living with your secrets.

While I no longer struggle with an eating disorder (although my past history of restriction and binge eating was shared in Food to Eat), my tipping point crystalized soon after my diagnosis with MS. It hit me that I didn’t know what tomorrow would bring. (Brilliant, huh? Nobody knows what tomorrow will bring! We could be hit by a car or by lightning, heaven forbid.) The awareness that I could lose my ability to walk, or bike or go up the stairs in my home at absolutely any time highlighted for me that the time was now. I needed to start acting like life is short—because it is. I needed to carve out time for me and for my needs and to seize the moment. Putting off travel was no longer an option. Taking care of my body—including minimizing my stress level—was essential. Continuing to eat well and stay healthy—to take charge of the variables I can control—was essential.

So to my readers who want to challenge their status quo, consider the following—life’s too short.

Life’s too short:

• To count your calories, fearing you’ll run short while still hungry for more food;
• To jump on the gluten or milk free, low carb, or fill-in-the-blank-freediet when you have neither celiac, gluten intolerance nor milk tolerance issues;
• To live in your head, ruled by diet rules about when and how much you’re allowed to consume, disconnected from your body and its signals;
• To view foods solely as nutrients, versus the tasty, pleasurable part of your intake they are;

Do you believe this?

• To eliminate categories of foods—yes, even cupcakes and desserts—even if they have little nutritional value;
• To spend the majority of your waking hours consumed by your weight, or size of your hips/thighs/butt/stomach or muscle mass;
• To deny your hunger for the sake of dropping some weight;
• To omit those foods necessary to support your health and any diseases you may live with;

Yes, another one of my weekend breakfasts...

• To fail to attend to your body’s needs for fuel, for moderate activity (if you’re healthy enough to do so) and for kindness;
• To ignore the needs of your soul, denying yourself time for you and embracing your needs for fulfillment;
• To consistently override your fullness because you feel you’ve blown it and you don’t deserve to feel better;
• To abuse your body through unhealthy behaviors, including food restriction, binging, purging, and excessive exercise.
• To wait until you feel deserving to enjoy the food you eat with all your senses.
• To wait until Monday, or January first for change, or until you’re taken through the emergency entrance.

The only thing missing is Enjoy.

So assess your thoughts and your actions. And ask yourself “What do I need to change to improve the quality of my life?” Truly somethingis in your hands to change.

Because life’s too short.

Thanks for reading—and for sharing your thoughts.