Monthly Archives: November 2011

Thanksgiving Redux.

In the spirit of frugality, I’m recycling last year’s Thanksgiving post. Happy Thanksgiving to my Amazing Readers. Prayers and Peace for a wonderful holiday to you all. _____________________________________________________________________________________

Thanksgiving can be a nightmare for anyone dealing with binge eating, bulimia or other compulsive eating issues.  For many people, being around the stress of family coupled with giant amounts of food can be a recipe for acting out excessively with food.  Be prepared before you go to Thanksgiving Dinner.

1.)Have an intention around food and drinking. Think about what you are going to choose to eat and drink and how much. Making this intention will help you to empower yourself around food and alcohol rather than  letting the food take over.  Share this intention with a family member or supportive friend or a therapist.

2.)If you don’t have anyone supportive at the Thanksgiving meal, see if you can bring a a support resource with you, a friend who might be going through recovery with you or someone you feel safe with. If you cannot do that, have a support person who you can talk to on the phone intermittently throughout the meal.

3.)Make sure that you eat a good solid breakfast before you go to Thanksgiving dinner. Don’t show up hungry. If you do, your hunger might take over and squelch your intention.

4.)Just because there are several new and interesting foods there, you don’t have to eat everything. Make sure that you let yourself have a solid dinner, with protein, vegetables and a starch if you wish. If you just snack or graze on a bunch of different foods, you will inevitably wind up feeling unsatisfied, as though you’ve not really had a meal. This could lead to feeling too full and trigger a binge.

5.)Talk to people in rooms away from food. You don’t have to sit on a couch in front of a giant platter of cheese and crackers and nuts and hors d’œuvres talking to your aunt. Try to concentrate on conversations with  people.

6.)Eat slowly and mindfully. It’s not a race to the end. You can enjoy good food and good conversation.

7.)Don’t compulsively overexercise in anticipation of “eating extra calories.”  It will leave you very tired and hungry, again, unable to empower yourself to hold your intention.

8.)Take walks or time outs. Let yourself leave the situation and take mini breaks. Let yourself get away from the stress of the food and the stress of family that sometimes exists.  If it’s too cold or not realistic for you to leave, take your cell phone into another room and say you need to make an important call and talk to your support person.

9.)Bring your journal with you so that you can sit and relax and process your feelings during the meal rather than stuff your feelings.

10.)Bring your ipod with some mediation music or relaxing music that puts you in a calm mood.

11.)Make a gratitude list! Think about what you are grateful for during the holiday.

12.)If there are children there, spend time playing with them. If there are elders there, spend time talking to and getting to know them. Both things that will be enriching and get your mind off of food.

13.)Mediate. Sit quietly in the bathroom for five minutes and take deep slow breaths into your belly. Inhale slowly  to the count of five and exhale slowly to the count of five. This will calm your body and allow you to let go of any stress or anxiety that your body is holding on to.

14.)Remember that if it seems like it might be too hard this year,  you don’t have to go. It’s true, you might let some people down. But you can always explain to them that it’s important for you to take care of yourself in this way this year. If you don’t think that they’d be amenable to this, or you think that they will accuse you of being self centered or self absorbed, don’t offer any explanation that might leave you vulnerable to being shamed or insulted.

For information on how to help a loved one with an eating disorder, please read this article.

I would love to know what kind of intentions people are setting to make their Thanksgiving safe and fun this year. Please don’t hesitate to post your Thanksgiving intentions in the comments. If you have any additional ideas on how to make the holiday safe, please post those as well!

HAPPY HOLIDAY!

Friday Q&A- I’m Pregnant and I can’t Stop Binge Eating

Question: I used to have a huge problem with binge eating, restricting, and overexercising, but I’ve been relatively “clean” for the past 7 years. I’ve been exercising 1/2 hour 3-4 times a week, eating three meals a day, everyday, and my incidences of overeating or undereating are relatively rare. I got to a weight and size that I’m very comfortable with and I’ve felt pretty good food and weight- wise for several years. But then I got pregnant. And suddenly I’m binge eating again. And sometimes restricting, and I’m on exercise restriction as per my doctor, so I’m not even allowed to go swimming, like they say pregnant woman should. I have been eating extremely healthy for years, but all of a sudden, I find myself diving into cookies, cake, soda, pizza, bread, etc. I wish I could stop and just eat normally again. I’m going nuts! Can you help me?- Elissa (New Jersey)

Answer: Hi Elissa,

First off, take a breath. You’re in the realm of normal here. Many women who are in recovery for binge eating or other eating disorders might find that they relapse into bingeing behaviors when pregnant. It’s not uncommon at all. Pregnant woman are hungrier than non-pregnant women. And that hunger can be overwhelming. Especially if you’ve been in remission from an eating disorder for a long time, the feeling of not having any control over your own body can be daunting. You might find that you are eating more than you wanted to and then those old ED feelings of guilt and shame come up which cause you to binge eat.

1.)Never, ever, ever restrict or diet when you are pregnant. This is not the time. It’s okay to use your tools to avoid binge eating, but don’t skip meals, don’t count calories, this is the time to become more mindful of what your body says you need. Let your cravings tell you what to eat in a thoughtful way. Think of your body as having infinite wisdom and use your mind to hone that wisdom. For instance, if you are craving potato chips, your body might be needing some extra salt. Find something healthier that might satisfy that craving, like celery or a hard boiled egg or a piece of cheese or some olives.

2.)Eat when you are hungry, but really, really try to slow down your eating. You will find that as you become more pregnant, it’s more uncomfortable to have food in your belly. So eating fast and furiously will hit you 20 minutes after your finish your meal and you will feel sick. You might want to spread your eating out to 6 or 8 smaller meals a day instead of 3 big ones.

3.)Many women lose weight in their first trimester due to morning sickness. In the second trimester, which is an incredibly growth time for the fetus, you might find yourself being very, very hungry. Don’t try to fight it– let yourself eat and gain the weight that you need to for your baby.

4.)Be careful about what you are eating. Don’t worry about portion sizes when you are pregnant, but do be vigilant about the kinds of foods that you are ingesting. Pregnant women tend to crave lots of carbohydrates. Let yourself have carbs. But follow your cravings but in a thoughtful way. If you are craving cake and cookies and soda, try to eat lots of fruit. Your body might be needing the quick energy of glucose. But because gestational diabetes has become so prevalent, try to reduce your intake of sugar and processed foods.

5.)Do Not Go on a Low Carb Diet when pregnant.  A lot of women find that they have serious meat aversions and just crave lots of fruits and vegetables in pregnancy. Pay attention to your cravings and take them seriously. They exist for an evolutionary reason.  In fact,  Loren Coradain– who created the Paleo diet, a low-carbohydrate diet plan explains why you should not eat low-carb while pregnant : “You probably should increase your fat and carbohydrate consumption, and limit protein to about 20-25% of energy, as higher protein intakes than this may prove to be deleterious to mother and fetus for a variety of physiological reasons. In my next book, I have devoted a chapter to maternal nutrition before, during and after pregnancy and why protein must be limited during pregnancy.

My colleague John Speth (an anthropologist) at the University of Michigan wrote a paper on protein aversion in hunter-gatherer women during pregnancy. Listed below is the abstract: (note the 25% protein energy ceiling!!!)

‘During seasonal or inter-annual periods of food shortage and restricted total calorie intake, ethnographically and ethnohistorically documented human foragers, when possible, under-utilize foods that are high in protein, such as lean meat, in favour of foods with higher lipid or carbohydrate content. Nutritional studies suggest that one reason for this behaviour stems from the fact that pregnant women, particularly at times when their total calorie intake is marginal, may be constrained in the amount of energy they can safely derive from protein sources to levels below about 25% of total calories. Protein intakes above this threshold may affect pregnancy outcome through decreased mass at birth and increased perinatal morbidity and mortality. This paper briefly outlines the evidence for the existence of an upper safe limit to total protein intake in pregnancy, and then discusses several facets of the issue that remain poorly understood. The paper ends by raising two basic questions directed especially toward specialists in primate and human nutrition: is this protein threshold real and demographically significant in modern human foraging populations? If so, does an analogous threshold affect pregnant female chimpanzees? If the answer to both of these questions is yes, we can then begin to explore systematically the consequences such a threshold might have for the diet and behaviour of early hominids.’2

The physiological basis for this aversion stems from a reduced rate of urea synthesis during pregnancy that is evident in early gestation1 as well as increases in the stress hormone cortisol3. Hence, pregnant women should include more carbohydrate and fat (i.e. fattier meats) in their diets and limit dietary protein to no more than 20-25% of their total caloric intake.”

6.)Let yourself indulge in “forbidden foods” sometimes, but keep your portions controlled. Don’t rely on those things for sustenance. Use healthy foods to nurture you and your growing fetus. For instance, if you are craving cookies, first have an apple or orange, and a piece of cheese, then, if you are still craving the cookie, rather than a giant bag of cookies, have one serving which might be more like 2 cookies. Put the rest of the bag in the freezer.
7.)If you are on exercise restriction, let yourself be on exercise restriction. Ask your doctor what that means. Can you take walks? If so, walking for 20-30 minutes each day can be wonderful. If not, please take it seriously and don’t exercise.
8.)It feels like forever, but remember that pregnancy is a very temporary state (unless you’re a Duggar). It’s also a challenging state where your body doesn’t feel like your own. Just take each day as it comes and try to make the best choices that you can. Sometimes you will and some days you won’t. Don’t beat yourself up. Pregnancy and food choices are hard for everyone, because your body is no longer your own, and your choices won’t feel like your own either.  Be gentle with yourself.  You are not the only one in this position, figuring out the “right” way to eat when you are pregnant is tough. Remember that there is no “right” way despite what a million websites will tell you. You might need to gain more or less weight than the weight charts indicate. Continue to utilize mindful eating and try to be gentle with yourself. Try not to overeat and don’t undereat. Just do the best that you can and know that each new hour is an opportunity for you to do the right thing.
I hope that this is helpful for you. Please do feel free to email again or send a comment if you have further thoughts or questions on this.
Do you have a question about binge eating, bulimia, anorexia, or anything associated with eating disorders? Send an email to bingeeatingtherapy  at gmail dot com. All questions will be kept confidential. Include your first name or the name you want to be referred to as and your location.