Monthly Archives: March 2013

Book Review: Healing your Hungry Heart

Healing Your Hungry HeartJoanna Poppink is an eating disorder therapist down in Southern California whose blog I’ve been following for awhile. Her book Healing Your Hungry Heart was released in late 2011 and I truly think that everyone who suffers from any kind of food issue should read it.

What I love so much about this book is how relatable it is. Joanna writes as if she’s sitting there in the room with you, holding your hand and saying, “yes, I’ve been there, I know what it’s like, but look at me, I’ve really found peace with food, it’s so hard, but I know that you can do it too, and I’m here to help you.”  She shares her own personal experiences with a crippling case of bulimia that followed her all the way to her early 40’s. She goes deeply in depth to discuss the issues that are underneath the eating disorder such as not understanding how to adhere to boundaries and why that might be so. She discusses shame, anxiety, depression, sadness, angst, fear, distress, abuse, secrets and how you might be using food to heal yourself. She helps you with gentle exercises (meditation, breath work, affirmations) to cope with the intensity of life without food. This book is so gentle and very calming and soothing, it’s like having someone right there with you, compassionately guiding you.

There is so much wisdom in this book, you’ll have to read it several times, and each time you read it, you will discover something that you hadn’t or weren’t ready to grasp the first time, for example, In chapter 8, Joanna writes: Openness, so different from secretiveness allows you to see what you couldn’t see, understand what you couldn’t understand, forgive what you couldn’t acknowledge. Your openness and willingness to explore your true nature allows you to give yourself compassion and the desire to care for your authentic self. You learn to appreciate the consequences of your actions and attitudes over a lifetime

This contemplation allows you to open your heart and mind to the people around you, to those who were around you in the past, and those who are yet to come into your life. You have the opportunity to become free as imperfect beings in an imperfect world where you are surrounded by imperfect others and can recognize, give, and receive love and respect.

This way of being in the world is very different than the life you lead with your eating disorder. Please remember, this is a glimpse of what can come for you in recovery. Contemplation and mindfulness practices, jibing and journaling, and mindful breathing and doing your affirmations gradually but inexorably will heal you and bring you health and freedom.

 

I love that passage. Just imagine that, a life where you were free not just of judgement of yourself, but of criticism toward other people. Imagine freeing up all that mindspace, all that incessant chatter that drives you to stay in your eating disorder. imagine freedom. It’s not about being skinnier, it’s about being lighter.  It’s about extricating yourself from the tyranny of your inner critic who so ruthlessly destroys you and everyone around you.  This book is just full of amazing gems like that and ways to achieve this lightness. I wholeheartedly recommend it!

Leave Mindy’s Curves Alone!

don't call mindy fat
“If someone called me chubby, it would no longer be something that kept me up late at night. Being called fat is not like being called stupid or unfunny, which is the worst thing you could ever say to me. Do I envy Jennifer Hudson for being able to lose all that weight and look smokin’ hot? Of course, yes. Do I sometimes look at Gisele Bundchen and wonder how awesome life would be if I never had to wear Spanx? Duh, of course. That’s kind of the point of Gisele Bundchen. And maybe I will, once or twice, for a very short period of time. But on the list of things I want to do in my lifetime, that’s not near the top. I mean, it’s not near the bottom either. I’d say it’s right above “Learn to drive a vespa,” but several notches below “film a chase scene for a movie.”

― Mindy Kaling, Is Everyone Hanging Out Without Me?

 

Take one beautiful, talented, wildly hilarious woman. Add some glorious curves and what do you get? A whole lot of criticism and asinine assumptions.

10 Ways to Get a Healthy Body Now

10 ways to get a healthy body1. Eat mostly minimally processed and whole foods. This means choosing to actually eat a piece of chicken and broccoli that you get from the store rather than picking up a chicken and broccoli Lean Cuisine and having it pass for dinner. You want your food to have as few ingredients as possible. A steak is healthier than a 100 calorie snack pack. A baked potato is healthier than a slice of low fat  processed American cheese. You get what I’m saying. Try to keep it as simple as possible. It’s actually easier and will improve your health a million-fold. Check out these articles on the benefits of eating whole foods.

2. Don’t obsess about it.  So, eat processed foods most of the time, but say if a bag of cheez-its should pass your lips, you’re not going to ruin it all. You don’t have to binge on processed foods all day long and then vow to only eat apples and broccoli and chicken for the rest of your life. You’ve set up a baseline of healthy with eating mostly whole foods. So if you can eat healthy most of the time, you can have a little bit of the not so healthy every so often. It’s okay. It’s fine in fact. This is the way I suggest working it. When you see something that you really want, allow yourself to have it. But, first, go for the whole unprocessed so that you know you’re giving your body something healthy. Like if there is a choice between a fruit salad and a piece of (unhomemade/supermarket bought) cake, opt for both, but eat the fruit salad first, then eat the cake. You get your healthy food in, you don’t forgo one for the other. There’s no deprivation there and you are letting yourself eat for both health and enjoyment.  When you give yourself the healthy food first, there is also less opportunity for bingeing because you’re hungry or depriving yourself.  I differentiate between a piece of supermarket bought cake because I really believe that I homemade cake is healthier. There is less likely to be lots of artificial ingredients and preservatives and more love and whole ingredients added.

Obsessing about eating whole foods is just another diet. You don’t want that. You want to eat for health and for enjoyment — it’s okay to eat for enjoyment!  Obsessing will also set you up for failure. Think of eating whole foods as your way of nurturing yourself, not punishing.

3. Exercise with love- Forget about reading about the best ways to lose weight or how to get a ripped physique and think of exercise as something to bring you pleasure and to help you destress. If you like to run, then run. If you like to swim, then swim. If power lifting is your thing, more power to you.  If you like to take long leisurely strolls, then do that. If  you love yoga, do yoga.  If dance classes bring you joy, do that. You don’t have to exercise hard, you just have to get out and move several times a week. And seriously, you don’t have to power through your exercise, moving can be slow.  It can be a nice walk through the park with a friend or pushing a stroller or listening to a podcast or book on tape. Think of exercise as quality time with yourself rather than something you have to do. If you can exercise outside and get a little vitamin D grade sunshine, it’s a bonus.

4. Sleep at night. – Seriously get your sleep in order.

One of the ways to begin to encourage good health into your life is to start with your sleep.  Sleep and mood go together. When your sleep is off, your mood is off. When your mood is off and your sleep is off, your immune system is compromised and your emotional stability is off. You then become more susceptible to colds, flu, disease, as well as anxiety, depression, and car accidents. Sleeping too much or too little sleep can both be hazardous to your health. Healthy adults need 7-8 hours each night. My husband, who lived for years with chronic insomnia was helped greatly by this book.

Make your bed a welcoming place.   Go out and buy a nice, comfortable set of sheets and a new comforter and lots of fluffy pillows. Make your bed someplace that is inviting and luxurious. If you can’t afford new sheets right now, wash your current sheets and bedding and fluff it up, spray it with some lavender and try to give it a little bit of new life. At night, an hour before you think you should go to sleep, get into bed. Let’s say you want to be asleep at 11, get into bed at 10. Don’t turn your TV on, don’t bring your computer into bed with you. Bring a book, or a magazine, or your iPod. Listen to some relaxing music with your eyes closed or listen to a guided visualization, and just begin to let yourself relax. This isn’t about sleep, this is about relaxing your body. Sleep is a natural biological process that your body can do once you begin to relax your body and your mind. You might also want to get into the bath about 90 minutes before you want to be asleep. A hot bath with Epson Salts is a great way to relax your muscles and calm your mind and warm your body up for sleep. Try to think of a nice bedtime routine that you can do every night that will help you fall into a restful sleep. You might draw for 1/2 hour before you get into bed, you might bathe, you might write in your journal, but find something that works for you and do it nightly.

If you find that sleep is impossible, there are lots of natural sleep solutions such as taking extra magnesium supplements at night or checking out herbal sleep aids out there such as valerian, chamomile and skullcap as well as amino acids like 5-HTP and L-Tryptophan or a synthetic hormone of melatonin. Definitely ask your doctor or Naturopath about supplementation for help with sleep before you take anything. There are also over the counter solutions as well as prescription solutions that your doctor can help you sort through. There’s no shame in finding something to help you sleep. Being sleep deprived leads to poor decision making, especially around food choices. It also leaves you looking for more energy and many people use caffeine and sugar to achieve this.

5. Floss Your Teeth- Did you know that having good oral hygiene is a way to keep your heart healthy? Gum-disease-causing bacteria can contribute to cardiovascular disease. This may work through inflammation; people with more gum disease bacteria also had more white blood cells circulating in their blood because white blood cells are part of the body’s response to infection.  So floss daily!

6. Hug Someone-Believe it or not, hugs can reduce stress. Hug your Mom, your Dad, your Rabbi, your Pastor, your Son or Daughter, even hug your dog or you cat. Human love, compassion, and touch can be so healing.  In fact, A University of Virginia neuroscientist has found that women under stress who hold their husbands’ hands show signs of immediate relief, which can clearly be seen on their brain scans.

7. Stop drinking, or cut down dramatically if you are drinking daily-  I’m sorry to report that drinking alcohol daily dramatically increases your risk for cancer.  A new study shows that even as little as 1 drink per day increases your risk for breast cancer, mouth and throat cancers and stomach cancers. I wasn’t super surprised to hear this. I have a close friend who is an oncology nurse, who told me that what she often sees on people’s assessment forms is that they drink excessively. She said that it’s the one thing that is confirmed to her over and over and over again, that alcohol use and cancer have a very strong correlation.  Sorry folks. If you’re trying to quit drinking, I highly suggest checking out an AA meeting or a Smart Recovery. You might even try hypnosis to help you stop drinking.

8. Take a vitamin D3 supplement- We are super vitamin D deficient. If you don’t want to take something without getting first checked, ask your doctor to run a lab to check your level. Vitamin D deficiency has been linked to infertility, breast cancer, depression, colon cancer, anxiety, heart disease, obesity, recurrent miscarriage, and all sorts of other crappy things. Studies also show that folks who have higher vitamin D levels have lower risk of disease in general and better immune function.  However, the best way to integrate Vitamin D is with sunshine, so get out into the sun and soak up some vitamin D. Mushrooms are also a great source of vitamin D, so don’t be shy about your fungi.

9.Have Lots of Sex- You will be happier, calmer, you will sleep better and you will reduce your risk of heart disease, depression and anxiety. Now, if you don’t have a partner, going out and having sex with strangers probably won’t improve your health (or self esteem). However, there are proven benefits to having a healthy sexual relationship with yourself! 

10. Drink Honey and Cinnamon- Each morning, make a mixture of raw honey and organic cinnamon in a cup of warm water and drink it down for good health. This has long been a folk remedy that claims you can lose weight, decrease insomnia, fight anxiety, ward off cancer and heart disease and keep your skin clear and supple.  Is it true? Maybe a little. Snopes says sort of true.  But, it’s a pleasant morning drink if anything. If you see an improvement in whatever ails you in a few weeks, great, if not, stop drinking it.

Friday Q & A- How can I become motivated to lose weight?

courtesy of http://foodgloriousfood-toto.blogspot.com/

courtesy of http://foodgloriousfood-toto.blogspot.com/

Question:

This is from Sunshine:

Hi! I LOVE reading all of your posts! I still have the same problem. I am NOT motivated to lose weight and I sure would like to be. What should I do??? I don’t want to exercise or at least not very much. I don’t want to write down and track what I eat. But I DO want to lose weight. I just don’t have the desire or motivation to do it. HELP!!

 

 

Answer:

Hi Sunshine,

My question to you is, who would ever be motivated to lose weight? Yuck! That sounds awful… the deprivation, the scales, the months of restricting, dieting, stressing, obsessing… I don’t blame you for having no desire to do this. What I would recommend is that you reframe your thinking from looking to lose weight to either

-The motivation to GAIN health.

-The motivation to LOSE your obsession with food

– The motivation to GAIN self love, and self esteem

-The motivation to GAIN body trust.

-The motivation to GAIN freedom from the restraints that hating your body puts on you

Are any of these interesting to you? If so, you might want to make a list.  What would be positive about gaining health? What would be positive about letting go of my obsession with food? What would be positive about staying where I am right now and accepting it?  Think through all of these different ideas, and then decide what it is that you want to do.  I’m always a fan of intuitive eating. Tuning in to your body to eat what you need when you need it and forgiving yourself when you slip up and moving past it.   You might want to check out this blog about extreme intuitive eating.  Love your body for what it can do, not for what it looks like or what size it is. Love it and nurture it and give it what it needs. If it needs kale and egg whites, feed it kale and egg whites, if it needs a buttery english muffin, do the same. But let go of the idea of losing weight.  Let go of diets. Let go of your need to control. Let go of the idea of losing weight. You say in your email that you don’t have the desire to lose weight. So just let it go, I promise you will be a lot happier.

 

 

 

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.

More Clinical Studies for Binge Eating, Bulimia and Anorexia

After I posted about clinical trials a couple of weeks ago, I began thinking that I’m sure a lot of you would be interested in getting involved in some clinical trials for binge eating and or bulimia. What is a clinical study you ask?  Researchers are trying everyday to figure out better ways to treat eating disorders. So, they form hypotheses that certain kinds of therapy or certain types of drugs or combinations of psychotherapy and pharmacological intervention can help. Then, they have to actually test these hypotheses. That’s where you come in. They recruit a certain number of people for a set time to test their drugs or their non-drug therapies to see if they work. The drugs aren’t new experimental drugs (usually) they are most often pharmaceuticals that have been around for a long time. But as of right now, there is no drug used for the specific cause of binge eating.

So what do you get? You get free therapy, free pharmaceuticals, the chance to heal your binge eating or bulimia and the opportunity to contribute to a larger purpose– a way to heal eating disorders. In some cases you get paid too. But not all.

So here is a list of studies, where they are and how to contact them.

1. Located in New Haven, CT– This study will test the effectiveness of two empirically-supported but distinct treatments for recurrent binge eating in obese patients: 1) Cognitive Behavior Therapy, using a pure self-help approach and 2) sibutramine, an anti-obesity medication also found to have efficacy for binge eating. Self-help Cognitive Behavior Therapy and sibutramine will be administered alone and in combination in a primary care setting.

 For more information or to see if you qualify contact Rachel Barnes at 203-785-6396

2.Located in Palo Alto, CA--Guided Self Help for Binge Eating–The proposed study will employ a randomized design to evaluate the efficacy of two group-based guided self-help treatments: Integrative Response Therapy (IRT) and Cognitive Behavior Therapy Guided Self-Help, a treatment of known efficacy, in group-format (CBT-GSHg) in the treatment of Binge Eating Disorder (BED), and explore (1) moderators and mediators of treatment, (2) the relative cost-effectiveness of the two treatments, and (3) between group differences on secondary measures (e.g., eating disorder and general psychopathology).

For more information or to see if you qualify, contact Athena Robinson, 650-736-0943  athenar@stanford.edu

3. Located in Montpellier, France– The objective of this project is to assess whether a program of repetitive transcranial magnetic stimulation (rTMS) under high frequency at the left DLPFC reduces bulimic symptoms in the short term. To do this we will count the number of binge during the 15 days following the last session of rTMS.

4. Throughout the United States- Sponsorer University of Cincinnati– The use of a certain drug vs. a placebo in moderate to severe binge eating disorder. Contact  Shire Call Center 1-866-842-5335

5. Located in Palo Alto, CA-- For adolescents with bulimia– compares family therapy to cognitive behavioral therapy for the treatment of bulimia. James Lock, MD, PhD(650) 723-5473 jimlock@stanford.edu

6. Located in Richmond, VA–This study aims to develop a manualized and culturally sensitive intervention for adolescent girls targeting binge and loss of control (LOC) eating. The investigators will evaluate the feasibility and acceptability of the intervention in a controlled pilot trial. The investigators hypothesize that this intervention will serve to reduce binge and LOC eating, as well as improve psychosocial functioning as evidenced by decreased depression, anxiety, eating disorder cognitions, and impulsivity, and improved quality of life.  Contact:  Nichole R Kelly, M.S.804.827.9244 nrkelly@vcu.edu

7. Located in Pittsburgh, PA– For the treatment of bulimia, this study aims to compare two forms of CBT: face-to-face group therapy and online group therapy via cbt4bn.orgContact: Sara Hofmeier 919-966-2882 sara_hofmeier@med.unc.edu

8. Located in New York City--The aim of this project is to use both functional MRI (fMRI) and behavioral measures to investigate how disturbances in frontostriatal neural systems contribute to the impulsive and habitual binge-eating behaviors in patients with Bulimia Nervosa. Findings from this study will have wide-ranging importance for our understanding of the development and treatment of Bulimia.

Contact: Eating Disorder Clinic – 212-543-5739 edru@pi.cpmc.columbia.edu 

or Naomi Greenburg  212-543-6072 GreenbeN@nyspi.columbia.edu

9. Located in New York City- This study will evaluate whether people with bulimia nervosa will binge eat in a structured laboratory setting and display behavioral patterns similar to those of individuals who are dependent on drugs.

Contact: Eating Disorder Clinic – 212-543-5739 edru@pi.cpmc.columbia.edu 

10. Located in Mason, OH- The purpose of this research study is to study the effectiveness, tolerability and safety of armodafinil in outpatients with binge eating disorder.  Contact: Susan McElroy, MD susan.mcelroy@lindnercenter.org or Anna Guerdjikova, PhD anna.guerdjikova@lindnercenter.org

11.Chapel Hill, NC-  For the Latin American population suffering with eating disorders. Promoviendo Alimentacion Saludable (PAS)”Promoting Healthy Eating” is a research project funded by the National Institute of Mental Health. The purpose of this study is to develop and test a treatment for eating disorders in Latina adults that is appropriate for their age and includes culturally appropriate family intervention.

Contact: Mae Lynn Reyes, Ph.D.     919-966-7358 maelynn_reyes@med.unc.edu 

12. New York City- For people who engage both in bulimia and heavy drinking- Participants will be asked to complete computer-administered and paper-and-pencil assessments and two laboratory test meals on separate days. By probing the underpinnings of BN and alcohol use disorders, the investigators can determine whether these disorders have a shared diathesis, which will lay an essential foundation for future research to examine biological and genetic correlates of these disorders. Finally, as little is known about the treatment of patients with BN and a co-occurring alcohol use disorder, an exploratory aim of the current study is evaluate the suitability and efficacy of a 20-session cognitive-behavioral treatment (CBT) addressing both bulimic symptoms and alcohol use.

Contact: Robyn Sysko, Ph.D.     212-543-5739   

Contact: Robyn Sysko, Ph.D.     212-543-5739   

13. Located in Gentofte, Denmark.  This study has 5 months of group therapy. The trial aims to investigate the impact of continuous feedback on dropout and outcome in group therapy. The hypothesis is that continuous feedback to patient and therapist on treatment progress and alliance will 1) reduce the number of dropouts and 2) increase treatment outcome.

Contact: Marianne E Lau, D.Sci. +453864531 marianne.engelbrecht.lau@regionh.dk —  or 

Annika H Davidsen, MSc. Psych. +4538645300 annika.helgadottir.davidsen@regionh.dk

  

You can also go to  http://clinicaltrials.gov/ and search under “binge eating, florida” or “anorexia, new york” or “bulimia, california” etc. Type in the type of study you’re interested in and the location. Definitely add to the comments if you find anything of note. 

 

 

Rule Number One. Never Undo the Binge

i binged now what?The most important move to make in healing from binge eating or bulimia is to always move forward past the binge.  So, next time you binge, rather than saying to yourself, “okay, no dinner.” or “now I have to go to the gym for the next 3 hours to work it off…” or “no carbohydrates for the next three days,” or “now I can’t eat for another 24 hours…”  or, “okay, i’m going to binge for the rest of the day since today is shot…” instead you say to yourself, “okay. I binged. I need to leave the binge here and go forward. My next meal is going to be a healthy one.”

Because when you try to undo a binge, you stay in it. You are stuck in the past trying to make it not have happened and then you get yourself into a cycle, either a binge-restrict cycle, a binge-purge cycle, or a binge-exercise cycle. And all those cycles lead to more bingeing. You want to get out of bingeing and the only way to do that is to leave the binge where it is, in the past– without compensating for it, and without undoing it.

So, if there were any Saturday night binges let go of the idea of  any big diets today. Instead, today, vow to take care of yourself. Eat a healthy breakfast, drink lots of water, take a nice walk, get some fresh air, give yourself kind words, forgive yourself for bingeing, be compassionate with yourself and move past it into health and normalcy.