Author Archives: Leora Fulvio

How Do I Tell My Husband about My Eating Disorder?

How to tell my husband about my eating disorder

This one comes from a reader in Australia…

Question:

I’m in a bind. How do I tell my husband about my eating disorder?

I want to tell my husband about my eating disorder but I’m so stressed out because I really don’t know how to tell my husband about my eating disorder.   I know things have to change. I don’t know how to have this conversation, how to start it or where to get help. I’ve had this since I was 17 and i’m 29 now I really don’t want to go on like this.

Answer: I’m so sorry that you’re dealing with this, but I want to commend you on putting it out there and dedicating yourself to recovery. It’s extremely difficult to tell your husband about your eating disorder for so many reasons.

  1. You might feel embarrassed and ashamed and not want him to see you in a new light
  2. You might feel that if you tell him about your eating disorder that he might try to stop you
  3. Your eating disorder is so private and such a precious thing (even though we hate having them) disclosure would be exposing and difficult. 
  4. You might be afraid of his reaction since you don’t know how he’s going to react. 

Here are some ideas on how to tell your husband about your eating disorder. 

  1. Consider the worst case scenario. How will he react? What is the worst thing he will do? Will he leave you? Will he divorce you? In most situations, probably not, but really sit and think about what the worst thing can be. 
  2. After thinking about this, consider bringing your husband with you into your therapist (if you have one) or if not, check out ED referral and see if you can find an eating disorder therapist to bring your partner to. It might be easier if you have a professional there.  If you are not interesting in discussing it with a therapist, no problem at all. You can do this alone. 
  3. Set aside a day and time to tell him. Make sure that it’s not over a meal and make sure that it’s not at night. Your husband will likely have many questions and will spend a long time asking you. 
  4. Make sure that he knows that it’s not his fault and make sure that he knows that you are looking for help.
  5. Make sure that he knows that you don’t expect him to be the one to cure you. 
  6. Sit down with him or take a walk with him and gently explain that you’ve been dealing with this for a long time and you’re ready to reach out for support. You can say something like, “When I was 17 years old I started to make myself vomit after I ate. This habit sort of spun out of control.  I have spent the past 12 years dealing with this horrible secret and trying to stop on my own. I haven’t told you because I’m so embarrassed and so ashamed, but I don’t want to have secrets from you, and I don’t want to live like this anymore. I want treatment and I want to stop. And all I need from you is love and support. I know that I can beat this now that it’s out in the open and I’m asking for help.”
  7. Tell him that your eating issues have nothing to do with him. 
  8. Tell him that you don’t need him to “fix” you.
  9. Tell him not to tell you what to eat or what not to eat, that’s your responsibility, and it’s not good for your relationship. 
  10. Tell him what he can do to support you. Maybe that’s talking about feelings more often or helping you find a therapist or treatment program or driving you to treatment.
  11. Ask him not to talk about diets, calories, burning calories, losing weight, or what your body looks like.
  12. If there are some foods that you don’t want him to have in the house,  ask him to support you in that way
  13. Request that if he catches you in a binge, it’s not his responsibility to make you stop doing it, nor should he take food away from you, nor should he shame you. Instead, maybe he can say something like, “hey, is everything okay? do you want to talk? I’m here for you.”
  14. Ask him not to be your food police.
  15. Give him space to talk about his feelings and what it’s like for him to learn this about you.
  16. Give him the opportunity to ask you questions. If you feel uncomfortable with certain questions, let him know that you’re not ready to answer them yet or that you don’t know the answer right now,  but as you work through recovery, you will let him know what emerges for you.
  17. Ask him to READ THIS and to READ THIS

The 1200 Calories a Day Myth

1200 calories per day diet

Have you ever gone online to find out how many calories you should be eating to lose a certain amount of weight and the calculator spits out something like “you should be eating 1200 calories a day to lose 10 pounds by… ” whenever? The fact that a 1200 calorie per day diet is healthy is an evil myth.  

The idea behind the 1200 calorie diet is that it is enough calories to allow your body to keep up with all its essential functions while allowing you to lose weight in the fastest possible amount of time. It’s the lowest you can go without your organs shutting down and your body becoming very ill.   The only problem is that 1200 calories per day actually is starving for many, many people. The methodology is so fundamentally flawed, yet, somehow, that number became magic in the diet world. 

A long, long time ago, when I was still dealing with lot of my own disordered eating, I saw a nutritionist who asked me how much I was eating. I told her that I made sure I got 1200 calories each day. She said to me, “The World Health Organization defines anything under 1500 calories per day as starvation.” I can’t find that statistic anywhere in the literature. I’ve been looking for it for years, but it’s not findable. If anyone finds it, please point it out to me. 

I’ve had lots of clients come in who have been bingeing, who have lost their periods, who have lost hair, who all have physical symptoms of anorexia from living on a 1200 calorie diet for multiple months or even a year or more. Here’s the way the pattern usually goes. A client comes in and tells me she can’t stop bingeing, that she feels hopeless and out of control because she has been bingeing uncontrollably for months. She then tells me that she got her weight down very low by following a 1200 calorie diet. But then something happened, she fell off her diet, started bingeing and has now desperately been trying to get back on her 1200 calorie regimen.

Now here’s the thing, given how many reputable sources recommend a 1200 calorie per day diet for weight loss, you wouldn’t expect that someone who has been following these recommendations would be suffering symptoms of anorexia such as amenorrhea, hair loss, food obsession and binge eating, Yet they do. The problem is, when you eat a very low calorie diet, you will lose weight initially but your body will adjust and your metabolism will slow way down to compensate for the lack of calories.  Because your metabolism is so slow, the 1200 calories per day will level out and your body will stop losing weight after an adjustment period.

Because you will be starving, you will start to eat more and probably start bingeing.  Then, rather than blame the diet, you will blame yourself. You will tell yourself that you are to blame because you couldn’t stay on your diet. You will try again and again to get back to that 1200 calorie per day diet. Because you’ve had the initial “reward” of weight loss, you will believe that you can replicate it by getting back to the 1200 calorie per day diet and getting your body back to where it was when you originally lost the weight. It will be difficult though because your body will be afraid of starvation and when you are tired, or emotional or your defenses are down, you will binge again. You will beat yourself up for it saying that it’s all your fault and that you can’t understand why you were able to do it once but you can’t do it again.  I see this happen again and again and again. If it weren’t a typical pattern, people would have gone on one 1200 calorie diet once in their life and never had to do it again.  It’s almost like an addictive drug cycle. You repeat the same behavior again and again to achieve that initial high, but it’s unattainable now. 

Low calorie dieting creates adrenal fatigue, high stress issues (which can trigger emotional eating) and food obsession. It can also create additional stress for those who feel that they cannot do things socially because they are afraid of the food.  In fact, studies have shown that a 1200 calorie per day diet leads to weight gain by increasing cortisol levels and emotional distress. 

Eating 1200 calories per day is not sustainable in the long run, though you will lose weight initially, will wind up gaining more weight than you lost. 

  • because your metabolism will slow down in order to sustain your low calorie intake
  • because you will most likely binge

If you are even a little bit active (that means doing more than just laying in bed all day), this low calorie amount will lead to increased hormonal stress levels and there is a good chance that you will lose your hair, lose your period, and lose bone density.

There are 30 year old women who sustain themselves on low calorie diets and wind up with the bone density of 80 year old women. I know, I see them in my practice all the time. 

A 1200 calorie diet is not sustainable. In fact, when I went online to find more information about it, I found tons and tons of forums with people talking about how much weight they lost on their 1200 calorie diets, but they gained the weight back and needed to get back to it. That should be a red flag for everyone.  You are not alone. This kind of caloric restriction works for almost nobody. 

So how to find a comfortable weight for your body in a healthy way?  

Don’t restrict your calories. 

Make sure that you are eating more high density nutrition foods than low density nutrition foods

Don’t let yourself get very hungry nor very full. 

BE PATIENT  Finding your body’s healthy weight is a game of patience and loving kindness. The 1200 calorie game is tempting because it’s quick weight loss but it can set up years of dysfunctional eating and body distress. When you allow yourself to slowly let yourself settle in to the body that your body wants to be, the body that feels wonderful and healthy, you will find peace. 

References: 

Yes you should eat 1200 calories

Why 1200 calories is so wrong

The Calorie Theory, Prove it Or Lose It

An Open Apology to my Former Weight Loss Clients

1200 Calories- Sophia Herbst

How to deal with Boredom in Recovery

Boredom and Binge Eating

“God,” she told me, “it’s not that I WANT to keep binge eating, but when I’m not bingeing, I’m just so fucking bored…” 

It’s true, boredom is the enemy of recovery. 

Stella, a new client of mine was explaining to me why she continued to binge each night despite having lots of tools, support and repeated attempts at recovery. I understood what she meant.

The binge was exciting. Although she hated the feeling afterward, she couldn’t resist that desire. She began to feel it at 4pm. She couldn’t wait to get home from work and sit alone in front of the television while digging into a pint of Ben & Jerry’s and a baguette with brie. The idea of going home to nothing, nothing to do, no one to talk to, nothing exciting planned, just watching television or reading and going to sleep without bingeing was stressful for her.  She couldn’t even imagine what it would be like.  Not only was bingeing exciting, but the after effects of bingeing were exciting, planning her next diet, counting all her calories down to a T, keeping her mind occupied. What would it be like if she didn’t have the binge to look forward to? What would it be like if she wasn’t dieting or picking out smaller clothes, or  looking forward to the moment when she would be at her goal weight, what would it be like?  She couldn’t imagine her life. It seemed dreadful. Full of nothing. Nothing to look forward to, not looking forward to food, not looking forward to being skinny. Bingeing gave her life meaning, direction and a path. 

So let’s dissect this for a moment, there are a few different components going on here:

1. Stella’s binges take on a hugely addictive cycle, when Stella thinks about bingeing at 4pm, her nucleus accumbens (pleasure center of the brain) lights up and she becomes excited for the binge. Anyone with a drug or alcohol addiction can tell you the same thing, they start to become aroused and excited even thinking about their drug of choice. For instance, a cocaine addict begins to fantasize about doing cocaine later that evening. Even though they are at work, their brain begins to release dopamine just by thinking about the cocaine.  Imagine that, just by thinking about bingeing, your brain begins to actually pull you into the binge. Now that’s rough. What a let down it would be to make the choice not to binge. 

2. Stella feels that bingeing and restricting give her life meaning, Stella is also a diet addict, so whenever she begins to feel bad about herself, she starts to fantasize about what she’s going to look like when she hits 120 pounds, how her jeans are going to fit, how her body is going to feel, who is going to pay attention to her, who will notice her, who she will start dating and the fun things she is going to do, She keeps thinking about these things but does not initiate any fun into her life because she is waiting to lose weight. This makes her life terribly boring. She refuses to do anything until… which makes bingeing a very compelling pastime. It is her only pastime.

3. She is in a very tricky cycle of deprivation and self loathing. I understand why she wants to binge at night because the alternative is so much more difficult to swallow, being alone with her thoughts. My old supervisor once told me that boredom was actually a coverup for a more difficult emotion that we didn’t want to deal with. In Stella’s case, those emotions are loneliness, a sense of unworthiness, and a deep fear of having nothing ever. She is lonely because she doesn’t want to be around people, she doesn’t want to be around people because she feels that she is “too fat” to be around people, she says that once she loses weight, she will start to spend time with people. Losing weight won’t ultimately change her sense of worthiness. She is a worthy and beautiful human being now. Being skinny won’t change that, it also won’t change the way she feels about herself.  Letting yourself out of the trance of unworthiness is an inside job, not a matter of changing who you are, but about allowing yourself to be who you are now. 

So what should one do here?

1 Remember that boredom is the enemy of recovery, but that boredom won’t kill you. Though  the sense of boredom might be alleviated by bingeing, it is alleviated because it is replaced by a sense of shame, self-disdain, anger, and an uncomfortable feeling in your body. The alternative is certainly not the easier pill to swallow. 

2. Make plans for the evenings — even if you are not leaving the house, even if your plans are something like sitting home and painting your toenails while watching a movie or having a phone date with a good friend, or painting or writing, or doing anything else other than being alone with your wallet or your binge foods. 

3. Notice when the desire to binge comes no matter how early in the day it is and begin to reach out for support.  Send a note to a friend or support person and let them know that you are in the danger zone for later tonight and tell them what your safety plan is for that evening. Have them check in with you later that night. 

4. Recognize that you can have a really nice evening without bingeing. Take note of how much better you feel when you don’t binge than when you do. Breath into that sense, feel it in your bones. 

5. When you feel that tingly feeling of dopamine being released into your body when you think about bingeing, try to slow yourself down and tell yourself that you don’t need to binge – that you don’t have to follow this urge and desire– just because it has initiated, doesn’t mean that you have to follow it, you can choose not to. The good news is that after a few weeks of not following that dopamine initiation, the urges decrease quite a bit as does the desire to binge. 

Further Resources

Radical Acceptance– a cure of the trance of unworthiness

OA online– to find support folks

Eating Disorders Anonymous– to find support folks

 

 

 

 

Q&A Friday- My family is causing me to binge eat!

My family is causing me to binge eatThis one comes from L in the UK.
Question: 
Dear Leora,
Thank you so much for your book and emails. Could you help me with a problem?
I had just started the first few chapters of your book and felt that I was making progress with my Binge Eating Disorder. I only had to cook for myself, I had no binge foods in the house and because I have just retired my life was calm and I felt in control. 
BUT … then family members from overseas, whom I love dearly, came to stay with me for 3 months while they do some work here.
Now I am cooking for 6 people, looking after and home schooling an 8 year old boy most days and feeling as though my life is frantic. My family are binge eaters so there are lots of sweets and chocolates in the house.
I feel so helpless and powerless to know how to tackle the problem. I have given up and have gone back to binging every day.
Can you give me an idea about how to stop binging when I am living with other bingers? Is there a particular part of your book I should read if I get a spare moment to myself?
Thank you very much for your support.
Answer:
I’m glad you wrote. There is a section in the book where I talk about binge eating with family members- how it’s possible to feel that you are not part of the family if you decide not to engage in unhealthy habits with them (Step 27). How you might even feel guilty, as though you are letting them down or even survivor guilt, that you are going toward a healthier life in recovery but leaving them behind in their binge eating and dysfunction.  Is that part of what might be going on for you? Do you feel that you must engage with them as to stay “part” of the family? It might be an interesting experiment for you to try to get back to your non-bingeing and see how they react. Some family members might use you as an example to slow down. Others might feel threatened (unconsciously) and try to re-engage you in bingeing again. Remember that when you make an effort to take care of yourself first and foremost, you actually wind up taking care of people around you. You are more available to them, more solid, and they learn from your self-loving example. 
What do you think? 

Do you have a question about binge eating, bulimia, anorexia, or anything associated with eating? 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. Are you interested in online therapy or coaching to deal with your eating disorder? Please contact me to discuss getting started. 

Thoughts on Suicide

be-kindIt’s been many weeks since I’ve written a blog post or sent out a newsletter. Oh, it’s not that I have nothing to talk to or that I’m not thinking about you guys or my clients or that I’m not still out there crusading against eating disorders and working to help people find self acceptance and self love, that’s all still going on. It’s not that I don’t have new to anything to tell you. It’s just that I’ve been tripped up. Stuck.

Something happened and I felt like I had to talk about it before I continued my regularly scheduled blogging. But it’s been hard to discuss and I haven’t known how to present it. You see, a friend of mine committed suicide five weeks ago. He wasn’t a super close friend. He was my husband’s friend. His wife and I were pregnant both times at the same time and our kids are the same age. We lived down the street from each other in San Francisco before we all had to up and move out of the city because baby #2 came along and our tiny one bedroom apartments would no longer hold our broods.

My friend’s suicide hit everyone who even remotely knew him extremely hard. Because it was so damn unexpected. Not that suicide is ever expected. But there are signs. Someone is depressed for a long time, their life looks hopeless, even from the outside, terrible and unthinkable things happened to them, they are heavy users of drugs and/or alcohol… suicide isn’t always a huge surprise. We know that someone had been suffering. And we just hope that they are finally free from suffering, that they’ve found peace. But this guy, I’m going to call him Jonathan- he seemed to have it all. A calm peaceful demeanor, a smile on his face, he was easy to be around, lovely really. He had a beautiful wife, and two beautiful children and a big beautiful house that he owned. He was at the top of his game at work. Just an all around enviable life. From the outside. But inside, something else was going on. Something that he didn’t talk about and something that was undetectable, even by his wife and friends. I think that’s the level of depression where you feel trapped. Hopeless. Like you are powerless to change anything around you. And no matter what,  you see the world through crap colored glasses. You can be successful, wealthy, devastatingly handsome, but you are deeply wounded and everything around you feels painful. There is no why, no reason,  your life and being in it feels like a jail sentence. Feels like there is no way out. Your mind cages you into a horrific bleak world of despair. A dark, dark place.

Jonathan is not the first person I’ve ever seen do this. The last one was Michael. A friend of the family. He took his own life 15 years ago. He was kind, loving, caring, so much fun to be around, so handsome, so funny. But what I remember most about Michael is that he was so comfortable to be around. He was the kind of person who just allowed you to let your guard down and relax and not worry about what you looked like or if you said something stupid. I was 19 when I first met him, and so I was very hyper sensitive to how I might be perceived, but with Michael, he just made me and everyone he met feel comfortable. Even my brother who was six at the time. He was just  pleasure to be around. You could let down all your inhibitions and be you.  A rare personality to have. Michael was also successful. Both financially and careerwise. He’d made brilliant career moves and could have retired at the age of 30 had he wanted to. But he ended his own life, which was devastating for everyone who knew him, anyone who had even had the honor of spending an afternoon with him. He must have been in pain. In lots of pain.

So I chose to write about this particular suicide first because it’s at the top of my mind. I’m having trouble thinking about much else a lot of the time. Add despite the fact that I’m still going to work and talking to my clients every day and thinking about them and food and eating and bingeing and under eating and everything else that I think about all the time, I need to get this all off my chest before I write anything else.  I feel that as a mental health provider that it is my responsibility to acknowledge and discuss these things.

The very first thing I need to remind you of here is that you never know what is going on under the surface. Jonathan and his wife had what I would call an enviable life. He was an architect at the top of his game, he was handsome, he had two healthy children, a big gorgeous house and a smart and “super hot” wife.  I’m imagining that there were lots of people who could have looked at them and felt jealous or wished that they had their lives. But we can’t compare our backends to anybody else’s front end. That is, we can’t compare what we are feeling about ourselves to what other people present to the world. Everyone has a significant battle to fight. You are not alone.

And then of course there’s the suicide. There’s something about suicide that make people so angry and ashamed. There’s this way that people think that suicide is selfish, that leaving your family and your friends is selfish. And though it can be perceived as such, remember that we all have the inherent drive to live, no matter what the circumstances around us are. So if someone is suddenly feeling the opposite, the urge to die, especially when their circumstances seem fine,  well then we have to understand that their brain is sick.  They actually believe that the world would be better off without them. That their children would be better off without them. Their beliefs are completely distorted, some kind of zombie brain (depression) is taking over their brain, like their reality is being seen through a funhouse mirror, but they believe that they are stuck in that funhouse forever. Like a Twilight Zone episode. When someone is feeling suicidal, they see the world through depressed colored glasses. Successes don’t feel exciting, they feel tired, they feel hopeless, they feel trapped, they feel like nothing around them is good. They feel powerless to change their circumstances. The thing is, in many cases that it’s not about the circumstances outside of them, it’s about the way they are looking at the world. I’ve seen people lose their children, their spouses, all their money, their homes and not commit suicide. Life can be extraordinarily difficult for everyone, yet suicide tends to only be an option for some people. Because we are born with the will and the drive to survive.

So if you come to a place where you don’t want to live anymore, when you are seriously choosing to take your own life,  please forgive  yourself for having those thoughts and remember that your brain is playing tricks on you. What you are seeing is not real, it’s just your perception of what’s real. And you can get help for that. You can get out of this without committing suicide. You aren’t trapped by your circumstances, you are trapped by your own mind. But you’re not really trapped. There is a path and a way out, one that’s different than suicide and you just need to ask for help, for someone to help lead you on this path.

If you are considering suicide, please get help. Please talk to a doctor, psychiatrist, therapist, peer counselor, friend or call the suicide hotline. You will get the help you need. Suicide is not the way out.

Suicide Hotline: 1 (800) 273-8255

National Suicide Hotlines 

Now, as it goes, soon I’ll be back to my regularly scheduled topics. I just…. really had to get that out.

P.S. If you would like to donate to the family who lost their father please email me privately and I will send you the link.

 

The vegetables are Dizzy!

Don't make the vegetables dizzyWhen I was home from college one weekend, I walked into the kitchen and lifted the cover off the pan to see what my Mom was cooking us for dinner. Squash, onions,  brown rice, tofu… the usual. I picked up the wooden spoon and began to mix the stir-fry. “Stop,” my mother told me as she gently placed her hand over my wrist, “you don’t want to make the vegetables dizzy.”

My Mom had lots of new-agey philosophies and was always reading a book or  participating in certain spiritual food fads, some which were downright obsessive or unhealthy like  the *master cleanser (lemonade diet that we’ve all come to hate), or *Fletcherism (which means chewing your food 100 times before you swallow it- even your water), or a *liver detox (where you swallow nothing but apple juice and laxatives for a few days) and some that more mainstream and had deeper philosophies like Veganism and eating a seasonal Macrobiotic Diet.  Many of them were just oblique ways of masking disordered eating into a spiritual path- but there were a few things within the many different things that she tried over the years that were valid and made sense.

That moment with Mom pops into my head a lot, where she lovingly put her hand on my wrist and warned me against making the vegetables dizzy. I remember smiling at her in an amused but adoring way. She wanted to keep the energy of the food balanced and stable so that when she fed it to me, the food would help me to remain balanced and stable. Her philosophy at this point in her life had a lot to do with the energy that you put into food and how that energy reflected back on you.  She was ill and wanted to regain health and she felt that this was a path toward that.

She had integrated this Eastern Philosophy of being aware of the Qi (life force) in everything- including her food. She believed that what you put into the world around you, that you would get out of it. So she chose love and kindness toward her food and hoped and believed that it would return to her and to me.

I’ve often felt in the years since I’ve lost my Mom that this might have been a healthy path that she came to too late. I don’t necessarily think that it would have saved her life, but I wonder if it would have saved her lots of fruitless years on senseless diets and food and weight loss fads.

I want to put out an experiment to you. What if you took a day and showed loving kindness to everything you ate? If you can’t do a whole day, what about one meal?  You don’t have to eat just brown rice and kale or green smoothies (making smoothies makes the vegetables dizzy anyway… :) But what if you were to take even a piece of pizza or a cookie and look at it before you ate it and said something like, “You are loved! Thank you for providing me with your nutrients, your yummy taste and the enjoyment I will get from eating you…” what do you think that would do? Do you think it would help you slow down? Do you think that it would alleviate some of the guilt that you might sometimes feel around eating certain foods? Do you think that it would help you to be more mindful about the food that you were eating and the intention that you had around food?  Try it, let me know how it goes.

*Links are provided for reference, but please don’t try these methods 

Q & A Friday- Why Can’t I Eat Just One…

Chasing the TasteThis most recent comes from Jodi a new reader: 

Leora, I am having a hard time with a binge that comes from “just one candy, cookie, etc.” I will be craving something sweet and then say I’ll have one piece of chocolate and then keep going back for more. I don’t know how to avoid that cycle and do something else instead of binging. Sometimes after the one sweet thing I want something salty, too, and then I’ll end up binging by going back and forth between the two foods.  Can you help me?- Jodi

Hi Jodi, I know this problem well!  This is what I call chasing the taste. You end a meal only to need the opposite taste in your mouth. Salty becomes sweet, sweet becomes crunchy and salty, crunchy and salty becomes fatty and warm… there is something that you want but… you can’t  quite find it, and you spend the better part of an hour chasing after a sensation in your mouth to satisfy that desire. Before you know it, you’ve ended up bingeing. I have some tips for this. Try them and let me know how it goes. 

Before you begin eating the desired food that can potentially start a binge, create an intention around it. Tell yourself, “I’m going to eat this piece of chocolate and I’m going to enjoy it and it’s okay for me to do that,”  and then put it on a plate. I would also choose to eat more than one piece, because one small piece of chocolate is not necessarily satisfying. Put a couple of pieces on your plate and put the bag away, close it tight and put it up on a high shelf, one that you have to climb to get to or in the freezer under something else.  

Remind yourself that there have been times when eating one piece of chocolate has led you to chasing the taste and looking for something else, but that you are choosing a different behavior now. 

Sit down with your chocolate slowly. Taste it in your mouth. Feel the sensation of the chocolate melting on your tongue. Notice what it feels like and notice what you feel like when you are eating it. When you are finished, note any sensations that you are having to run back to the kitchen and get more or something else. Ask yourself if you are chasing the taste. If you are, either drink a glass of water, or walk into the bathroom and brush your teeth, or rinse with some mouth wash… anything to change the taste in your mouth and help you to interrupt the compulsion of chasing the taste and using food to elicit different taste sensations or sensory experiences for yourself.  After you’ve changed the sensations in your mouth and tongue, sit for a moment and do some breathing- breathe into your nose to the count of ten, hold it and exhale to the count of ten. Do this 6 times to give yourself 2 minutes of breathing. This will calm your amygdala, bring more oxygen to your brain, help you to regain your senses rather than letting the food cravings hijack your brain and suck you into a binge. You now have more authority and a choice about what you want to do. The fact that you’ve put the food in a hard to reach place will also help to interrupt the compulsion to keep eating. 

I hope that helps you J! 

Take good care of you and I’ll talk to you soon. 
Warmly, 

Leora

 

Do you have a question about binge eating, bulimia, anorexia, or anything associated with eating? 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. Are you interested in online therapy or coaching to deal with your eating disorder? Please contact me to discuss getting started. 

How to Raise Your Self Esteem in 10 Easy Steps

how to raise your self esteem

Last week, one of my clients said to me, “Leora, can you just teach me how to gain self-esteem? If I just had some self esteem my life would be so different…”  I knew what she meant. She tries to use her eating disorder to give her self confidence. She believes that if she were thin enough that she would be worthwhile and important, but if she is not thin enough, she is a worthless human being with no value. But she is never thin enough. And so her life has been spent waiting to feel valuable and trying to be good enough. Her focus is always on her weight and never on anything else. Her critic is always telling her that she will be better, more people will like her and she will be happier when she is thinner. She is already very, very thin.

What she thought was that she could “get self esteem,” like gain something that she’s never had before, something new.  The truth is, having self esteem isn’t about harnessing some mystical force or  acquiring something new- it’s about letting go of something old– old messages that tell you that you’re not okay, that you have to be better than you are, that there is something wrong with you. Self esteem is about being kind to yourself, accepting and loving yourself even if you’re not perfect.  Self acceptance can often become confused with settling for something that you don’t like. But that’s not what self esteem is about. It’s about accepting who you are in the moment and accepting that it’s okay to be who you are as you go toward  greatness (even more greatness!) and allowing yourself to evolve, but caring for yourself and being kind to yourself and even loving yourself in that process. It’s about holding yourself with integrity to the best of your ability, always being kind, thoughtful, compassionate and loving to the people around you and to yourself.  It’s about knowing what your values are and doing your best to uphold those values. So, when you hear the voices telling you that you’re not okay and that you won’t be okay until you… CLIMB MT. EVEREST, RUN A MARATHON, LOSE WEIGHT, FIT INTO A SIZE XX JEANS, READ WAR & PEACE, WRITE YOUR FIRST NOVEL, BECOME A BEST SELLING AUTHOR, MAKE 6 FIGURES, GET MARRIED, HAVE A BABY, QUIT DRINKING,  QUIT SMOKING, QUIT EATING CARBS, EAT NOTHING BUT KALE SMOOTHIES AND SUNFLOWER SEEDS, BECOME A VEGAN, HAVE CLEAR SKIN, GET YOUR MBA… Or whatever those voices are telling you, remember that you don’t have to engage with those thoughts. It’s not true and it’s not real. It’s okay to be okay with who you are in the moment instead of after you’ve done these things. People confuse acceptance with resignation and defeat.  Acceptance doesn’t mean resigning yourself to being stuck in your circumstances. It means accepting that you are in the place that you’re in now and you don’t have to wait to be who your are until after you’ve changed your circumstances. It means that you can be yourself now and thrive and be in the world while at the same time improving your circumstances. We all have goals to achieve, that’s part of what makes us psychologically healthy and what helps us move forward in life. But when you get into the cycle of “I won’t be okay until…” you set yourself to be unhappy and you have a very hard time finding happiness… because it’s never enough.

So, how do you do this? I’ve created 10 tangible steps to achieving self-esteem. You don’t have to do all of them right now. But just try one this week and see how it goes. When you start to feel a difference, try another one. I know that doing these exercises will be life-changing for you.  

1. Make a List of What your Values Are 

Think about what is fundamentally important to you and write it down. This could be being a kind and compassionate person, being the kind of person people turn to when they are having troubles, not judging or criticizing other people, living with integrity, having positive intentions. Knowing that you are never going to be 100% at all these things, when you are feeling badly about yourself, check in and ask yourself if you are doing your best to live in accordance with your values. If you are, then you can fall back on that foundation of strong values and strength. If you are not, give yourself a reminder of what your values are and try to live according to them. So, if someone does or says something to you that hurts your feelings or if you yourself say or do something to yourself that hurts your feelings, check in with yourself and ask, “am I living according to my values? Am I behaving and acting in a way that I can feel good about? Am I acting like the kind of person that I would want to have as a friend?”  And remember, we always forget to do these things and fail at them sometimes, and that’s normal, but having your values written down in a list form can be a great reference for you to come back to. It will help you remember what is truly important to you and when you remember and when you live according to those values, you find self-efficacy.

2. Don’t Compare Yourself To Other People

Your values and your dharma (path) are different than anyone else’s, so you just can’t compare. You can’t compare your money situation to anyone else’s, your relationships, your jean size… we were all born with our own individual paths. When you begin to look at other people’s paths and think that you should be like them or different from who you are, you fail to move along your own, or you reject your path. This inherently makes you feel bad. This keeps you from moving forward.  You also shouldn’t be comparing your backend to anyone else’s front end. Meaning, you can’t compare the knowledge that you have about your own situation to what someone else is outwardly showing you about their own. You never know what is going on with someone else. As M. Scott Peck says in The Road Less Traveled, life is hard for everyone, not just you. And once you remember that life is hard across the board, you can transcend the existential angst and pain that comes with the difficulties of life. You can understand that when things happen (you get a parking ticket, break your arm, get into a car accident, lose a parent) that it’s painful and it’s difficult- but you are not alone, that bad and difficult things happen to everyone who chooses a life of being human.

3. Do Things for other People Often

Performing acts of kindness actually makes you happier and boosts your self esteem, making you feel more valuable and more at peace. A study published in the Journal of Social Psychology showed that participants who performed directed acts of kindness every day for 10 days in a row showed an increased level of life satisfaction. Self-esteem comes from life satisfaction and feeling your value in the world. Doing things for other people can be as small as smiling at someone when you are walking down the street or as big as volunteering your time to help someone out. It can also be remembering to give loved ones around you big hugs, kisses and compliments and reminding them why you love them so much and telling them how proud you are of them.

4. Live Mindfully  – Mindful living is about being aware of your body, being aware of your choices, your environment, being mindful or your choices, your environment, your bodily sensations, your thoughts, your actions and your fears. Often, people who are suffering with eating disorders have a really rough time living mindfully. They reject their true needs to focus on the goal of weight loss or looking better and  either binge or starve themselves, they don’t honor their appetites, they hate their bodies because they believe that there is something wrong with them. They completely reject themselves. When you are living mindfully, you are working to honor the needs of your body.

If you are signed up for the newsletter, you should have received your free mindful eating meditation. If not, sign up here to get it. You might also like the loving your body and letting go of negative body image meditation.  

Do check out this article on mindful living. 

5. Learn Self Acceptance:  Part of self acceptance is knowing what your strengths are and honing in on those and not punishing yourself for things that you are still working on. Make a list of things that you are good at and that you like about yourself. Be with that list and do more of those things. Make another list of things that you are not so happy with and that you want to change. Tell yourself that it is okay that you are where you are. And that it doesn’t make you bad and you can still like yourself and care for yourself as you are working to change those things. Get love and support and help for changing the things that you want to change. Change and healing is difficult all alone and in a void. But when you find other people who are working on the same change together, you have a group of encouraging, loving folks to keep you accountable and to be kind to you when you fall down. You can also do the same for others which will help you (see #3!)

6. Take Responsibility for Yourself: This is about not blaming other people for choices you made. Understanding that you have power and that you are not stuck and that just because you made a bad choice, you are not stuck in it because you have the power to constantly be rethinking and recreating your life. If you make a mistake, don’t shift the blame. Don’t say that you did this thing or said this thing because someone made you. For example, “I’m sorry I yelled at you, but if you weren’t acting so irrational, I wouldn’t have.” You have just negated your apology and given away your power. Always take ownership for your actions. Knowing that you have it in you to make your own decisions based on your own values (see #1) is part of what gives you self efficacy and self-esteem. Saying that someone else made you yell or act mean or say something wrong basically says that you have no power to make your own decisions about how you behave. Remember that you almost always have the power to undo a decision that you made. 

7. Be an Advocate for Yourself:  When you have self-advocacy, you always treat other people with respect and you do not allow other people to talk down to you or to treat you poorly. If you have a boss, for instance who is verbally abusing you or yelling at you, it’s okay to look at them and say, “it’s not okay to talk to me that way.” You also stand up for others who might not have the ability to voice their own needs. If you are unable to stand up for your own needs and have your own voice, you find someone who can be an advocate for you. 

8. Live with Purpose: 

Consider your life’s purpose. When you begin to live with purpose, you take care of yourself, but your main purpose in life isn’t about getting thin or getting pretty or making money or trying to impress or look good to other people. It’s about having goals that long term feel important and meaningful to you and using your life to work on these goals that help the world at large. 

9. Have Lots of Integrity: 

What is it to live with integrity? In my opinion, it’s to be as honest as you can without being hurtful. Being honest doesn’t mean telling someone that they look fat in their new dress or that they’re acting like a jerk. That’s not honest, that’s your subjective opinion. Being honest is more like telling someone that your feelings were hurt when they didn’t answer your phone calls or respond to your messages. Being honest is not stealing, not lying, not purposely saying things to hurt people, not spreading hurtful rumors, and not using other people to achieve your own means. It’s about being kind, being helpful, but also not sacrificing yourself or your own needs for the sake of others. Personal integrity is about knowing what your values are trying to live up to them.  (See #1). When you identify your values and do your best to live up to them, you will always know that you are okay and you won’t have to worry about what other people think about you.

10. Challenge Your Inner Critic- 

What would it be like to gently let go of the old thought patterns that you are so intensely holding onto? As I said earlier, self-esteem isn’t about gaining or building and changing, it’s about letting go. Imagine the beliefs that you have that plague you and make you feel bad,  (ie: “I have to be thinner, I have to be smarter, I have to be cleaner, I have to be richer, I have to be prettier…) and just choosing to disengage with them. Choosing instead to engage with the above ideas that are helpful and help you to feel better about yourself than the thoughts that intrude into your mind and keep you from living your life with zest and enjoyment.  That doesn’t mean you won’t have these thoughts pop up. They are old and part of old patterns. However, what about trying to hear them like background noise (like a fire engine siren outside) but not follow them. Let them fly through your mind, notice them and rather than grasping onto them, think about doing things that align with what makes you feel good about yourself. 

For more help on improving self esteem, check out some of Nathaniel Branden’s sentence completion exercises. 

What about you? What are some things that you have done that helped you feel into your self esteem? 

 

The New Binge Eating Miracle Drug

Medicine background

Medicine background I’ve had a lot of people ask me to talk about Vyvanse, which is being touted as the new miracle drug for binge eating. The New York Times ran an article about it last month and lots of folks have been calling me and asking me if I recommend it. 

Before I discuss my thoughts and feelings about the drug itself, lets discuss what it is. Vyvanse is an ADHD drug and it’s an amphetamine. It’s been used for years for folks with ADHD. So, these ADHD drugs are cognitive enhancers, meaning they increase focus and decrease impulsive behaviors. If you’ve ever seen a kid before and after his (or her) ADHD meds, you know how different they show up with an amphetamine in their system. It works the same with BED, it increases focus and decreases impulsive behaviors, so one is less driven by their desires and urges, and for many folks it will decrease bingeing and help them find some peace around food. 

 That being said, I do have some feelings about it.  The very first is that amphetamines have been prescribed and abused for weight loss for decades. Most people with BED don’t purely have Binge Eating Disorder, they also deal with severe food restriction, exercise addiction and obsessive dieting, so being on this drug might feed their desire to restrict. Without the drive to eat, they might find themselves depriving themselves of food or not eating at all. 

And although I’m saying this theoretically – the truth is, that I know of a lot of women who abused drugs like Ritalin and Adderal to keep themselves from eating- and when I was in college, I was definitely one of them.  

 If someone is taking this to stop binge eating, they will also need to learn how to use mindfulness and cognitive behavioral therapy to stop binge eating because when they stop taking the medication, their impulses will return because they are not getting the dopamine effect that they were getting from the drug.

 

Next, it’s not a benign drug, it’s an amphetamine which does have addictive consequences, so people with BED might be switching out one addiction for another. There are also side effects to consider like sleeping issues, anxiety, constipation, and others, but those are the main side effects that have a massive contraindication for people with BED.

 So do I recommend it? I don’t know. I have heard from a few women that it’s been heaven for them- that they feel finally free of their urges to binge. As with all medicine, you have to weigh the risks with the benefits.  I definitely wouldn’t say that I’m against it, but I think it would better for very short term use, to get over the hump of BED and teach you that you actually can be free those urges and impulses, but at the same time, learn through therapy how to stop those behaviors.

If you have tried Vyvanse for binge eating- please do share your experiences and what it’s been like for you in the comments. Thanks!

10 Ways to Train your Brain to Stop Overeating

Beautiful young woman dining at a restaurantYou know how sometimes it’s not even noon but you know that you are going to have a binge when you get home from work that night? You begin planning it, thinking about what stores you’re going to go to, what foods you’re going to get, where you are going to eat it, what you’re going to do when you eat it, what it will feel like in your mouth, what you will be doing while you’re bingeing (will you be watching television? will you be searching the web? will you be on the phone? or will you just be sitting alone with the food?) You begin to get excited and your amygdala (the part of your brain responsible for emotional reaction) lights up with excitement. Just the anticipation and desire of a binge creates activity in your brain that basically brings you to the binge. So your actual binge starts about hours, sometimes even days before the binge starts. It’s those first thoughts about it, the anticipation which just carries itself and basically makes you feel as though you don’t have a choice. The thoughts of bingeing carry you straight to your binge. But that’s not the only thing that the anticipation does. Just think about food and you flood dopamine into your nucleus accumbens (the pleasure center of the brain) which then excites you, calms you and motivates you to go for the food that you are thinking about.  Just like the drug addict who starts to think about cocaine which then motivates them to score their drug of choice despite whatever dangers lurk. So, not only are you addicted to the binge, and those pleasurable feelings that come with it, but you are actually addicted to the process of bingeing, the thoughts about food, the plans that you make to get food, the thoughts about food. Each thought that you have has a biochemical reaction.

Which makes quitting binge eating as difficult (or more difficult) than quitting heroin or cocaine. When food is your drug of choice, you can’t just stop eating, you have to learn to stop abusing.

SO HOW DO YOU DEAL WITH THE ADDICTION OF OVEREATING?

When you first have those thoughts and the pleasure center in your brain begins to light up with anticipation (it’s not unlike the process of flirting, or hooking up with someone pre-sex or orgasm), it feels as though it’s over. You’re going to binge. However, when you check in with yourself and say, “oh yeah, there are those thoughts again, I’m planning my binge…” you can slow yourself down. You can tell yourself that just because you are planning your binge, doesn’t mean that you have to go through with it. Just because the process part of the addiction has begun does not mean that you have to go through with it. Remember, this is the SAME EXACT function that cocaine addicts go through before they score their drug, it’s the same process that sex addicts go through when they are looking for a prostitute, it’s the same process that gambling addicts go through when they are selling their wedding ring for money to put in a slot machine.

So what we want to do here is slow your brain waaaayyyy down. Even though it’s just noon and you are at work in front of your computer, your mind is at home in the refrigerator or in front of the television with a pizza.

So what can you do?

1. First, recognize “oh, I’m having THOSE thoughts again…” And say it out loud, “there is that urge to binge…”

2. Remind yourself, “I’m not in the middle of the binge yet, I’m right here at my desk.”

3. Ground yourself, look at your feet on the floor, look at your hands, put your hand over your heart and breath into your belly. Be where you are, not where your mind is taking you.

4. Remind yourself why you don’t want to be on the other side of the binge. Think to yourself, “I don’t want to be in bed tonight with my belly hurting, feeling bloated and uncomfortable, I don’t want to wake up tomorrow morning feeling bad.” Then let yourself feel those bad feelings of how you feel after a binge. Reliving them will be a deterrent for you.

5. Think about alternatives, think about what it would be like to wake up the next morning without a binge, let that process excite your mind. Imagine yourself eating a healthy dinner in a healthy way and see yourself in bed that night feeling comfortable and waking up the next morning with a spring in your step.

6. Plan something equally relaxing for that evening ie: date with friend, bubble bath, taking a long walk outside while listening to music or podcast

7. Call someone and tell them that you have a binge planned and you don’t want to go through with it.

8. Get on the forum and ask for support.

9. Remind yourself that you have a choice. It doesn’t feel like you do, but you do, the thoughts and the desire can’t make you binge, they are just thoughts and desire. You have thoughts and desires a million times a day that you don’t act on.

10. Calm your brain down and slow down your thinking with deep breathing and meditation.

Eating disorders are notoriously rough because they hit you on lots of different levels, process addiction, food/sugar addiction, trauma relief, bad habit… there are a million different reasons that people binge, but if you can bring some mindfulness into the equation, you have an amazing chance of recovering and not having to deal with the urges and the pain of bingeing anymore.