eating disorder

Q & A Friday- I’ve Stopped Binge Eating but I Haven’t Lost Weight- Help!

Q & A FridayToday’s question comes to us from Pamela in New Jersey.  This is a super common and difficult question that comes quite often in ED recovery. 

Question –

Hi Leora,

I have an ED therapist and ED nutritionist and I’ve been seeing them for over a year. I’m also in a weekly ED recovery group.

I think I’m doing good with recovery but I’m not losing weight. I think it’s because I’m still eating to take the edge off. Not in a binge sort of way but in a starting point sort of way. I’ve been paying more attention to using the hunger scale recently and that’s improving. Not losing anything since starting a serious recovery program is very discouraging. I’m no small fry, I’m over 300 pounds. I have very low energy and still sleep quite a bit which makes sense considering my body is very large. Everyone in recovery says it’s not about the weight. It’s about healing the behaviors and the weight I suppose will come off eventually. I’ve found a lot of peace but it’s not easy being so large.

When I bring up weight loss to my ED nutritionist she say’s that should be on the back burner for now. However even after all the progress and peace I am discouraged and down mood wise. My poor body has endured much with the BED. I’m getting up there in years now (55yo) and it’s not getting easier carrying the extra weight. I understand the goal isn’t to “lose” weight but to find more normalized behaviors around food and resolve the need for emotional eating.

But i am tired, I am feeling low and today I’m discouraged. I’ve done a good job not making about the weight over almost the past two years and weight wise I’ve let go of 10 pounds or so. When do I let it go of the big excess weight. I know you cant tell me but there must be a way to combine releasing extra weight with recovery even if it is some form of a “diet”. There has got to be a way to gain physical health and normalized eating together. I have no illusion of being super small, I think I have a very real thought of what my body is comfortable size/weight wise. But when I bring it up I am told that losing weight cant be the focus. But that doesn’t change that it’s just to hard and humiliating carrying this extra 150 pounds. Yes Humiliating at times when I cant sit at a table at a restaurant for example, or cant sit on someone’s couch bc it wont hold me. I’m in pain emotionally and physically over this weight issue and I need someone with some direction other than put it on the back burner.

I’m asking you bc whenever I read what you have to say you make sense.

Any thoughts? Thank you Leora,

Answer-

Your question is such a good one.  As long as I have been working in Eating Disorder Recovery, this conundrum has come up on an almost daily basis. People either start to gain weight in their recovery and it’s very upsetting for them, or they find that they have been not bingeing, not purging, no restricting, and not dieting — but they have not lost any weight. They then become extremely discouraged and also very angry.

The anger is usually directed at recovery or at their recovery team. They wonder why they’ve wasted all this time not on a diet when they could have been on a diet and lost weight rather than what they’re doing right now. 

My friend Sheira, who is a well known eating disorder therapist often says, “when you focus on weight loss, you make a pact with the devil.”  As an Eating Disorder Therapist, when you promise anyone that you will help them lose weight or you focus on weight loss with them, you begin corroborating with the societal message that got them into their Eating Disorder to begin with.  The very first thing we need to do with someone who is recovering from an eating disorder is to help them take their focus off of food and weight and the scale and diets and weight loss and help them to refocus on their mental and physical health.  Dieting and the pursuit of weight loss does not equal health. The problem is that we have been told that it does– not only does weight loss equal health, it also equals beauty and it equals our worth in the world. I remember an interview many, many years back with Duff (she was one of the first MTV Vee-Jays). She was a model and model thin– and then she became ill. While going through multiple chemotherapy treatments she became really skinny, sick skinny– and people started complimenting her on her weight loss and saying things like, “whatever you’re doing- keep it up! You look great!” She was appalled. She was already super thin and then she was sick. Skinny culture is not about health.  This is why we don’t focus on weight loss in ED recovery. We focus on health. And sometimes health means weight gain while focusing on mental health recovery. 

This is a super common argument that occurs when the Eating Disorder Community gets into a room with the Obesity Awareness community. When we go to Eating Disorders conferences, there are always inevitably lots of folks from the Obesity recovery community. The obesity researchers look at weight loss while the ED recovery community feels that the goal of weight loss most often ends in an eating disorder for the ED population, so treat the eating disorder and weight will come to its natural place. The belief is that concentrating on weight loss will bring you back to a place of obsessing on the scale,  feeling like a failure and then reverting to eating disorder ways. In ED recovery, we want to treat your brain first and help you to find a place of peace. We believe that your healthy body will come concurrently with a healthy mind. 

This argument however does not really fly when people feel that their weight is negatively impacting their lives. People tend to interject society’s negative connotations of their weight with their own feelings about how wrong they are and feel in the world. The answer is to address the problem that you’re dealing with, not the weight. For instance– pre-diabetes. The recommendations for reversing  pre-diabetes includes eating healthy food and exercising 30 minutes a day.  Exercise does not have to be pejorative or punishing or painful. It can be a walk with your kiddos around the neighborhood, it can be swimming, it can be a yoga video, it can be jumping on a trampoline. Pre-diabetes is having an elevated blood glucose level and can be helped by exercise because when you utilize your muscles they will pull glucose out of your blood for energy and stamina.  And healthy eating doesn’t have to be a diet determined by someone outside of you. Healthy eating includes eating lots of whole unprocessed foods when you’re hungry and stopping when you’re body is satisfied and allowing yourself to eat foods for enjoyment (like ice cream!) in a non-bingeing and loving way.

Having no energy is something that you can work on as well.  People of all shapes and sizes (especially women) feel that they have no energy. Ways to increase your energy again include getting 7-9 hours of sleep each night, exercising and eating for both health and enjoyment.   If you are able to eat when you are hungry, stop when you are satisfied and incorporate loving, healthy movement into your daily routine– your body WILL come to its healthy weight without you focusing on weight loss as the goal. Try to shift your focus instead on personal health and inner peace. 

According to Deb Burgard of The Association for Size Diversity and Health,  (The Health at Every Size movement) “…advocates eating in a manner that balances individual nutritional needs with hunger, satiety, appetite, and pleasure. We also enthusiastically support individually appropriate, enjoyable, life enhancing physical activity rather than exercise for the purpose of weight loss. A “normal weight” is the weight at which a person’s body settles as s/he moves towards a more fulfilling, meaningful lifestyle that includes being physically active and consuming nutritious foods. Not all people are currently at their most “healthy weight.” Movement towards a more balanced life will facilitate the achievement of a “healthy weight.” “

When my clients ask about weight loss, we try to look and see what they think weight loss will offer them. Often answers vary from things like: Losing weight will give me:  more friends, more confidence, more energy, more love, the ability to go out and do things that I’ve been missing, I can wear whatever I want… The truth is, you can reverse engineer this. Don’t think about losing weight as the antidote to the issues. When you look to treat each issue individually, you wind up finding the benefits that you think weight loss will give you. Chasing the almighty number on the scale– for someone who has been in that rat race for a number of years, will only keep them in it.  Chase true health instead. 

What do you think? Does it makes sense? 

For further reading on the topic,  go to: 

National Eating Disorder Association Thoughts on The Health at Every Size Approach 

Health at Every Size Approach 

Health at Every Size Book 

 

I hope that this response was helpful for you. 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. 

Round Up of ICED 2016

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It’s been more than a week since I’ve returned from the International Academy of Eating Disorders annual conference (though returned is really a silly word as it was only 12 miles from my house this year), and I’m finally able to sit down and gather my thoughts about it. If you’ve never been, even if you’re not a clinician, I highly recommend. There is a lot of advocacy and research there and many things to learn.  Next year it’s going to be in Prague! I certainly won’t be able to go, but I was psyched to have an opportunity to go this year as it was in San Francisco. With two littles at home, big travel is hard.

There were  a few main themes ICED 2016 (International Conference of Eating Disorders) that were floating around:

Eating disorder research and treatment vs. obesity research and treatment.  Wow. There was serious, serious controversy there. This is because obesity researchers as well as state funded grants (think NIH) are still using ideas such as food restriction, caloric restriction and BMI to measure recovery. All eating disorder clinicians and researchers have evidence that all of this, dietary restriction, BMI, “weight management” and dieting all lead to disordered eating patterns. Obesity researchers believe that obesity has to be treated because it leads to heart disease, Type II diabetes, etc. But Eating Disorder researchers and clinicians (and me too!) believe that when you focus on the obesity as the health problem, you are doing a disservice to the patient – you should be focusing on health and treating the specific disease. “Treating Obesity” continually leads to failure. Obesity isn’t a disease, but heart disease is.

Next off we discussed ADVOCACY a whole lot. People often think of eating disorders as a white woman’s disease, but the truth is that EDs hit not just white women, but women AND MEN across all races. In fact, Latina women have a higher incidence of eating disorders than white women. But most people of color or folks who aren’t cisgender tend to shy away from treatment – for many reasons. It’s not accessible (affordable), it’s not relatable- treatment is geared toward one gender and one race, and it’s stigmatized and unsupported by family and community. For instance, many years ago I had a client who, despite the fact that she had a horrific case of bulimia, her family would not support her treatment because they said it was a “white women’s disease.” She did come in for treatment and got great support from our treatment center and the treatment community but not from her family or her own community. This is not an uncommon situation. The fact that she came in for treatment is really fantastic, but most people don’t.  The conference spoke a lot about getting it out there that EDs strike everyone everywhere and nobody should be ashamed to try and get help. And, as a community of ED professionals- we have to provide more help in different and more accessible ways. So lots to do there. And a note, if you are a human being who is not a white woman and you are suffering from an ED- please do reach out (you can even reply to this post) and I’ll point you in the right direction for treatment- thanks to this conference I have some really great resources now.

I met some of my heros of Eating Disorders, like Deb Burgard – and I was really seriously starstruck and took a selfie with her- it was more exciting to me than meeting say Johnny Depp (but honestly that would excite me too).  If you don’t know about Deb, please click her name above and check out her work. She is a brilliant Psychologist, speaker and advocate for size diversity and Health at Every Size.  I also got to meet Lizabeth Wesely-Casella from Bingebehavior.com – (have you read that blog? It’s awesome). And that was really exciting as well. Such amazing people do this work – it’s good work, and it’s hard work. 

Body Positivity – A lot of people ask me why as a a clinician treating Eating Disorders I advocate for Health at Every Size and why it’s important. The answer is easy- almost every eating disorder started with a diet. If we can eradicate people being told that they are not good enough and they need to diet, we can deeply change the internalized messages that dieting is the only way out – we then allow people to live in bodies that were meant for them. Those bodies might be big or they might be small- but what we want them to focus on is their true health. True health isn’t about getting on a scale to measure your health. It’s about giving your body what it needs- good healthy food and good healthy movement (where you can), but of course movement and exercise can be difficult for those in larger bodies because of the social stigma. So it’s all very challenging and there needs to be a lot more kindness and acceptance out there.  And the obesity paradox actually says that people in the “overweight” BMI category live longer and are healthier. So there you go. There’s no good science around these debates yet.

Body Image – The body image part was interesting. I talked to a lot of different experts on it. The consensus is really that body image is deeply ingrained and that we should be working on prevention more than anything else. The body project is a good example of that kind of early intervention.

I went to a ton of neuropsych panels that were fascinating, but I’ll metabolize them into a different and accessible post soon enough.

Eating disorders are notoriously difficult to both treat and understand, but people are working really hard to make it happen and to find help for those suffering. Fortunately many people have gotten to the other side of their EDs and recovery is possible. If you need help, please reach out, you can reply to this post, email me directly or go directly to NEDA or call 800-931-2237.

Overeaters Anonymous- The Good, The Bad & The Crazy

Does OA work?

“I don’t eat no matter what… “

or 

IDENMW as they say in certain OA circles.  

I have an extremely complicated history and relationship with Overeaters Anonymous, both as a clinician who treats eating disorders and as a past member. A lot of people ask me “Does Overeaters Anonymous work?” It’s definitely not black and white. It “works” for some but not for others- but you have to define what “works” means.  I want to share with you some of my personal history with it. 

 

My First Experience with OA

Back in the 1990’s,  when we were flannel clad teenagers, my friend Melissa and I sat in a field discussing when we would be able to go off our diets. We’d been drinking Diet Coke since our Bat Mitzvahs and trying to lose weight for longer than that. “Will we ever get there?” we wondered. Our mothers, both in their early 40’s at the time were still dieting. Thin, but dieting. Always dieting. When will it be done?  Doesn’t it seem like dieting should have some defined end? Like that you go on a diet for 6 months, lose your 10 pounds and then you’re not on a diet anymore? But no, we were always dieting, and our mothers- always dieting, and our mothers friends- always dieting and our Aunts and cousins and friends’ mothers – always dieting. It didn’t end.  And so when Melissa ended up dieting herself into a nasty bingeing and purging habit that lasted years, her therapist insisted that she join Overeaters Anonymous to cure her. “It worked.” I say it that way because it worked in the sense that she stopped bingeing and purging. She also finally lost the 10 pounds. Plus more. In fact, at 5’7″ she wound up weighing less than 100 pounds, losing her period and growing a nice coat of *lanugo all over her arms and legs.

I asked her if she was eating and she said, “Oh my god, I eat a ton! Lots of fat and oil and vegetables, and meat. It’s great.”

And then one day, after exactly 478 days of “abstinence”  she binged.

And it wasn’t just a binge- it was a binge that brought down the skies and the heavens and the thunders- one of biblical proportions where hours ran into days ran into weeks ran into months. She stopped answering her phone, she stopped leaving her house except at night to go to the 24 hour grocery store to buy binge foods, she stopped going to work and to school…  It was a binge that cost thousands of dollars,  that clogged her toilet with vomit and it was a binge that hit her with a force that felt unbeatable. She was crushing under the weight of it. She couldn’t stop bingeing, she couldn’t stop purging, she couldn’t stop running to the store to buy more binge foods. She put on 70 pounds in 6 weeks.  “Fuck,” she told me, *”I need help.”

That’s where her relationship with OA ended. Her friends and sponsor dropped her, she couldn’t get back to where she was and she hated herself. She wound up back in treatment but this time without OA. 

My next was sometime right after college.  Although I was no longer dieting, no longer restricting, no longer controlling my food, I still felt trapped in thinking too much about weight, body image and calories. It was making me crazy and I wanted it to stop. I longed to feel peaceful around food and embrace my body. A friend of mine who I respected enormously told me that she had found deep recovery in OA, that she no longer had any desire to count calories, hadn’t binged or purged in over a decade and really felt comfortable in her body. She said she just didn’t worry about anything food related. I wanted what she had. So, together, we went to her home meeting where she  introduced me to  my new sponsor, Kate. When Kate first met me, she looked me up and down, sneered and said, “you’re not fat, why are you here?” I explained to her that I wanted peace around food and my body image. I didn’t want to worry about calories and I was sick of unintentionally doing math in my head all day long- that it was stressful and I just wanted to be free. She gave me a food plan and she assured me that it would cure me but said that  I had to buy an electronic food scale, an electronic human scale, weigh and measure every morsel that I ate and call her at 6am each morning and report my weight and my food into her. I explained to her that I didn’t want to be on a foodplan and I didn’t like to weigh myself. She told me that this was the way that I could have the recovery that I wanted without being willful or being stuck in my disease. She said that the foodplan was the way out- but that I had to follow it perfectly otherwise it wouldn’t work. She told me that there was a line of people waiting to be her sponsee so if I didn’t want help and I didn’t want to recover and if I wanted to spend the rest of my life a compulsive overeater that it was fine, that I should leave.  I felt ashamed and embarrassed. Rather than finding a different sponsor (now I know) I  decided to work with Kate, because after all, it was the only way and she had lines of people behind me begging her to be their sponsor. She must be right. 

The first day on my meal plan,  I was so hungry that I ate an extra apple between breakfast and lunch. Kate scolded me and told me that it showed a defect of character. If I was hungry I needed to drink black coffee, black tea, diet coke or chew sugar free gum.  Each night I went to bed feeling starved, with my hands on my belly feeling my ribs for inspiration and saying “I don’t eat no matter what- I don’t eat no matter what…” as I tried desperately to go to sleep. My eating disorder hands and eyes were reactivated as I felt the outlines of my bones and stepped on the scale every morning. The obsession was familiar and it was easy. It was easy to get pulled back into that vortex. Only this time, my Eating Disorder wasn’t inside my head- it was Kate. I’d allowed her to be the voice of Ed- dictating my behaviors for me and shaming me if I went off program by taking a bite of a carrot while I was prepping my lunch – and sending me back to day 1. I felt like Sisyphus.

I drank gallons of diet coke each day and chewed packs of sugar free gum. My stomach swelled up from the aspartame and carbonation- I wasn’t able to run or swim or exercise at all- I found myself breathless,  my thought process was often slowed down and to be frank, I hated my sponsor.  It was this one day that I was sitting there and more than anything I wanted to put some milk into my tea. My stomach was so bloated and I was so hungry. I called my sponsor to tell her how stressed out I was- how I wanted to go for a run but I had no energy, that I wanted to hang out with my friends but they were going out to a cafe and I couldn’t sit around all that latte’s without wanting one,  that I was depressed, that I hated the way I felt. She told me that I should be grateful for being abstinent, that I shouldn’t think about running or socializing or exercise, that it was the time to figure out my food shit, to go to a meeting, that my complaining was showing a defect of character. I just wanted to put some goddamned milk in my tea. And that’s when I realized it, this group was insane and it was driving me crazy as well. I knew that putting milk in my tea wasn’t worse than drinking liters and liters of diet coke a day. Yet in this sect of OA- putting milk in my tea meant I had a character defect, but drinking liters of diet coke every day was okay- chewing gobs of gum was okay.  Honestly – there wasn’t much payoff for me- Besides an initial couple of pounds, I wasn’t losing much weight at all- which in retrospect, I understand was a good thing- my body was at a healthy weight and my metabolism had slowed way down to compensate for the restriction of calories- the numbers in my mind had only gotten worse. I called Kate and told her that was leaving the program that moment.

Being an OA drop out was a no-brainer for me. But it’s not like that for everybody. 

I have seen people go in and lose 100’s of pounds for the first time in their lives- and then feel like they owed that organization their life. But when they decided to go off plan or put weight back on (which lots of folks do) all the people who supported them, the most important people in their lives turned their back on them, shamed them. Made them feel like they were bad people. Because they ate cake or because they wanted something different. I’ve seen women who haven’t had periods for years- and have that be supported by the group, with many women telling them, “yeah, that’s normal, nobody here gets their period…”  In some cases of OA- eating disorders are supported and it just becomes a huge support for ED under the cloak of recovery. 

And that’s part of what makes OA so confusing. 

My next experience with OA was when I was a graduate student in Psychology learning how to treat Eating Disorders. I interned at an Intensive Outpatient Treatment Center for women with Eating Disorders. The protocol was that every client needed to go to 3 OA meetings a week- no arguments – or they were out of treatment. It was rough. Although many clients were  getting amazing recovery, finding lots of support and fellowship in the rooms,  some were feeling traumatized, pained and so wounded by the program, but they couldn’t leave otherwise they’d be kicked out of treatment and then where would they go? It was definitely extremely difficult to watch and be a part of. I knew how wounding OA could be and I saw that their choices were being taken away from them. Sometimes in recovery, taking away choices is liberating- that way the patient has nothing to focus on except themselves, but other times it is extremely harmful. No two people or recovery stories looks the same so you have to find what works for you – for your mind, body and spirit wholly. 

My own personal experience with OA had really skewed my feelings about the fellowship. The problem is that Overeaters Anonymous tells people how to eat and teaches them not to trust their instincts. And that’s really the concept that they are coming from, “you are a compulsive eater and so you can’t trust your instincts because your instincts will always be to overeat.” This is a cognitive distortion known as emotional reasoning.  You believe something to be true and so it is.

“Whether you think you can, or you think you can’t–you’re right.”
Henry Ford

You believe that you cannot stop after one bite of chocolate – or that if you eat flour or sugar- it will lead you to binge eat and you’ll never be able to stop, so the best thing to do is not eat it at all. This belief triggers black and white thinking for most.

In OA- where people count days of “abstinence” from their drug of choice (food), they have to start their day count all over again if they eat even a cracker or a slice of white bread. So, let’s say you were in OA and you had 100 days off of sugar and flour. Then one day you had a small bite of birthday cake. You would have to start on day one the next day- so you ruined your abstinence already- why wouldn’t you go to the store and buy a gallon of ice cream and cake- you’ve ruined your abstinence and have to start on day one tomorrow anyway. OA is a huge setup for binge eating. They will tell you that you cannot eat birthday cake because it will trigger a binge for you. You then believe that one bite of sugar will trigger a binge for you and so it does. And it should because your belief is that your day count is ruined and after today you won’t be able to have any cake again, so you might as well binge on all the cake you can. See what I’m getting at? Certain sects of OA keeps people in huge diet mentality and shames them (it’s a defect of character) if they eat off program. It’s a self-fulfilling prophecy. You think that one bite of white bread or a bite of birthday cake will lead to a gigantic binge and so it does- and all the parameters for that to happen are set up in the OA infrastructure.  And then, a binge eating habit or disorder gets activated.

I’ve had hundreds of clients over the years come in both damaged and traumatized by groups like OA, Greysheets, HOW, and Food Addicts Anonymous. They are in a place where they can’t stop bingeing and they are feeling shamed and angry at themselves. They just want to get their abstinence back- but they can’t. They can do 10 days or 2 weeks – but they seem to just not be able to get to that multi-year abstinence that “everyone else” has. Oh yeah, that’s the other thing- they somehow believe that they are alone in their struggles with OA.  They believe that they are the only ones and that they are bad. The feel ashamed. OA then becomes their own inner critic and often takes the place of their own over-critical parent.  It’s retraumatizing. They’ve given their own inner critic an office and a team. And the worst part is feeling totally alone, without your tribe, your village.  If you are someone who feels  this way, you are not alone. I see multiple OA/FA drop outs each year who have scars and trauma from the fellowship, who have been rejected by this “family” because they cannot get their abstinence back. You are not alone. If you are not comfortable with the group and you have an instinct that something is wrong, their probably is. 

But is there any good to OA? 

YES! Definitely. OA is a fellowship where you can find other folks struggling with the same issues that  you are. One of the best things that you can do for recovery is get support and OA definitely has support. There are some amazing OA groups out there- where you will find smart, kind people who want to help you recover spiritually and not make it all about the food.   There are some people who have life long amazing recovery in the rooms.  Though I’ve seen people find pain in OA, I’ve also seen people find amazing recovery. There are some really amazing fellowships out there that don’t rely on food plans, or rigid rules. You have to find what works for you. As they say, take what you need and leave the rest.

If you want to find some recovery in OA here are my suggestions- this is what I’ve seen that really helps people recover in OA.  

1. Don’t define your abstinence as abstinence from a food. Define it as abstinence from a process. For example: Abstinent from obsessing about food and calories. Abstinent from dieting. Abstinent from bingeing. But never abstinent from flour or sugar or anything like that. That puts you right back into diet mode. 

2. Find a sponsor who will work on you with your steps – but not with a food plan- don’t call your food into anyone. If you need a food plan for recovery- please see a registered dietician who specializes in treating eating disorders. Find one here or here.

3. Find like minded people who report a recovery of self love, kindness and  a mind body and spirit connection. Try to stay away from the weight loss and dieting parts of OA. 

4. Go to several different meetings until you find one that really resonates with you. 

5. Consider eating disorders anonymous as well. Their principals are more aligned with eating disorders as a process and dieting as part of that process.

6. Understand that everyone is doing the best that they can– have compassion for everyone around you and honor their process. Don’t judge people’s choices in OA nor their relapses, it’s always important to have oodles and oodles of compassion for yourself and for those around you. Honoring your own process might mean that your needs change at different times.  

The situation is not black and white. There are many people who have found complete peace with food and their body image in OA- however there are as many who have not. If it feels right and good and your are happy- stay. But if it feels bad – listen to your instincts. You have everything you need inside of you to know what you need. 

Articles about OA worth reading.

Why OA Doesn’t Work

Why I left Overeaters Anonymous

Inside Overeaters Anonymous

Power, Control, & Overeaters Anonymous

How Overeaters Anonymous Saved Me

Using OA after Bariatric Surgery

 

 

*Lanugo is soft light blond peach fuzz that grows on women who have anorexia

*After years of treatment, both in patient and therapy- her bulimia is in full remission, she is on the other side of recovery and she’s a successful surgeon.

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

Why Do We Really Diet?

Dieting hasn't made Kathy any happier, and she's been doing it for decades

Dieting hasn’t made Kathy any happier, and she’s been doing it for decades

The obvious answer is “to lose weight.”

But is that really, really true?  I don’t think it is.

Think about it, when do you start a diet?  Usually it’s after you’ve had a particularly bad day or week or month or you’ve seen a photo of yourself that you don’t like or someone makes a comment about your weight, or you’ve gone clothes shopping and things don’t fit the way you hoped they would, or you’ve broken up with someone…  Or anything that caused you to feel bad.  So, then you thought, “I’m going to start a diet on Monday…” and you chose the diet you were going to start, thought about what foods you were going to eat and were not going to eat and instantly you felt better.

Why? Why did the thought of going on a diet make you feel better?

Because in a time in your life when things around you felt totally out of control, this felt like a way that you could gain some control. And then you felt on top of things rather than underneath the weight of the world.

Dieting is a method that people use to feel as though they have some control. And how long does that last? Usually until you go out to eat or wind up at an event and think, “well just for tonight… then tomorrow I’m back on my diet.” And just like that, you’ve believe that you’ve lost control and you feel bad about yourself. Or worse, the diet controls you. You go out and rather than enjoying your time out, you feel obsessed with staying away from the food you want to eat and then you just can’t stop staring at other people’s food or thinking about what other people are eating or what they weigh or what you weigh.

Does any of this resonate for you?

So how do you gain control and feel better without using dieting? How do you get back on top when you feel that you are underneath the world?

A lot of it is about accepting the place that you are in without trying to make it go away. For example, “Oh, these jeans don’t fit me… I’m so fat, I need to go on a diet so I can fit into these jeans…”  Instead of that saying to yourself, “I’m going to find a pair of jeans that I am comfortable in and make me feel good, I’m not going to let these jeans dictate how I’m supposed to feel about myself and what I’m supposed to do with my time…”  or “I just broke up with my partner and I’m devastated… breakups are terrible and difficult and it’s okay for me to be in pain.”

Being in acceptance of your situation without trying to make the feelings go away is so empowering. It gives you permission to be in your life and be in your feelings without trying to avoid your life and avoid your feelings by dieting.

The next time you are tempted to start a diet, think about what you are trying to accomplish, what feeling are you trying to make go away? (Fat is not a feeling! It’s a description). Is it insecurity? Loneliness? Anger?

This doesn’t mean that you have to sit and dwell on feeling bad, but the irony is, when you accept what is, it makes space for change. Rejecting and not looking at what is real keeps you stuck in it.

Make a Pact to Detox from Looksist Gossip

don't let the media inform you how you're supposed to feel about yourself.

don’t let the media inform you how you’re supposed to feel about yourself.

Can we make a pact? I just did something that made me so mad, and I don’t want to do it again, so I wonder, will you make a pact with me not to support a media that exploits other human beings as a means to achieve their own ends?

This is what I did. I clicked on a link that said something like “14 Famous Celebs with Terrible Teeth.”  I’m not going to link to it.  And for some reason I started clicking through it and it made me angrier and angrier and angrier. Why? Why would someone just make fun of someone else (someone more famous and more accomplished than they are) just to get clicks and to get traffic? Why?  I guess because people click on those kinds of things.

But can we stop? 

 

Because I’m sick of people making money by making fun of other people. And I’m sick of people (celebs and non celebs alike) feeling insecure and ugly and not good enough because it’s somehow socially acceptable and even encouraged to trash on people’s appearances.

So can you join me and vow not to click on links that are purposely defaming people based on what they are wearing, how fat (or skinny) they’ve become, how much they’ve aged, what kind of bad plastic surgery they’ve gotten or whatever else they are gossiping about?

It’s up to us to change the way we are valued by choosing carefully what we pay attention to. And clicking on something is powerful. Choosing not to is more powerful.  When we choose not to click, we keep ourselves safe by not engaging in toxic looksist gossip. We might not be able to put an end to this type of cyber bullying but we may be able to feel better by not engaging in it. We disengage from a paradigm that is critical of ourself and of others.

If we want to really support our own positive body image, we have to stop supporting a media that devalues people based on their outward appearance. So can we make a pact? Can you “sign” this by putting a note in the comments vowing not to support a media that devalues women and men based on their appearances, and pass this along encouraging others to  vow to not click on those mean links.

Photo Credit to endlessorigami.com

Ten Myths About Binge Eating Disorder

Ten Myths About Binge Eating1. All binge eaters are obese

Completely untrue. In fact most of the people I see in my practice are considered a “normal weight.”  Food is their drug and bingeing is something they do in private and something people will go at lengths to hide, including maintaining a normal weight. In fact, I’ve  had clients who were downright skinny but who binged on food often and felt completely out of control with it.

2. All obese people are binge eaters

Actually, binge eating affects 8% of the obese population. Which means that 92% of obese people are NOT affected by binge eating.  In fact, despite the media’s belief that all fat people are unhealthy, there are many, many people who are both fat and fit. 

3. People who binge eat need more will power and self-control

People who binge eat usually have incredibly amounts of will power and self control. And though this is not true for every binge eater, for the most part, people who binge eat tend to be extremely high achieving and controlled in many aspects of their lives, including controlling their food. It’s this control that tends to sometimes backfire causing an all out rebellion against  the person’s inner critic. What a person who binge eats actually needs is more self compassion and support, not more rules and self control. Learning to support oneself in a positive way, not in a pejorative way will empower the binge eater feel more comfortable around food and less likely to be overpowered by an all out binge.

4. People who binge eat purge by vomiting

Not everyone who binge eats purges by vomiting. Some people compensate by over exercising, some compensate by fasting, some compensate by dieting, some compensate by taking laxatives, and some don’t compensate at all.

5. Binge eating is a bad habit and not a true disorder

Binge eating is more complex than simply a bad habit, it’s actually an impulse control issue, although it is not technically classified as and impulse control disorder.  However, using similar techniques as are used in certain other ICDs (like compulsive shopping) binge eating can be healed.  I’ve seen wonders done with DBT and mindfulness training.


6. Men don’t binge eat

Actually, Binge Eating Disorder affects 2% of men.  However, men don’t tend to get help as often as women. In fact, it’s stigmatized as a woman’s issues, so men tend to shy away from support and feel that they have to just stop or do it alone. In his blog about healing from binge eating, Alan Standish says, “Guys, Binge Eating Disorder affects us just as much as it does women. Don’t be embarrassed.”

7. Binge eating is incurable

It’s really not as grim as it’s made out to be. In healing from binge eating, you really heal your life in so many different ways. You become more organized in your thinking and more thoughtful and mindful. You can come to a place where you are able to let go of your feelings and fears about food. Food becomes nurturing instead of the enemy. I’ve seen it happen over and over again with my clients and that has certainly been my own experience.

8.Binge eating is caused by chronic emptiness

Just because you are binge eater, it doesn’t mean that you are broken. It doesn’t mean that you have a bottomless pit that you will never fill. However, having binge eating disorder can feel hopeless and you might feel as though you are totally out of control and a total mess. But you’re not. You need support, you need compassion and you need some help to get you passed it.

9. Drinking a glass of wine can help curb binge eating

Sometimes people will have a drink in order to calm down the urge to binge eat. But it often backfires. This is what I call “the solution becoming the problem.” If you drink to feel more in control, your problem might then become the drink. And more often than not, people wind up bingeing if they have drank too much- if not that night, then certainly the next morning to deal with a hangover and the shame that often accompanies it.

10. Quitting carbohydrates can help stop binge eating

No. It doesn’t. It really doesn’t. I’m very much a proponent of eating whole foods as much as possible and eschewing processed foods for the most part. So, eating lots of foods out of a box, probably not the best idea for overall health, however, unless you have sugar issues (as in hypoglycemia or diabetes)- it is not advisable to give up fruits and vegetables- even yams and potatoes. Your body runs more efficiently when you are eating a variety of whole foods. If you wind up on a very low carb diet, it’s likely that you might find yourself bingeing on carbs. It’s not because you have no lack of control, it’s because your cells are screaming for glucose and your body will push you into getting what it  needs for survival!

How to Support National Eating Disorder Awareness Week

 

large_The War On Women's BodiesIt’s that time again! National Eating Disorder Awareness Week. 

What is NEDAwareness Week and why is it important you ask?

I’m glad you asked.  Bringing focus to eating disorders is more than just showing support for those who are struggling with anorexia, bulimia and binge eating disorder.  The intention here is to show just how pervasive eating disorders are and how much support there is for eating disorders in our culture. Yes, eating disorders are supported, not recovery.   You can see it everywhere. You can see it when you turn on reality television, you can see it in a yogurt commercials or cereal commercials when you are encouraged to give up a meal and replace it with this artificially flavored yogurt or processed cereal to lose weight. You are supporting eating disorders when you sit around with people and talk about how fat you are and what your next diet is or when you start to discuss someone else’s weight gain or weight loss.  All of this behavior supports eating disorders by reinforcing the idea that you are not okay as you are, that you have to do something dramatic to change yourself.

How can you support National Eating Disorder Awareness?

1. Choose not to engage in Fat Chat– that means, don’t base a friendly conversation around how much weight you need to lose or how much weight others need to lose or who looks like what right now. You have better things to do with your time and more important things to discuss. If someone tries to engage you in their own conversation about their body or someone else’s body, be kind and explain to them what you’re trying to do, “I’m trying this new thing where I don’t speak disparagingly about my own body or anyone else’s. And I don’t want to engage in any negative conversation about your body. My hope is to change the conversation and society’s focus on women’s bodies. Are you onboard?”

2. Don’t buy women’s magazines, especially diet magazines that are disguised as health magazines.

3. Check out NEDA’s How to page– to help you support eating disorder recovery

 

Friday Q & A- Help, I’m obsessed with food

eating disorder therapyQuestion: Help! I saw your blog and realized that a lot of my odd habits have to do with my unhealthy association with food, but I do not know how to stop it. I am constantly thinking about food, looking for food, and seeing where I can get free food. When I’m at work, I look for places where there is free food available, even if it is not on my floor/department. When there are samples, I can’t help but take more than one. I sometimes even go to places like Costco, just to get the free food samples. At times I have fallen so low as to “try” other people’s food from the fridge without asking. I managed to stop this for a while, but now I have started to feel the urge again.

How do I stop these embarrassing habits? Part of it has to do with the fact that I love to try new things, and a little of different things. Also, I’d like to “sample” some items, but know I don’t want to buy the whole container of it to take home.  However, a part of it, I know deals with the fact that I don’t allow myself to eat some of these foods, like take out, because it is not good.
I feel like these habits have started to interfere with my life, and don’t know how to stop exactly. Any advice would be appreciated.
Thank You,
Nadia
Answer: Hi Nadia, thank you so much for your question. I feel for you. It sounds like food obsession is taking over your life and your mind.
I imagine that there are a few things going on here. The first is that you have these big conflicting emotions about food. One is excitement and curiosity– but the other is fear. So you allow yourself to find ways to keep food limited for you. You don’t trust yourself to set your own limits, so you find places to that will set those limits for you. You go to places where there are free samples so you don’t have to deal with setting your own limits.
The other thing that I am thinking is, I wonder what you would be thinking about if you weren’t thinking about food? Is there something else that’s going on that you might be avoiding? Is obsession with food helping you to look toward something easier than what is really going on?
I think that the answer for you is two-fold, first to practice limit setting and second to figure out what it is that you’re avoiding. For instance, find a safe person and tell them that you are experimenting allowing yourself to buy and eat new foods in a healthy way. Then, think about what it is that you’re wanting to eat. Is it a pretzel? Can you go out and buy a pretzel and bring it home and eat it very slowly, mindfully and allow yourself to enjoy it? Can you stop when you are done? I recommend that you have your safe person there with you so that you have someone to talk to if you feel like bingeing or if you feel out of control. You might want to try a mindful eating download.
When you find yourself obsessing or scavenging for food, ask yourself, “what might I be avoiding? Is there something underneath these thoughts of food that I’m thinking about or needing?”
I do think that eating disorder therapy would be super beneficial for you to help you explore these questions. Check out edreferral.com for a therapist in your area. 
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. Are you interested in online therapy to deal with your eating disorder? Please see my website or email me to discuss getting started. 

10 Reasons Not To Diet

With much love and credit to the nearsighted owl. http://www.nearsightedowl.com/

With much love and credit to the nearsighted owl. http://www.nearsightedowl.com/

1. Dieting is a temporary state of deprivation and therefore an ineffective way to lose weight. As soon as you return to your normal eating habits, you will regain the weight.

2. If dieting was a solution to a problem, most people would only ever have to diet one time in their lives ever. But it’s not.

3. Dieting makes you grumpy and unpleasant.

4. Dieting turns people without binge eating issues into people with binge eating issues.

5. Dieting takes your mind off of more important pursuits of life and turns you into someone hyper-focused and even obsessed with losing weight.

6. Dieting can cause you to stop doing things you used to find enjoyable, such as spending time with friends or at social events because you dread being around non-diet friendly foods.

7. Diets teach you to measure your worth in terms of numbers on the scale, calorie counts and grams of carbohydrates instead of nurturing the lovely person that you are.

8. Diets force you to reject your current life and look toward a different life that you might never have. They cause you to wait to live your life with passion until you are thin. You don’t have to wait, you can choose be happy now.

9. Diets can drain you financially, especially if you’re constantly spending money on new diet books, or diet foods or special foods or training programs.

10. Diets can set you up for self-esteem issues. Because they are a set-up for failure for 98% of the people who diet, each time a diet doesn’t work, it causes you to evaluate your self worth according to a system that is set up for you to fail.

 

What should I do instead?

Think about making a lifestyle change and just make one small change a week. For instance:

Week One: Add a fruit to your breakfast each morning.

Week Two: Add a salad or a vegetable to your lunch each day.

Week Three: Cut down from 3 sodas per day to 1 sodas per day and substitute with water.

Week Four: Take a walk each afternoon after your lunch.

etc.

 

Make it work for you and your schedule. Think about what you could do for the rest of your life and each week add one small thing to make that change sustainable. Slow methodical change is the way to make change last a lifetime. Sudden unsustainable change is the way to set yourself up for failure.

Check out this old post, how can I lose weight without dieting? 

Need help to stop dieting? Try this hypnosis session to help you stop dieting and start eating intuitively. 

 

CREDIT TO THE NEARSIGHTED OWL FOR PHOTO.