Continue reading »]]> What exactly happens when you go to therapy to heal from an eating disorder? What is therapy anyway?

This is the first of a series about different levels of treatment.

Unfortunately, most people who suffer from eating disorders don’t get treatment, either because they don’t have the money, the time or they feel that they should be able to heal from eating disorders all on their own, or that their particular issue isn’t severe enough to warrant treatment. What is important to remember is that it’s always okay to get help. Your eating disorder thrives in isolation and reaching out and getting help is what will heal it. Trying to work through it alone often perpetuates the issue. It doesn’t have to get to the point of totally unmanageable before you ask for support. You don’t have to hit bottom. You don’t have to be vomiting all day long, or starving yourself down to nothing or eating constantly all day to get help. It’s really common for someone to come in and feel embarrassed that they’re asking for help because they feel that they’re “not sick enough” or even “not skinny enough” to qualify for an eating disorder. If food feels hard for you, if you find that you’re simply overthinking eating, if you’re uncomfortable in your body, or you just want someone to talk to in order to suss out your situation  and figure out if you even need help and what kind of help you need, it’s okay to call someone. Going to therapy or to treatment doesn’t mean you’re crazy or that you “need help.” Therapy is a place for you to take care of yourself. It gives you time and space to think about your needs and to act on them. It’s a way to take care of yourself.

You can choose to see a Psychologist (Psydoc), a Licensed Social Worker, (LCSW), a Licensed Marriage & Family Therapist, (MFT) or a Licensed Mental Health Professional (LPC) or a Psychiatrist (MD).  Psychiatrists are the only ones who can prescribe medication, but many psychiatrists don’t do counseling. If you need meds, your therapist will usually consult with your psychiatrist, so that you are getting med management one place and therapy elsewhere.

Before a therapist becomes licensed, she or he must see patients a certain amount of hours (usually 3000) and then take some exams in order to be licensed in their state. This process can take anywhere from 3-6 years after finishing from graduate schools. Before getting licensed, these interns are supervised by licensed professionals while seeing clients. If you would like to see an intern, they usually charge much less than those who are licensed.

When you go in for eating disorder treatment with a therapist, they will often want to treat you along with a nutritionist and sometimes a psychiatrist.

So what happens in therapy? That’s difficult to say. First off, a therapist will not fix you. Therapy isn’t a magic cure, but it’s an open space that gives you the opportunity to think about your situation and strategize ways to improve it. There are a million different ways that therapists work to heal eating disorders. My own personal brand of therapy is eclectic integrative, which means I draw from many different modalities of psychotherapy to create  my own brand. I most often utilize a mixture of psychodynamic therapy  - which is more of the classic Freudian approach- where we discuss your family dynamics and past events in your life and how they have contributed to your current ways of existing in the world. This is incredibly helpful because it makes the unconscious conscious. It allows you to understand why you are behaving in ways that you’re behaving rather than purely reacting as you always have. It gives you some perspective and the ability to step outside of yourself so that you can make better choices about your behaviors. This goes well with cognitive behavioral therapy- which then takes your unconscious that you have now made conscious and enables you to make a choice by giving you options of different ways to think about your situation and react toward your situation. I also utilize somatic therapy and mindfulness which both make you more aware of the feelings that you are holding in your body so that you can work with the actual feelings that you are having rather than hiding from them by acting out with food. I also utilize hypnotherapy which is another way of increasing mindfulness and making you aware of your behaviors and the choices you have.

When you start with a therapist you will begin by education your therapist about your specific eating issues, how long you’ve been suffering, what your behaviors are and the severity of them. They might take your weight and find out how many times a day, week, or month you’re bingeing or bingeing and purging. Understanding the severity of your eating disorder is key to understanding what kind of treatment you will need. You might need weekly therapy sessions as well as sessions with a nutritionist and/or group therapy and a psychiatrist, or weekly sessions might be enough. It’s also possible that  you might need a higher level of care, such as an IOP, a PHP, residential treatment or hospitalization. But your therapist can help you to assess that. Sometimes, if you don’t seem to be on track with your healing, you might need a higher level of care as therapy goes on.  With eating disorder treatment, the first course of action is working to reduce the behaviors, as those decrease, you then begin to work on the feelings or the issues that trigger the behaviors. Often, as the symptoms decrease, challenging feelings increase.  I personally believe that it’s very helpful to stay in therapy after the symptoms (eating disorder behaviors) end in order to work deeply on the underlaying issues. This helps to prevent relapse and also helps you to continue moving forward in your life and achieve the things that you couldn’t before because your eating disorder was taking over.

To find a therapist who treats eating disorders, you can look on ED referral, Something Fishy, or  NEDA.

You can also search on Good Therapy or Psychology Today. Look for someone who specializes in treating eating disorders.

It is possible to find low-fee therapy. You might want to call a University near you that probably has students and interns in counseling centers. You might call a local hospital or mental health agency. If that fails, call a local therapist who probably knows where to refer you go.

Next up: IOP (intensive outpatient treatment)

Continue reading »]]> Here is a quick little round up of different ways to heal from binge eating. Several of these tips are longer posts in other parts on this blog, so you can bookmark this page and come back and read more when you are ready or just go through the tips quickly. Enjoy!

1.)Eat a balanced, healthy breakfast with protein every morning. Starting your day off with a solid meal will stave off hunger and mindless eating during the day that can trigger binge eating.

2.)Give up Dieting. Diets actually cause binge eating. Instead begin to adapt healthy eating patterns by adding a healthy habit instead of subtracting a kind of food or food group.

3.)Get Support. Binge eating is a disease of isolation and secrets. When you attempt to recover in private, you perpetuate the isolation that drives the disorder. Getting support helps you to be accountable and helps you to talk it out with other people who are going through the same issues. Good places to go to for support: A therapist, a 12 step group, an online support forum, online or telephone meetings.

4.)Don’t let yourself get very hungry. When you let yourself get very hungry, your blood sugar drops which in impairs cognitive skills. Your body just needs glucose and it needs it now, so instinctively, you will start to grab for anything you can to raise blood sugar. Instead, use the hunger and satiety scale to help yourself eat what your body needs.

5.)Learn intuitive eating. This is the opposite of dieting, where your body is the wise one that lets you know what, how much, and when you need to eat. Your body wants to be healthy, so learning to listen and respond to it, will help you to find peace with food and with your body.

6.)Exercise Daily. This doesn’t mean spending arduous hours at the gym or running 5 miles a day. This is about moving your body. The more you move it, the more aware of it you are, and the better you begin to treat it. This can mean anything from 30 minutes of walking each day, to doing yoga, or going on a jog, or lifting weights or even just window shopping. But moving and being out in the world is crucial. Need some motivation to exercise? Try this. 

7.)Learn Mindful Eating. Mindful eating is the act of slowing down and actually noticing, tasting and being with your food. Mindfulness is about being in the here and now. Binge eating is about chasing the taste. You don’t necessarily taste your food when you’re bingeing because your waiting for the next taste, the next bite, and this hunger is insatiable. When you incorporate mindful eating, you learn how to stop and interrupt a binge. Mindful eating is peaceful, yet it is an amazingly effective tool in fighting binge eating.

8.)Add more protein. Nutritionally, protein will feed your brain, keep you feeling fuller longer and it will help your brain to function better so that you can make better choices about what kinds of food to eat.  This doesn’t mean eschewing carbohydrates, but eat your protein first so that you can make better choices about the next bite.

9.)Set a timer. When you feel the urge to binge, set a timer for 20 minutes, in that time, do something different other than binge. Let yourself know that you can binge if you still want to in 20 minutes. Often the very act of interrupting the compulsion will stop it.

10.)Mediate. Daily meditation will help you to slow down so that you can think about what you’re doing. You don’t even have to do it every day or make a big deal about having a practice. You can spend a few minutes each day breathing. Even in the middle of a work day, you can escape to the bathroom, close your eyes and breath for a few minutes to help slow down and ward off stress. You might want to download meditations to stop binge eating.

11.)Eat by the clock. If you are too entrenched in binge eating, the when part of intuitive eating might be difficult. So, at the beginning, when you are first starting to recover,  you might want to set some parameters around when to eat. Example. Breakfast 8am. Snack 11am Lunch 1pm. Snack 4pm. Dinner 8pm. Or whatever feels right for your. Don’t forget to include at least three meals per day.

12.)Give Up Diet Coke.  A lot of people who suffer from Eating Disorders are addicted to Diet Coke. There are some theories that postulate that diet drinks cause weight gain. That may or may not be true. But what is true is that many binge eaters attempt to substitute food with diet soda. This causes bloating, discomfort and lethargy, all of which contribute to body disconnection making  binge eating more palatable.

13.)Remind yourself “I can always have it later.” Because binge eaters view food as so black and white (this is a special occasion, I have to eat it now) they tend to justify their binges. Just because it’s Thanksgiving doesn’t mean you have to eat Pumpkin Pie. Seriously. You will not stay up all night regretting what you chose not to binge on. This isn’t the last time that you can eat ice cream, it’s not black and white, it’s not all or nothing, that pumpkin pie will always exist. But do you need it right now? Can you have it tomorrow instead? Think about what your body needs in the moment.

14.)Know your triggers. Does going to the movies make you binge on popcorn? Does Halloween make you binge on Almond Joys? Does going to your parents house make you binge on bread? Does looking at facebook cause you to binge on candy? Does looking at fashion magazines cause you to binge on pasta? Get to know why and when you binge and intercept these events at the pass. Find ways to deal with the binge before it happens. For instance, if you know that going to the movies causes you to binge on popcorn, get there without time to go to the concession stand.

15.)Get more sleep. Being tired can cause binge eating. Again, being more cognizant and mindful of what you are doing can help you to extinguish these behaviors.

16.)Treat yourself with Love. Remember to do nice things for yourself at least once a day. This could be showering, taking care of your nails, your hair, your skin, making your bed.  Being self nurturing will remind you of your own value so that you can feel better about yourself.

17.)Don’t compare yourself to others. You have your own path and your own dharma. Comparing yourself to others takes you off your path and stunts you. Try to look forward and move forward on your path rather than stopping yourself by looking longingly at other people’s paths.

18.)Be kind to your body. Learn how to love your body.  Don’t say mean things to your body, don’t call it fat. Don’t engage in fat chat with other people. Don’t bond with others by discussing how fat you are or what different diets your going to go on. Don’t talk about other people’s bodys’ no matter what they look like.

19.)Learn how to fight the urge to binge eat. Remember that wanting to binge isn’t enough of a reason to binge. Even if it feels overhwhelming. Remember that you are stronger than the urge to binge.

20.)You are not perfect. If you have a slip, just start again. You don’t have to wait for the next day, you have millions of moments to start over. Start over immediately. Wash your hands, wash your face, take a shower and just recover from the binge. You can do that in any given moment.

Continue reading »]]> One of the really challenging things about recovery is being out in the real world,  around other people who either aren’t aware of or working on healing their disorder, or who don’t actually have a problem with the behaviors that you must stay abstinent from.

Some examples:

A bunch of people (presumably men) get together for a bachelor party and, as is traditional with American bachelor parties, they go to a strip club. But let’s say one of those men is a sex addict and one trip to a strip club has him spending the next several weeks going to strip clubs daily, spending all his money, ruining his relationship, and feeling unable to stop.

A group of ladies go out to Sunday morning brunch and all order Mimosas with their omelets. One women has a problem with alcohol and after brunch spends the rest of the day at bars drinking,

A woman has spent the past few years recovering from anorexia, bulimia, and compulsive exercise. She moves into a new apartment with a roommate who eats very little and exercises constantly. She begins to think that she should be stepping it up on her exercise and reducing her food intake, this then triggers a binge-purge cycle for her and she relapses into her eating disorder.

Recovery is hard. And when you are surrounded by people who have behaviors that trigger your own very dysfunctional behaviors, it can seem impossible. You might begin to feel angry and resentful. You might begin to wonder why it is that other people can do these certain things, but yo can’t. You might feel that it’s unfair. You might even begin to think that their behavior is normal and that it’s okay for you to do the things that you had spent so long trying not to do. It’s a trap.

If you are allergic to mangoes, you cannot eat mangoes no matter what. Even if you are at a party and everyone else is eating mango and talking about how great the mangoritas, and the mango salsa, and the fresh mango juice is, you cannot go near those mangoes because your throat will close up, you will break out in hives all over your body and you will wind up in the hospital being pumped with epinephrine.  Are you resentful of those who can enjoy mangoes?

That’s the way you need to think of your eating disorder. “I just cannot go there. I know that everyone is sitting around eating Halloween candy, but if I eat a couple of Almond Joys, I will spend the rest of the week bingeing, possibly purging, and being depressed. It’s just not worth it. Just because she can doesn’t mean I can. I’ve been there before and I don’t want to go back.”

The best way to deal with this kind of pressure is to get support from those trying to heal themselves. You cannot kid yourself into thinking that because everyone else can handle it (supposedly and you don’t know what others are dealing with) that you can. Don’t let yourself fall into that trap.  It’s so easy to become resentful and angry. That’s okay and it’s normal, but don’t allow yourself to get pulled into the false belief that because others can diet, can snack on Halloween candy, can drink a glass of wine with dinner, can look at porn (whatever!) that you can. You are a perfect individual with your own individual issues.

When you find that others are triggering your issues, it’s important to either extricate yourself from the situation or to grab some support. For example, you’re at a party and you get into a discussion with a woman who begins to tell you about her latest diet. You don’t have to engage. You can excuse yourself from the conversation. You can change the subject, or you can even say, “I don’t believe in dieting,” or you’re at a party where everyone is overindulging in food and alcohol and you find that your self control is running out. Leave the party. Or find a private space and call someone else who is in recovery so that you don’t feel so alone.

Remember, everyone has their own issues, and just because people can seemingly do things that you cannot, doesn’t mean you have to give it a try. You know yourself the best. If going to an all you can eat buffet will hurt your recovery, don’t go. If you are being triggered, leave the situation and get support. If you can’t beat ‘em, don’t join ‘em. Leave ‘em.

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Your eating disorder might feel like a tyrannical dictator, telling you what to eat, what not to eat, pushing you to give in to obsessive cravings, pushing you to purge, pushing you to starve or restrict, but for many  people, that voice is actually a scared little girl (or boy) living inside of you, dressed in adult clothing, trying desperately to get their needs met.

Often, in eating disorders, there is a child inside of you who didn’t get his or her needs met when they were little, perhaps she or he was ignored, or yelled at or abused, perhaps kids at school were mean to him or her, or perhaps she or he was part of a very large family where it was hard to get the attention he or she craved.

What did you desperately need, that you didn’t receive enough of when you were a child?

What helped you then? Was it food? Did you ever use food to make yourself feel better when you were lonely or picked on or ignored? Or did you get attention for not eating? Did you get attention for being the best athlete or the skinniest?  Did putting on weight give you attention?  Did your parents give you food to keep you happy when you weren’t getting enough attention from them or when they didn’t have time to give you what you what you needed?

This can be variable for everyone. But the most important thing is to think about that child who still lives inside of you and desperately needs something from you. Now think about what you would actually give a child who was needy right now. Would you give her a piece of cake if she was sad? Would you tell him to shut up and toughen up and stop crying? Would you sit with her and hold her and give her the attention that she needs? Try to give your child self what he needs. Try to send some compassion to the part of you that feels very angry and mean, but is just trying desperately to get her needs met.

Think about what you needed as a child but you didn’t get. How can you give it to yourself?

Continue reading »]]> Here’s a quick recovery exercise for you. Rather than thinking about weeks or months or years ahead of you, each morning set just ONE DAILY INTENTION.

Wake up in the morning and before you do anything, before you get out of bed, before you brush your teeth, think about what your intention for that day is. Just choose one. Think about it, visualize it, see yourself achieving it and hold onto it for the day.

Ideas for daily intentions.

• I will eat slowly and mindfully today. I will let myself eat when I’m hungry and stop when I’m satisfied. Just for today.
• I will go just for today without binge eating. Just for today.
• I will go just for today without purging. Just for today.
• I will not compare myself to anyone else today. Just for today.
• I will not say mean things to myself today. Just for today.
• I will drink 8 glasses of water today. Just for today.
• I will refuse to engage in aggressive driving or road rage. Just for today.
• I will floss my teeth before bed. Just for today.

Write it on a post it note and post it on your desk at work or your computer, or in your purse or wallet so that you can remember that one intention for the day.

Each day day that you set and stick to an intention will help increase your confidence, self esteem and help you on your road to recovery.

What are some of your daily intentions?

Continue reading »]]> This question comes to us from Matthew in San Francisco.

Q. I’m not sure what I should do here. There is this guy at my office, and he’s always stealing food from out of the refrigerator. He has stolen my lunch more than once, and I know it’s him because I’ve walked into the kitchen and caught him. He steals other people’s lunches too. Many of us have caught him in our lunches. He also scavenges food, so if there’s anything in the kitchen that’s there for the whole team, he’ll sneak in and just take humungous portions of it and hoards it in his desk. He raids kitchens on other floors and brings back food to his desk and hides it inside drawers. It smells really bad near his work station. Like rotting food. And everyone notices it.  And a few people have actually seen him eating food out of the garbage. He’s actually a really nice guy and I feel bad but I don’t know what to do, I don’t really feel comfortable confronting him, I don’t know him very well, but I’m starting to get annoyed! I’m afraid to bring my lunch to work! Help!

A. Hi Matthew,

First off thank you for your kind and compassionate question. You’re obviously correct in assuming that your co-worker has some sort of eating disorder and/or obsession with food. If you don’t know him and you don’t feel comfortable talking to him about that, you might want to head to your HR department and express your concern. They are trained to handle situations such as this.

Your might also want to offer the HR some literature such as:

http://www.strategichrinc.com/articles/Eating.htm

http://bookstore.oa.org/products/753-introducing-oa-to-health-care-professionals

http://bookstore.oa.org/products/130-a-program-of-recovery

This is probably a very stressful situation for your co-worker and no doubt puts stress on everyone involved. I understand how people in your office are probably feeling confused,  angry and disgusted. However, your co-worker is dealing with a very difficult disease and needs understanding and compassion to recover. This doesn’t mean that you’re in charge of fixing him. The only thing that you can do is  help him get the help he needs by talking to someone who can help him.  It’s also important that if you see him in your lunch again, that you set boundaries and tell him that it’s not okay for him to eat your lunch. This is not you being cruel, but it’s you taking care of yourself and defending your property. Often, for someone who is so entrenched in the behaviors, they are unable to pull themselves out without some kind of external stimuli to pull them out of that loop of compulsive behavior that they get stuck in.

I hope this helps.

Continue reading »]]> This is a more personal post, but a story that I think is important to tell.

My Mom was an amazing woman. She was smart, beautiful, kind, and cared about everyone she came into contact with. She was a dedicated junior high school teacher in the South Bronx in New York City and spent an incredible amount of her time taking care of her kids. She called all her students her kids. She loved them and they loved her. She was just an awesome person.

My mother however was not perfect- none of us are. She had an obsessive relationship with her body and a rigid relationship with food. Her meals and her diet were macrobiotic vegan and she was unwilling to waver and eat a piece of cake or drink a glass of wine or eat nachos or anything not considered healthy once in a while.

She also had an obsession with a number. The number.

A very petite 5’2″ and 112 pounds, my mother believed that she should weigh 108 pounds.  For as long as I can remember, every morning she would wake up, pull the scale out from under her armoire, step on it, curse and kick it back under. She hated that scale. She hated being 112 pounds. And so she obsessed. She did everything she possibly could to lose those 4 pounds. She ordered Sweatin to the Oldies, the Abdominizer, the Gazelle, Oxycise and other things that I forget and probably never knew about. And keep in mind, we had a small apartment in NYC, not a lot of room for these devises and contraptions. But she was a woman obsessed and the elusive 108 lbs was the object of her desire.

I remember her routine of  cursing and kicking the scale  as early as age 4. She did this for my whole life. By the time I was 28, my Mom became ill. Very ill in fact. Not from her food issues, but from a random autoimmune disease that life threw her way.  She lost a lot of weight very quickly. Her whole body deflated. She was nothing more than bones with skin hanging on it. I think that her final weight in her hospital bed was 68 pounds.   But that number, 108, it haunted her for most of her life. She was never quite satisfied with what she had because she was fighting so arduously for 108. But then, at 54 years old, her life was over. And she never got to her “goal weight.”

What the hell is a “goal weight?” It makes me so mad. It makes me SO mad. Because it makes me think of my mother and her obsession with her goal weight, and her inability to be happy with a body that worked. A goal weight is an arbitrary number that’s not grounded in reality. Who tells you what your goal weight should be? How is that realistic?

If you are a normal weight, and your body holds onto it, despite what you do to it,  you have to know that this is a healthy response from a healthy body. You are blessed. A healthy body wants to maintain the homeostasis.

You can run millions of miles, you can binge, you can starve, you can purge, you can diet, you can use laxatives, but no matter how much you abuse your body, a healthy body will do what it can to maintain the homeostasis.

So throw out your scale. Throw out your goal weight. Your goal should be health. Your goal should be a long healthy life with love, with adventure, with fun, with pain, with sorrow, with self love, with self criticism, with anger, with sadness, with joy, with excitement, with ups, with downs. But your goals should have nothing to do with sizes and numbers.

If you are healthy, your body will do what it can to get to its healthy number, and that might have nothing to do with what the BMI says, or with what Hollywood says or with what Met Life height and weight chart says.  When your body is healthy, it knows where it should go. All you have to do is treat it with love and respect. Feed it, exercise it, water it. Give it lots of fruit, lots of veggies, lots of protein, and even let it have a piece of cake or slice of pizza or a glass of wine every now and again.

I know it’s not this simple. It wasn’t for my Mom, nor for many, many people.  But it’s your one life. Take just one day or even one week if it’s doable to let go of your number and embrace health.

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you are not alone

“Life is Difficult.

This is a great truth, one of the greatest truths.  It is a great truth because once we truly see this truth, we transcend it.  Once we truly see that life is difficult – once we truly understand and accept it – then life is no longer difficult.  Because once it is accepted, the fact that life is difficult no longer matters.

Most do not fully see this truth that life is difficult.  Instead they moan more or less incessantly, noisily or subtly about the enormity of their problems, their burdens, and their difficulties as if life were generally easy, as if life should be easy.  They voice their belief, noisily or subtly, that their difficulties represent a unique kind of affliction that should not be and that has somehow been especially visited upon them, or else their families, their tribe, their class, their nation, their race or even their species, and not upon others.  I know about this moaning because I have done my share…” M. Scott Peck -The Road Less Traveled

I think something that is hard to remember is that life is not necessarily supposed to be easy. It’s pretty hard. It’s hard for everyone because we all have to deal with life, death, pain and suffering on some level.    Sure, there are some people who seem to have it easier than others, but of course it’s all relative.  A client of mine was once discussing how awful it was for him to have depression when people in third world countries were suffering without food, clothes, and water. It’s true, but of course they’re not suffering existential crises. We all suffer, though we all suffer differently. It’s the first noble truth- Life means Suffering.

But that’s okay, because we don’t suffer alone. We all deal with the very human dilemma of being human.

I bring this all up because I’ve noticed in the past few years,  how many of my clients get really depressed about Facebook. “Everyone is so happy. They have all their pictures up of their dogs and their boyfriends and their girlfriends and they look so good and their status updates sound so exciting…” But they’re suffering.  Most people don’t update their facebook profile with:

Lulu Smith feels like crap this morning because she woke up with a horrible hangover, a gigantic pimple on her nose, hasn’t had a date in 7 months and her favorite pair of jeans are too tight and ripped in the crotch last night while at a bar with her 4 gorgeous co-workers who got hit on while she was ignored the whole night.

It might look something more like this: Lulu Smith thinks raisin bran is a pretty awesome way to start the day. Two Scoops! Woot! Awesome night with my girls last night

No matter how Lulu looks or feels, she probably won’t post a picture of herself looking tired, with her hair unruly and gigantic nose pimple and the rip in her crotch. We somehow want people to see us at our best. Even when we aren’t there, even when we’re not in the vicinity. This causes each and every one of us to forget that we are not suffering alone. So many of us feel so isolated in our pain because we feel as though we are the only ones who are having a crappy day (or week or month or year)!

One of the things to remember is that you are not the only person who is suffering. You are not alone. When you feel as though everyone is the world is happy, doing great and you’re the only one who is struggling with food, with work, with money, with a relationship (or lack thereof), with lack of confidence… whatever it is, someone very close to you is suffering as well. It might be the person who seems to have it all, the perfect relationship, perfect body, perfect skin, hair teeth,  tons of money, tons of friends… but each one of us suffers uniquely. It can be so isolating to feel as though you are the only one with problems, but next time you are feeling sad and alone, pick up the phone and call someone you love and trust. They might not be suffering at the same time as you, but trust me, they’ve suffered at some time in their life and want to give you love and support.

Isolation is a huge part of eating disorders, in recovery, one of the best ways to break out of the cycle is to reach out for human contact. You don’t have to be alone with your thoughts, your fears, your problems and food.

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binge eating

This question comes to us from someone who prefers to remain anonymous.

Q: I hate myself so much. I buy food all the time then I eat some and then I get rid of it by throwing it out so I don’t eat anymore, and then later I go through the garbage can to get it. I’ve even tried pouring coffee grounds or cigarette ashes on top. It doesn’t matter, I’ll eat it anyway.  And I’ve even eaten a half eaten slice of pizza out of the garbage that was in the street. I’m disgusting. I’m not poor and I’m not homeless. I’m just gross. I hate myself so much. I can’t believe I do this. I don’t eat off the street very often, just a couple of times, but I’ve eaten out of my garbage, out of my parents garbage, and when I was in college, out of the dorm garbage. I don’t know what is wrong with me. I’m a mess. Can you help me?

A: I am so, so very sorry to hear that you are going through such a tough time. First off, I’m so happy that you reached out for support. What I want you to know is that eating out of the garbage is not uncommon for someone with an eating disorder. You are not alone. I can tell that you are feeling a lot of shame and guilt. This is not a character flaw, this does not make you a bad person, this does not make you disgusting, this does not make you worthy of self hatred. This is a very intense addiction and compulsion that you are dealing with. I would encourage you to get help from a therapist as well as doing some group therapy. I would also encourage you to join a group such as OA or CEAHOW or EDA.  You will find others who have acted compulsively with food, whether it be shoplifting food, eating out of the garbage, scavenging or stealing food, or any other type of way that people tend to act on their compulsive desires around food. So many people who deal with these kinds of issues feel so isolated and alone, as though they’re the only person who’s ever done this. However, as I said before, this kind of behavior is very, very common amongst people dealing with an eating disorder. Working to heal your shame and change these behaviors will take active work on your part, however, I think that as you begin to tell your story, you will find hope and healing.

If anyone has any other answers, suggestions, experience, strength or hope,  please do feel free to contribute in the comments.

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.

Continue reading »]]> This question comes from Elizabeth in New York City.

Q:  I went on a diet last summer. I lost 40 pounds from June to November by eating exactly 1200 calories each day and running on the treadmill for 45 minutes every morning. Starting around Thanksgiving, I lost it all. I started bingeing at the Thanksgiving meal, and I tried to get back to calorie counting, but I haven’t been able to. I’ll go like one day but then I’ll binge again. I’ve gained back most of the weight that I’ve lost and I can’t seem to get a hold of my eating, and I’m barely even exercising anymore. Can you help me? I feel so out of control. How can I stop bingeing and get  back to my goal weight again? I’m miserable.

A: Hi Elizabeth,

First off, I’m so sorry that you’re on this roller coaster ride. I know how awful and out of control it feels.  Unfortunately, your case is pretty classic. Binge eating disorder almost always starts with a diet. Ironic, huh? I would encourage you to:

1.)Stop counting calories immediately.

2.)Eat at least three healthy meals each day.

3.)Learn your cues for hunger and satiety. Check in with your body and understand if it’s hungry, full, satisfied, neutral.

4.)Eat slowly and mindfully and as you’re eating, continue to check in with your body and see what it needs.

5.)Don’t let yourself get too hungry, don’t let yourself get too full. Try to satisfy your hunger gently.

6.)Bingeing and restricting are both very harsh, almost violent acts that you commit toward your body. Try to be very gentle and give it what it needs.

7.)Don’t restrict any particular food. This doesn’t mean that if you can’t figure out if you want pizza, or tuna fish, or a hamburger for dinner that you should have all three. Remember that there is always a next meal, and always another opportunity to eat. Often, the impetus behind a binge can be the rational, “I’m starting a diet tomorrow, so I’m not going to be able to eat this for a long time…” if you take that out of the equation and remind yourself that you can eat what you want to eat in a moderate and healthy way, you will find that the temptation to binge, the all or nothing mentality can shift a bit.

8.)As with your food, don’t let your exercise be black and white. Allow yourself to exercise 3-5 days per week even if you’ve had a challenging or a bad day with food. If you don’t feel good or are injured, let yourself rest.

9.)Recovering from an eating disorder is all about giving your body what it needs. That can be so hard. Self love and body respect are integral parts of recovery. Even if you don’t feel it at first, that’s okay and that’s normal. But that’s what you’re working toward. So even asking yourself, “if I loved myself and respected my body, how would I honor it right now? How would I treat it? What would I feed it?”

10.)Stop weighing yourself! Don’t let the scale dictate the way you feel about yourself. It’s incredible that we can allow arbitrary numbers (ie: 1200 calories, 120 pounds, size 2) tell us how we’re supposed to feel about ourselves. I blame the school system. But that’s another story…

As you find a middle ground between bingeing, restricting, and exercise, your body will find it’s healthy weight which will be comfortable and pleasing to you. I hope that this answered your question. Good Luck.

If anyone has any other answers, please do feel free to contribute in the comments.

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.