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My Best Friend is Getting Gastric Bypass Surgery

I have noticed a lot of talk in the Facebook groups about WLS (weight loss surgery). Some have had it, some regret it, some are considering it, and some are vehemently against it. 

I have been asked to weigh in on my feelings about WLS, so rather than answer you all individually, I thought it was important to tell you about one of my closest friends in the world… Eloise.

Her real name is not Eloise, but in my head she could totally be an Ellie. She’s really charismatic and vibrant and alive and confident. She has the ebullience of an Ellie. 

Anyway, Ellie and I have been friends for close to 20 years. We got married in the same year, we had our first kids within mere weeks of each other… We are super tight. And as long as we’ve been friends, we’ve had open and frank conversations about what we have dealt with in terms of food issues, disordered eating issues and body image issues.  There are differences though. I of course went through deep deep recovery for my disordered eating and even became a therapist to help others deal with it.  As much as I did have severe food and body image issues, the body image issues seemed to reside mostly in my own head. Sure, I saw myself as unacceptable and my ED told me that I truly was unacceptable, and I strongly believed that the world found me unacceptable. But in recovery I came to understand that it was a cognitive distortion. A trick of ED. Ellie has the same issues, except her body image issues are not her own, they are society’s problem.  So despite the fact that Ellie is a brilliant, hilarious, beautiful and super talented woman with lots of confidence, she still has to contend with society and the medical community’s collective feelings about fat women. 

Back in May Ellie told me that she was considering having Gastric Bypass Surgery and wanted to know what I thought.  It’s a hard question because my instinct is to say “NO NOT EVER, DON’T EVEN CONSIDER IT!” Which is basically what I said. I told her that the long term studies on bariatric surgery weren’t well documented, that the surgery is risky during, but also complications years later can be deadly, and that it was a very difficult road. I told her to first try an eating disorder program that was specifically geared for people who were considering bariatric surgery but might look into working through the specific issues first. And she said to me, “do you realize that I’ve been in therapy with an Eating Disorder specialist for years? Do you realize that my therapist has read YOUR book in the process of researching her own? do you realize that you and I have been friends for close to 20 years and you’re on the other side of recovery and I’m not? Do you realize how frustrating that is?” 

I hadn’t. I hadn’t thought about how frustrating it might be for her to continue working on recovery and feel like she couldn’t get any where.

“But what about acceptance?” I asked her, “What about accepting your body size and just working on your health, your own self-care, your own inner-peace, your own self-love…”  

“I can’t,” she told me, “I can’t accept this body size. You know I used to think that people paid attention to me because I was pretty and now I realize that people pay attention to me because I’m fat…” 

“Umm…” I said to her, “People pay attention to you because you’re fucking awesome. You have more charisma in your pinky than most people have in a lifetime… when I’m out with you, we’re always surrounded by people and meeting new friends. That doesn’t happen to me when I’m not with you.” 

“It doesn’t?” she asked.

“No, ” I told her,  “Not even a bit. You know how you meet new friends wherever you go? It’s because you’re cool and people want to be near YOU… I don’t have that when I’m not with you, when I’m with you, people are literally clawing their way toward us to get close to you. You’re just… really likeable. Inherently.” 

“REALLY?” she asked me,

“Yup. Totally…”  I told her. “Your spirit and your soul are much bigger than your body. And, you know, more significant of course.” But even if this wasn’t the truth, even if she was unpleasant (which she’s nowhere close to), she would still be valuable and worthy as a human being. 

It’s amazing the stories we can tell ourselves about ourselves. We have these mythologies, these “roadmaps” about who we are and what other people think about who we are and what we look like that we then build our self-esteem around. Our super-ego can tell us anything to agree with the stories with have in our heads about ourselves. Ellie had at one point believed that people paid attention to her for the way she looked, she then believed that people paid attention to her for, well, the way she looked. People pay a lot of attention to her because she’s  fun, funny, the life of the party, compassionate, kind, calming to be around and loving.  When she took that in she realized that she might not be seeing the full picture. We left it off by her saying that she would consider the acceptance piece and the Health at Every Size ideology. 

Last weekend we took the boys swimming together and she told me that she’d decided to go forward with the surgery. That she talked to a surgeon, an RD and several people who had gone through the surgery. I asked her what they said, she told me that they all said the same thing, that it didn’t change their brain around food, just their ability to eat it, and it was a battle, a struggle every day, even for those 10 years or more out from it. So her idea is to schedule it for April and spend the next 8 months working on health and self-acceptance and finding other things to use as coping mechanisms and that maybe she will opt not to when the time comes, but that she likes having that option open to her. 

She told me that she was afraid to tell me because she thought I might not be supportive. Here’s the thing. I believe this: Your body Your choice. And I also believe that when there are big decisions to be made, you have to get all the information and be well informed. You have to be informed of the risks, the long term side-effects, the possible outcomes either negative or positive, and told all of this in a neutral way as to not sway your opinion.

Gastric Bypass surgery is not the easy way out. It’s a hard-core surgery with side-effect that border on discomfort to death. For some people it can be a positive experience. It varies greatly.  My feeling is, if you are considering it, be as informed as possible, know all your options, all the possible side effects and make your choice based on real facts rather than promises of a better life or feeling pushed into it by friends or doctors.  Being fat doesn’t make you inherently unhealthy (or unworthy) and fatness is not a sickness to be cured from.  If you do make the decision to do it,  find your support tribe, the friends and family who will be there for you without judgment or disdain. Your body, your choice. But make your choice from a very, very, very informed and well thought through space. Take months, if not years to make the decision. This is your life and your choice.  I do encourage you though to work with a therapist who specializes in EDs to help you change your brain so that you’re not stuck after surgery without your coping mechanism and feeling alone and feeling as though you need to turn to another sort of coping mechanism (such as pain pills or alcohol) which does happen as well.  Gastric Bypass surgery can only treat the weight, but it can’t treat the underlying behavioral issues or the drives that create these behaviors. So working on coping mechanisms and behaviors is paramount as the surgery can often undo itself due to the disordered eating that was never addressed. 

I hope that this post can explain to you more about my feelings about weight loss surgery. It’s extremely complicated and there is not a black and white answer. No one should be shamed for their choices or their desires. No one should be shamed about anything related to their bodies. But of course everyone should be informed and educated. 

 

 

 

 

 

 

Eating Disorders Protect You from Thinking Too Much

I have this brilliant client. Let’s call her Megan. Megan is brilliant. She comes in and waxes poetic about politics, philosophy, relationships, ethics, medicine… Really anything. She has a lot on her mind and needs to talk through it. I love to listen to her and I love to hear her thoughts and her ideas on life and the world around her.  But Megan’s big brain tortures her. It keeps her awake at night. It keeps her stuck and paralyzed and it keeps her from moving forward in life. And there are some weeks, after months and months of being free of eating disorder symptoms that she comes in and says, “I spent the last 48 hours bingeing and purging and I can’t stop.”  

I have several Megans in my practice. In fact I have  been having Megans for years.  These Megans have helped me come to a very important conclusion, which is that eating disorders help calm down an overactive brain.  I continue to see brilliant people with active minds using food to help them stop thinking. Eating disorders come in handy that way. If you are thinking too much, bingeing can just shut it down. If you are thinking too much, you can go on a diet and redirect all of your stress into working out and losing weight and restricting and bingeing. It’s a way to distract, it’s a way to shut down. And it’s common. 

Do you ever go on a diet because you just have so much going on in your world? In your brain? Like maybe work is making you crazy, your relationship is not working or you don’t have a relationship, your kiddo’s IEP is a mess, your dog has diabetes and you can’t afford his insulin, the theoretical framework of your dissertation just isn’t working, your husband’s ex-wife is sending you death threats, you got fired, you can’t find a job, you can’t pay for diapers,  your wife is having an affair… and you just want to stop thinking about life… so you go on a diet. Or maybe none of these things are happening. Maybe you just can’t shut your overactive brain off, so you go on a diet and you put all of your energy into it. And then you start bingeing. And maybe then you start purging. And then what happens? Then you have to go back into treatment and your whole life is about treatment and nothing else matters for awhile.  Eating disorders and eating disorder recovery become coping mechanisms, ways to not have to think anymore when thinking is so torturous.

So when life gets too much and all you want to do is dive into a binge episode or run on the treadmill to avoid food and your feelings, what else can you do?

Other Options: 

You can send yourself love and compassion, you can talk to people about what’s going on in your mind. You can use guided meditations to calm your brain and its meanderings.  But mostly you can try to remind yourself that your thoughts are just thoughts and you don’t have to be afraid of them. Just electric impulses that pass through you and you don’t have to follow them down the rabbit hole. Even thoughts about bingeing, purging or dieting. It is possible to teach your brain not to follow certain thoughts that don’t serve you and not to feel controlled by them. In the 5 week program we use cognitive behavioral therapy, mindfulness techniques and neuroplasticity to learn how to take control of the thoughts that feel overwhelming. A quick CBT trick is to ask yourself “is that thought objectively real or true? how do I know it’s true? Is there another possible truth? If there were another possible truth that I could think of that would feel better in my body, what would it be?” Then write that down and think about what that would be like. Just the mechanism of finding the possibility to change thoughts can help you to calm the overwhelming feelings. 

 

How Did I Gain 7 Pounds Overnight?

I Gained Seven Pounds. Oh Sh*t

 

At the gym the other morning, I saw a  young woman hop on the scale, move the weights to a place that apparently she did not like and immediately burst out crying. I was heading toward her to see if she was okay but another woman ran over to her and said, “what’s the matter? are you okay?”  “NO!!!!” She screamed! “I gained seven pounds! SEVEN pounds! Overnight! How did that happen? I’ve been so careful, I’ve been trying to lose weight! How did this happen? How did this happen to me?!!!”  

As you know, this is my territory, this is the population I work with all day, women who are having a really hard time with scales, food, weight, disordered eating, bingeing, purging, restricting, poor self-image and body image.

That scale is evil!

When I walk into the dressing room at the gym and I see it there, I jump away like it’s a snake. I can’t go near that thing. I see other women hopping on and off of it nonchalantly and to me it almost looks like they’re heading to a cigarette machine. For someone with disordered eating, weighing yourself is like an alcoholic walking into a bar. It’s an unhealthy obsession and it will make you feel both crazy and out of control. 

The young woman continued crying, deep heaving wails and sobs. She told the woman who was trying to comfort her that she texted her sister and told her about the seven pounds. That she hated her life. That she didn’t understand why this happened to her…  She then got up and started gathering her things to leave. The woman comforting her said, “wait, aren’t we going to do our workout?” and she said and  “No! Why would I bother? I gained seven pounds!”   and with that, she left.  

She was so upset. She was devastated actually. She had gone to the gym to get her workout in and stepping on that scale ruined a perfectly fine day. She decided not to work out, she went right to black and white thinking.

What do you think would have happened if she hadn’t stepped on the scale? What do you think would have happened if rather than being focused on a specific outcome, she’d just been focused on her day-by-day self care?  I was really sad all day thinking about her, and I wished that I’d had the opportunity to chat with her, but it just wasn’t appropriate. If you are a doctor and someone falls and hurts themselves, you say, “I’m a doctor, let me look at that knee,” but in my case, “I am an eating disorder therapist, I can help you with your cognitive distortion!” As you can imagine,  I really wanted to do that… but it wasn’t appropriate in the moment.  

Later that day, I came across an article about a woman who did an experiment of weighing herself each hour for one whole day to see what happened.   Here’s the general gist of the article. 1. Her weight fluctuated that day by – you guessed it- seven pounds!  And despite the fact that she clearly saw that fluctuation (wait, I haven’t eaten or drunk anything in the past hour, why is my weight up by 2 pounds?) she still started to get really stressed out by the scale!

This is what happens when you start measuring your worth by something that has no use in life other than to measure mass. It doesn’t tell you anything good that you did that day (“I rescued a baby from a burning building!”) It just spits out an arbitrary number. And then you give it the power to make you feel a certain way. This takes you away from having power over your own life. Don’t let a piece of machinery tell you how to feel about yourself. Don’t let it dictate your day. You are worth more than that. I can’t stress enough, the number on the scale has nothing to do with your worth, who you are is perfect, whole and complete at this moment. In another moment your weight might be up five pounds, in another moment it might be down five pounds. But in both those moments, you still are perfect, whole and complete exactly as you are. You haven’t changed. So instead of using this external thing to tell you how you are supposed to feel about yourself, what kind of day you’re supposed to have, instead, do something that makes you have a good day. Buy a meal for a hungry person, dig a sand castle with your neighbor’s kid, plant butterfly fennel in your front yard, say something nice to someone you don’t know… anything else but weigh yourself. The scale is not an accurate measure of your worth, and clearly, it’s not even an accurate measure of your body mass. 

The Most Important Piece of Nutritional Advice You Need

There are a lot of “nutrition experts” out there. Everyone fancies themselves a nutrition guru. I see these folks all over the Internet, amateur nutritionologists- they give weight loss advice, they tell people what to include in their diets and what they should absolutely NEVER eat. But here’s the thing. They’re not really nutrition experts. I’m sure that many of them have read everything they possibly can on the Internet about nutrition, I’m sure that they are avid readers and self-experimenters (I won’t say researchers, researchers are in labs) many have taken classes on nutrition, or have a certification in health coaching from an online coaching school…  and I’m sure that they truly believe that they are nutrition experts.

The truth is though, that the highest, highest level researchers in the field of nutrition, molecular biology and metabolism– I’m talking people with multiple PhDs and years of research– those people know that they are not nutrition experts either. This is because the fields of nutrition and metabolism are largely mysterious and untapped as of right now.  The people with the highest degrees and research backgrounds are the ones who are most willing to admit how little they know about nutrition. 

If you are dubious, let’s do a comparison. Here is a list of the classes needed to become a PhD in nutrition and metabolism at Boston University, and here is a list of the classes needed to get a degree from Health Coach Institute. Of note, the PhD in nutrition is a six year program and the coaching certification is a six month program. In looking at the curriculum of the coaching program, only one of those modules is dedicated to actually learning about nutrition, the other five months are coaching and business skills. I don’t necessarily think that health coaching is a bad thing;  there are people who can certainly benefit from learning to eat healthy whole foods, how to shop for them, and how to look inside themselves with a support person to help them understand what foods will help them feel their most optimal. But nobody can actually tell you that. That’s because nutrition and metabolism are extremely complicated.  For instance, there are some foods that are considered anti-inflammatory that will interact horrifically with one person’s constitution and will be great for another person’s constitution. Not even someone with a PhD in nutrition can tell you what foods are best for your body and how specific molecules will interact with different molecules given any particular time in your cycle, or given how much or little exercise or sleep you’ve gotten, where in the world you live, what genetic components your Grandmother was made of… etc. There are a billion different variables that make up how you will react to a certain food at a certain time. Don’t look outside yourself for nutritional advice, look within.

Here’s what inspired me to write this post.

My client (we’ll call her) Jenny. Jenny’s boyfriend is super into bulletproof coffee (hey we’re in the Bay Area, it’s a thing here..) anyway, her boyfriend swears by drinking his coffee with yak butter and coconut oil and raw cocoa every morning. He swears that it gives him mental clarity and that he can run 15 miles without eating anything other than his coffee drenched in high quality fats. He keeps on convincing Jenny to drink bulletproof coffee with him so that she too can lose weight and feel great. So Jenny keeps drinking bulletproof coffee… and she hates it. It makes her have diarrhea every.single.morning.  But she continues to drink it because of what the “experts” on the bulletproof forums say. She feels that she is not doing the right thing by being miserable drinking it, she feels bad about herself. The experts on the forums keep tell her to push through this “break-in” phase where your body has to get used to the coffee and eventually it will habituate. You know what else does that? Laxatives. That’s why laxative dependent bulimia sufferers keep upping their dose of laxatives. Jenny’s body is telling her something pretty significant, yet she’s ignoring it and listening to the advice of “experts.” She doesn’t trust herself or her body, she trusts strangers who don’t live inside of her body. 

My other client (we’ll call her) Debbie.  Debbie was told by her health coach that if she gave up gluten, grains, sugar and dairy that she would feel amazing. So Debbie gave up all those things and she did in fact feel amazing. Wanna hear another thing about Debbie? She’s a recovering anorexic. So being restrictive in her eating complements her psychological schema of feeling amazing when being totally in control and deprived of food. Oh and the other thing about Debbie… after four years of recovery, she started bingeing and purging again.  Her health coach keeps telling her that if she stays away from those four things that her system will heal and that her brain chemistry will even out and she won’t binge and purge anymore. The truth is, when Debbie’s not restricting, her eating disorder is fine. It was her depression that led her to look for nutritional alternatives to Prozac. She then started restricting again, which was of course helpful for her depression because she used her eating disorder to manage her depression symptoms. But now she’s bingeing and purging again. It makes sense… depression is super painful and distressing and anything we can do to make it go away quickly feels better than working with it directly. So the eating disorder comes back and we are distracted from the depression because we have to work on the ED symptomatology. See how that happened? 

If you want to work with someone around nutrition, the best way to do it is to start to focus on what your body tells you that you need. Your body knows. YOUR BODY KNOWS!  

When two of my girlfriends came back from being in the Peace Corps in Mali for two years, one came back super curvy and the other came back super skinny. They told me that they were both eating the same things (lots of rice) but one lost copious amounts of weight on a low protein high-carbohydrate while the other gained weight on the same diet. Two different ways of processing nutrients.

Sit with your food after you eat it and see how your body feels. Are you energetic? Does your belly hurt? Do your joints hurt? Do you have rashes? Are you sleepy? Are you anxious? Are you happy? Looking within and feeling your feelings both emotional and physical is the only way to know what foods are helping your body and what foods are hurting you.  Your body wants you to take care of it, and when you listen carefully to it, it will give you the right messages. Let the wisdom of your body be your nutritional expert. 

How To Shut Down Without Food

15 Ways to Shut Down Without Using FoodThere is a theme in my practice this week. All of my clients came in telling me that one of their biggest problems in healing from binge eating is that they feel like they NEED food to just…shut…down.  Sheila, an extremely busy attorney explained to me that in the evenings, after working a 12-14 hour day, she looks forward to coming home, sitting in front of the television and being able to eat, it’s the way she shuts down after a crazy day. Lindsey, a mom of twin 3 year olds told me that at night, after she gets the kids to sleep, but before her husband comes home, she just NEEDS to sit down with a pint of ice cream and Netflix to shake off the day, that the thought of it is the only thing that keeps her going throughout her evening. This is not new, I’ve been hearing this from my clients fo decades. Food serves a very important purpose- it is soothing, it’s calming and it helps signal the end of the day. It gives you that much coveted self time that you were missing all day.
IT IS SOOOOOOOO important to soothe yourself after a long day of work and kids and stress and everything that you do. You need to be calmed, you need to be soothed, you need a separation between you and the day. Food is what has been doing that for you.  But there are some other things that you can do at end of the day that are not binge eating and will help you shut down.  
And, I’ve compiled a list of my favorites for you: 
  1. Take a hot bath with Epsom Salts. Hot water is good medicine. And the magnesium in Epsom salts will relax your muscles and allow you to get the peace you need between work and sleep. It will also lull you into a deep and lovely sleep.
  2. Read a book that has nothing thought provoking in it. Remember, this is about shutting down. Really turning your mind off, so get into bed with a book that is fun, engrossing and captivating. No books on tape. You need to be using your hands to hold the book- this integrates your tactile senses and satisfies your sensory needs to eat.
  3. Meditate or do a guided visualization. No need to silence your mind or take too much effort. Close your eyes, lay down and breath in through your nose for 10 seconds, hold it and breath out through your nose for 10 seconds. You can also check out wellness hypnotherapy to find specific guided meditations for different subjects (binge eating, relaxation, anxiety, etc.)
  4. Do a Savasana- the most relaxing yoga pose (also called corpse pose) usually done at the end of a yoga class to help you take space between your yoga practice and getting back to your day. It’s so easy. The Savasna pose is really lovely because it just relaxes your whole body. You can use a bolster or a lavender scented eye pillow as shown here- or if you don’t have those things, you can bunch up some towels to put under your knees and heat a wet wash cloth in microwave to put over your eyes. But you really don’t even need all of that, you can just lay on the floor with your arms out, your legs separated, relax your jaw, relax your forehead, just let your body find peace. Make sure that the lights are dimmed, your eyes are closed and even have some quiet music on.  I do however, highly recommend the eye pillow. I use this with all my hypnotherapy clients and I find it helps them to relax very, very deeply. (Photo credit to Suza FrancinaSavasana or -corpse pose- will help you turn your mind off!
  5. Take a restorative yoga class or do some restorative yoga. Restorative yoga is ecstasy grade relaxation. It’s not power yoga, it’s not about fitness, it’s about really relaxing your body and releasing very, very deep tension both in your muscles and in your mind. You don’t have to be a yoga guru to do it either. It’s for every level, even someone who has never done yoga before. When I was in graduate school, I took a one-credit weekend long class on how to relax with restorative yoga poses. A French Psychologist yoga teacher flew in to teach the class- which was about six of us in a big studio in Mill Valley. We each had a big collection of bolsters and pillows and some rope around us that we used to drape ourselves over and around. After getting into each pose, we’d meditate for about 45 minutes to an hour. This was for 9 hours each day. When the weekend ended I felt like my body was jelly and there was no way any worry could ever get into my mind or body. I felt like I was levitating. I don’t even know how I drove home- I think I might have floated.  If you can dim the lights and light some candles and have some nice smelling aromatherapy around you- even better. In San Francisco they offer some evening restorative yoga classes and I’m sure they do in other parts of the country and in certain parts of Europe- but if that’s not an option, definitely check out YouTube and see if you can find some good classes.
  6. Get Body work. I know you can’t go get a massage every day before bed, but you can every once in a while- and if not, try some self massage
  7. Watching television can be rough because lots of people binge in front of the TV- however, if you can do something else while you’re watching tv, like give yourself a manicure, pedicure, hot oil treatment, face mask- something loving and self nurturing that occupies your hands and mouth.
  8. Adult coloring books – can be more relaxing than meditation. It calms your mind and gives you a very similar effect that you’re looking for with food- it gives you another way to  shut down after a long day.
  9. Make jewelry. Seriously, making beaded necklaces or bracelets is an extraordinary way to occupy your hands, relax your mind, and feel that high that you get from your reward centers lighting up when you accomplish a goal or task. It’s easy to do, just have your beading kits right there so you can grab them, sit down on the floor, put on some relaxing music and make some pretty jewelry. Give it as gifts, wear it, or sell it on Etsy.
  10. Knit. Knitting is actually used by occupational therapists to help people alleviate stress, relax, and focus their brains. 

So what about you? Can you add to this list? What are some positive ways you shut down without going to food? 

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 and FA circles.  

I have an extremely complicated history and relationship with both Food Addict Anonymous and 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 FA, 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 food plan 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 food plan 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 FA- 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 FA 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 and FA 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 FA had really skewed my feelings about the fellowship. The problem is that FA and often 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.

How Do I Tell My Husband about My Eating Disorder?

How to tell my husband about my eating disorder

This one comes from a reader in Australia…

Question:

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

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

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

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

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

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

10 Ways to Train your Brain to Stop Overeating

10 Ways to Train your Brain to Stop Overeating

top ten ways to train your brain

train your brain to stop overeating

 

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

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

SO HOW DO YOU DEAL WITH THE ADDICTION PIECE OF ALL THIS IN ORDER TO STOP OVEREATING?

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

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

So what can you do?

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

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

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

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

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

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

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

8. Get on the forum and ask for support.

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

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

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

Top 10 Binge Busting Foods

Top Ten Binge Busting Foods

Do you ever feel like recovery is impossible because you will binge on whatever foods you have in your house? Even if you refrain from keeping your trigger foods in your house, you still feel unsafe unless your cabinets are empty? But sometimes an empty refrigerator is even more unsafe because a starving brain will behave in a compulsive manner and order take out or delivery and binge in a way that you never prepared for. 

Stay prepared by keeping your house a binge free zone by having lots of high density nutrition safe foods that will keep your body and your brain fed. 

1.)Apples- The crunchiness and time it takes you to eat an apple will help you pause before a binge and figure out if you were really hungry or if you just wanted to crunch and chew to relieve anger or stress.

2.)Avocados- The good (monosaturated) fats will keep your appetite sated and as a plus helps to raise HDL (good) cholesterol and lower LDL (bad) cholesterol. 

3.)Eggs- Hard boil a dozen eggs and just keep them in your refrigerator for when you are getting bingey. Peel and eat one and wait 20 minutes. Feeding the protein to your brain will help you make a clear minded decision about whether you are choosing to binge or not. 

4.)Frozen grilled fully cooked chicken breasts or chicken strips (like these). Chicken is a great high protein food to have in the house, but difficult to cook after a long day at work. Just throw a handful of chicken strips with a bag of frozen vegetables into a pan and viola! A healthy meal. 

5.)Raw Unsalted Pumpkin Seeds – Pumpkin seeds are a great source of high density nutrition and include iron, zinc and healthy fats. They will keep both your body and mind nourished. 

6.)Yams – The easiest and most delicious side dish ever. Just wrap up a yam in aluminum foil and throw it in your oven at 350 for 90 minutes. If you have a timer on your oven, you can even do it before you leave for work in the morning. Then come home to a potassium, fiber, magnesium, b-vitamin rich, delicious snack. 

7.)Cans of Tuna and Salmon – Easy peasy. Canned salmon (I like boneless, skinless pink) is wild and not farmed. You can just throw a can onto a bed of raw greens, throw some olive oil or dressing on and have an easy lunch. 

8.)Lots of bags of organic frozen vegetables (spinach, kale, broccoli, brussel sprouts, corn on the cob,   etc.) Make sure there is nothing added besides the veggies themselves. Just throw these in a wok with some soy sauce or Bragg’s liquid aminos or a little bit of salt and pepper and olive oil and you have a great little stirfry. Throw in chicken and a grain or potato or yam for a complete meal.

9.) Bags of raw greens, raw spinach, etc.- Super easy to make salads with this. Just empty into a bowl and toss one of those hardboiled eggs in, some of those pumpkin seeds you already have, maybe some capers and dressing, and you have an easy high protein, high fiber snack. 
 
10.) Lots of bags of frozen fruit- This makes smoothies easy and, like frozen vegetables, it keeps you from having to worry about your fruit rotting if you don’t eat it fast enough. Just throw your frozen fruits into the blender and there you have your instant smoothie without doing too much of your own chopping work. The biggest pain will be cleaning the blender. 

Bonus # 11.)Condiments, (ie: miso paste for warm soup, broth, salsa, butter, bragg’s liquid aminos, tahini, mustard)

Remember to start each morning with a big, gigantic meal of high density nutritious foods to feel satiated and energized and to keep the urge to binge away. A high density nutritious breakfast could be something like 3 eggs, an avocado and a piece of fruit or a nice big bowl of oatmeal with bananas and walnuts and berries or even a few links of nitrite free chicken or turkey sausage with some fruit and eggs. 

Enjoy your food! Feed yourself well and often and feel good!