EDNOS

Intermittent Fasting and Binge Eating

Intermittent Fasting - A cure for binge eating disorder or just new fangled dumbness?

Intermittent Fasting: 

The newest  old thing with a fancy name. 

I have been getting lots of emails recently asking me if Intermittent Fasting is helpful for people with Binge Eating Issues. I have lots of thoughts, but I want to start by telling you about my early experiences with IF. 

The very first time I learned about intermittent fasting was in 1985. I was in 5th grade and my best friend’s upstairs neighbor, who was in 6th grade had lost 13 pounds through intermittent fasting. I mean, we were children and it was 1985 so it wasn’t really intermittent fasting, it was that Shoshana drank a cup of tea for breakfast,  a diet coke for lunch and then whatever her parents gave her for dinner.  I thought that sounded CRAZY! But then in 7th grade, when my hips and breasts started coming in and my period started, I thought that I would try it. Of course it wasn’t called intermittent fasting back then. It was called  “the diet that we all went on so that our parents wouldn’t know that we were dieting.”

Puberty, incidentally is a high risk time for girls to begin eating disorders. That’s because in order to start menstruating, girls’ bodies begin to put on body fat and the changes that take place can seem sudden and out of control. I remember for sure that when I began maturing, my mother made many comments about how my body was changing and that I’d better watch out because once I got my period, weight would be impossible to lose. Wow! Crazy messaging!  But I believed it and wanted to do whatever I could to stop that cycle. So I went on Shoshana’s special diet of tea for breakfast, diet coke for lunch and dinner was whatever my mother gave me. 

Nowadays, you can’t open your computer or look at your phone without seeing something about intermittent fasting. An eating disorder for adolescent girls turned into a way of life for tech bros. People have written books about it, people sell programs, apps, meal plans… it’s just the next diet plan that people are looking to cash in on. I mean, Shoshana Kaufman could have written a book back in 1985, it would be called “How To Diet Without Your Parents Finding Out.”

Intermittent Fasting: Or How to Diet Without Your Parents Finding Out By Shoshana Kaufman – Grade 6. P.S.24, Bronx, NY 1985

Chapter One – Don’t Eat Breakfast

Chapter Two– Don’t Eat Lunch

Chapter Three- Eat Whatever Your Parents make you for dinner

Often I will write about certain diets and I’ll be attacked by people for having a differing opinion about them. I wrote a post about low carb diets some years ago and got attacked by the low carb mafia. Really nasty, nasty emails and comments. Here’s the thing… this is a blog for people who are trying to recover from an eating disorder. And for people who have eating disorders or disordered eating behaviors, these kinds of rulesy eating plans are always contraindicated.  However, there are so many promises that intermittent fasting makes that people are being led to believe that it’s a panacea for all that ails them. 

Intermittent fasting has lots of promises behind it:

Promise #1. You will become “clear-headed” and able to concentrate better if you’re not worried about eating.

My thoughts: Are you able to concentrate when you’re hungry? I’m not. In fact all I can think about is food. I remember being in school as a kid during my restriction days and just zoning out while I fantasized about food. I did this in college too and early on in my adult life when I was still in my eating disorder. In fact, the more I restricted, the less engaged in life I was because I was just focused on not eating and fantasizing about food and what I would eat when I finally let myself eat! 

Are there people who are clear-headed? I’m not sure, but what I do know for sure is that my anorexic patients do come to a place of feeling almost ethereal when they’re not eating. Why? It’s likely because their brain and their organs are beginning to shut down. Their body is using less energy and trying to conserve what it has to use. 

Promise #2. It gives you lots of energy. 

My thoughts: Well, as someone who was an athlete in high school and continues to be athletic now, I can tell you for sure that not eating NEVER gave me more energy. On the days that I would do Shoshana’s diet, I was super sluggish in swim practice. On the days that I did eat breakfast, I would fly through the water. As I got older and started running, I had the same experience. A banana goes a long way before a morning run. A run on an empty stomach in the morning is nothing but a way to run out of gas immediately. Again, I have no idea why people would suggest that their energy is increased. My suspicion is that if you are someone who wakes up and eats a very large and difficult to digest breakfast that creates more sluggishness in your day-to-day, then this would be an improvement. Yet that can also be solved with mindful eating, figuring out what gives your body energy and vitality through your own self-experimentation and trial and error. For instance, I’ve figured out that breakfast cereal will leave me feeling sluggish and hungry, but eggs and cheese and fruit carries me straight through my morning and holds me until lunch. That’s something I had to figure out on my own, not something that someone else could tell me. Your body, your needs. It’s okay to experiment until YOU find what works for YOUR body. No one else can tell you that. 

Promise #3. You will lose weight effortlessly

My thoughts: Now here’s when we come to the Binge Eating Disorder issue. When I did Shoshana’s diet, I was very, very, very likely to binge at night. And honestly, I did that crazy diet for many years. I did it from the age of 12 until I was in my early 20’s. Not every day of course, but I did it often and I binged pretty much every day. It was awful.  And did I lose weight? Actually, no I gained a good amount of weight because of the bingeing. 

If you have an eating disorder, intermittent fasting is likely not the right path for you. Here are the reasons: 

People with eating disorders tend to have black and white thinking. Thus, if you are planning to restrict your food for a set amount of time and then you “mess up,” it’s likely that it will trigger some extreme behaviors, like either a binge or compensatory exercise or a purge or a long period of restriction. 

People with eating disorders teeter between extremes so a full day of not eating could often lead to an evening of binge eating. 

People with eating disorders will often go to extremes to “get it right” even if their body tells them that they need to eat, so they might either completely ignore the cues of their bodies or they might engage in dangerous behaviors (like drugs or excessive coffee drinking) to ensure that they stick to their goals. 

Read How Intermittent Fasting Triggered my Binge Eating Disorder

Do I think that there is anything valuable about Intermittent Fasting? 

If you have a propensity toward eating disorders, I’m going to say that no, intermittent fasting is nothing more than the same diet you went on in elementary school that started this whole disordered eating thing to begin with. You could have written the book and sold the items. Intermittent fasting teaches you how to ignore your body’s cues for hunger. And those of us with disordered eating have known how to do that for years. And we know what happens when we ignore our bodies’ cues for hunger – when we are tired, our body fights back and we binge.  Perhaps for people who eat mindlessly all the time, a day or two of intermittent fasting might help them to hear their bodies’ cues for hunger and learn what that feels like, but beyond that, I don’t believe that this is the best new thing. I think that people have found a way to package an eating disorder into a new fangled diet with a fancy name.

What intermittent fasting does is the same thing that all diets do, it takes away choice – and in that taking away of choice, people feel safer around food. It creates a structure where they can control their food intake. As Soren Kierkegaard said,  “anxiety is the dizziness of freedom…” and it’s true. People become so overwhelmed with choice around food and diets, that this feels like an easy way to take away the choice and limit their food intake. 

As always, my opinion remains – listen to your body, give it what it needs when it needs it.  You CAN trust your body to guide you toward what it needs to be healthy. Your body knows. I can promise you that. You might not always get it right, but the closer you listen, the better you will get to know your body. Your body has so much wisdom. Unlike 1000 or even 100 years ago, food is readily available to you and so you have the opportunity to give it yummy, nourishing food when it needs it. 

Intermittent Fasting
Intermittent Fasting and binge eating
Intermittent Fasting and binge eating
Intermittent Fasting and binge eating

Intermittent Fasting and binge eating

intermittent fasting and binge eating

 

How to Support National Eating Disorder Awareness Week

 

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

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

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

How can you support National Eating Disorder Awareness?

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

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

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

 

EDNOS- The Deadliest Disease… What does that Mean?

So lots of people have been sending me this clip and asking me to comment on it. This is a great clip, if a little sensationalized. First off, I want to comment on the “Ednos is the deadliest eating disorder, even more deadly than anorexia, even more deadly than bulimia.” So I want to clarify here, EDNOS stands for “Eating Disorder Not Otherwise Specified,” and really, it’s main purpose is for coding and billing. Anorexia and bulimia have a very specific set of diagnostic criteria. For instance, to be diagnosed with bulimia, you are bingeing and purging twice a week for at least three months. So what if I had a client who was purging daily for the last month? She’d be EDNOS. But she’d still be bulimic. And what if I had a client who vomited every week, but usually just once a week, and she’d been doing it for years. What if she also binged, then overexercised, but restricted most of the time? What if she’d lost her period, but her weight wasn’t 85% of her expected weight? Then she’d be EDNOS for diagnostic purposes. She wouldn’t fit into a diagnostic criteria for anorexia or bulimia. What if I had a client who binged on cookies and ice cream several times a week, then compensated by not eating the next day. She’d have Binge Eating Disorder, but until 2013, there’s no DSM diagnosis, so she’d have EDNOS.   So, the misleading sensationalism about “EDNOS, the most deadly disease that is the most common that no one ever talks about…” is really just a catch all phrase for your typical eating disorder. Most EDs just don’t fall into the diagnostic criteria neatly. They’re really complicated. Which is why most people with eating disorders are diagnosed with Eating Disorder Not Otherwise Specified.Now, other than my criticism of that, I liked the clip. It’s a good description of what happens with an eating disorder. It starts as restricting, gets more and more severe, turns into bingeing, which can then turn into bulimia… I liked the clip with the therapist who sat with Taylor and checked in with her after she finished her pizza, I liked how honest Taylor was about how difficult it was for her to eat the pizza. I liked how they brought eating disorders out of the clinics and explained how confusing and scary they really are. Overall, it was good to see. I’m glad that EDs and recovery are getting some attention. It was super courageous of those two women to go on national television and discuss their eating disorders. What did you think of this clip?